Dennehy Penelope H
Division of Pediatric Infectious Diseases, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA.
Clin Microbiol Rev. 2008 Jan;21(1):198-208. doi: 10.1128/CMR.00029-07.
Rotavirus infection is the most common cause of severe diarrhea disease in infants and young children worldwide and continues to have a major global impact on childhood morbidity and mortality. Vaccination is the only control measure likely to have a significant impact on the incidence of severe dehydrating rotavirus disease. In 1999, a highly efficacious rotavirus vaccine licensed in the United States, RotaShield, was withdrawn from the market after 14 months because of its association with intussusception. Two new live, oral, attenuated rotavirus vaccines were licensed in 2006: the pentavalent bovine-human reassortant vaccine (RotaTeq) and the monovalent human rotavirus vaccine (Rotarix). Both vaccines have demonstrated very good safety and efficacy profiles in large clinical trials in western industrialized countries and in Latin America. Careful surveillance has not revealed any increased risk of intussusception in the vaccinated groups with either vaccine. The new rotavirus vaccines are now introduced for routine use in a number of industrialized and developing countries. These new safe and effective rotavirus vaccines offer the best hope of reducing the toll of acute rotavirus gastroenteritis in both developed and developing countries.
轮状病毒感染是全球婴幼儿严重腹泻疾病的最常见病因,并且持续对儿童发病率和死亡率产生重大的全球影响。接种疫苗是唯一有可能对严重脱水的轮状病毒疾病发病率产生显著影响的控制措施。1999年,美国一款高度有效的轮状病毒疫苗RotaShield在上市14个月后因与肠套叠有关联而退市。2006年两款新的口服减毒活轮状病毒疫苗获得许可:五价牛-人重配疫苗(Rotateq)和单价人轮状病毒疫苗(Rotarix)。这两款疫苗在西方工业化国家和拉丁美洲的大型临床试验中均显示出非常良好的安全性和有效性。仔细监测并未发现接种任何一款疫苗的人群中有肠套叠风险增加的情况。新型轮状病毒疫苗现已在一些工业化国家和发展中国家引入用于常规接种。这些安全有效的新型轮状病毒疫苗为降低发达国家和发展中国家急性轮状病毒胃肠炎的危害带来了最大希望。