Bernstein David I
Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA.
Pediatr Infect Dis J. 2009 Mar;28(3 Suppl):S50-3. doi: 10.1097/INF.0b013e3181967bee.
Rotaviral gastroenteritis is a serious public health problem in both developed and developing countries. The disease is ubiquitous, affecting nearly all children by the age of 5 years. It is the most common cause of hospitalizations for gastroenteritis among children in the United States (30%-70% depending on the season) and is associated with direct and indirect costs of approximately $1 billion per year. Symptoms of rotaviral gastroenteritis are nonspecific (ie, diarrhea, vomiting, and fever), with disease severity varying considerably. Diagnostic confirmation of rotaviral gastroenteritis requires laboratory tests (most commonly enzyme immunoassay or latex agglutination); however, because specific diagnosis is costly and does not affect treatment, laboratory tests are generally not performed. Because no antiviral therapies are currently available, treatment of rotavirus infection is supportive and primarily aimed at the replacement of fluid and electrolyte losses. Based on the observations that improved sanitation does not decrease disease prevalence and that hospitalizations remain high despite the availability and use of oral rehydrating solutions, the primary public health intervention for rotavirus infection is vaccination. Current vaccines (ie, RotaTeq, Merck and Company; Rotarix, GlaxoSmithKline) are effective for reducing rotaviral gastroenteritis (particularly severe disease), emergency department visits, and hospitalizations. Rotavirus vaccination is now included as part of the routine vaccination schedule for all infants in the United States.
轮状病毒性肠胃炎在发达国家和发展中国家都是一个严重的公共卫生问题。这种疾病普遍存在，几乎所有5岁儿童都会受到影响。它是美国儿童肠胃炎住院治疗的最常见原因（根据季节不同，占30%-70%），每年造成的直接和间接费用约为10亿美元。轮状病毒性肠胃炎的症状不具有特异性（即腹泻、呕吐和发烧），疾病严重程度差异很大。轮状病毒性肠胃炎的诊断确认需要实验室检测（最常见的是酶免疫测定或乳胶凝集试验）；然而，由于特异性诊断成本高且不影响治疗，一般不进行实验室检测。由于目前没有抗病毒疗法，轮状病毒感染的治疗以支持治疗为主，主要目的是补充液体和电解质流失。基于改善卫生条件并未降低疾病患病率以及尽管有口服补液溶液且已使用但住院率仍然很高的观察结果，轮状病毒感染的主要公共卫生干预措施是接种疫苗。目前的疫苗（即默克公司的Rotateq、葛兰素史克公司的Rotarix）对减少轮状病毒性肠胃炎（尤其是重症）、急诊就诊和住院有效。轮状病毒疫苗接种现已纳入美国所有婴儿的常规疫苗接种计划。
