Aliabadi Negar, Tate Jacqueline E, Haynes Amber K, Parashar Umesh D
MMWR Morb Mortal Wkly Rep. 2015 Apr 10;64(13):337-42.
Rotavirus infection is the leading cause of severe gastroenteritis among infants and young children worldwide. Before the introduction of rotavirus vaccine in the United States in 2006, rotavirus infection caused significant morbidity among U.S. children, with an estimated 55,000-70,000 hospitalizations and 410,000 clinic visits annually. The disease showed a characteristic winter-spring seasonality and geographic pattern, with annual seasonal activity beginning in the West during December-January, extending across the country, and ending in the Northeast during April-May. To characterize changes in rotavirus disease trends and seasonality following introduction of rotavirus vaccines in the United States, CDC compared data from CDC's National Respiratory and Enteric Virus Surveillance System (NREVSS), a passive laboratory reporting system, for prevaccine (2000-2006) and postvaccine (2007-2014) years. National declines in rotavirus detection were noted, ranging from 57.8%-89.9% in each of the 7 postvaccine years compared with all 7 prevaccine years combined. A biennial pattern of rotavirus activity emerged in the postvaccine era, with years of low activity and highly erratic seasonality alternating with years of moderately increased activity and seasonality similar to that seen in the prevaccine era. These results demonstrate the substantial and sustained effect of rotavirus vaccine in reducing the circulation and changing the epidemiology of rotavirus among U.S. children.
轮状病毒感染是全球婴幼儿严重肠胃炎的主要病因。在2006年美国引入轮状病毒疫苗之前,轮状病毒感染在美国儿童中导致了显著的发病率,估计每年有55,000 - 70,000例住院病例和410,000次门诊就诊。该疾病呈现出典型的冬春季节性和地理分布模式,每年的季节性活动始于12月至1月的西部地区,蔓延至全国,并于4月至5月在东北部结束。为了描述美国引入轮状病毒疫苗后轮状病毒疾病趋势和季节性的变化,美国疾病控制与预防中心(CDC)比较了来自CDC的国家呼吸道和肠道病毒监测系统(NREVSS,一个被动实验室报告系统)在疫苗接种前(2000 - 2006年)和接种后(2007 - 2014年)的数据。发现全国轮状病毒检测率下降,与疫苗接种前的7年总和相比,疫苗接种后的7年中每年下降幅度在57.�% - 89.9%之间。在疫苗接种后的时代出现了轮状病毒活动的两年周期模式,低活动年和高度不稳定的季节性与活动适度增加且季节性与疫苗接种前时代相似的年份交替出现。这些结果证明了轮状病毒疫苗在减少美国儿童中轮状病毒传播和改变其流行病学方面具有重大且持续的效果。