a Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine , Tel Aviv University , Ramat Aviv, Tel Aviv , Israel.
b Department of Pediatrics , Hillel Yaffe Medical Center , Hadera , Israel.
Hum Vaccin Immunother. 2019;15(6):1284-1293. doi: 10.1080/21645515.2019.1599522. Epub 2019 May 3.
Following the introduction of universal immunization against rotavirus, concerns were raised regarding pathogen-replacement of rotavirus by norovirus. The study aim was to examine the incidence and characteristics and norovirus gastroenteritis before and after the introduction of universal rotavirus immunization in Israel. We studied 1179 stool samples collected between November 2007 and December 2014 for a prospective hospital-based surveillance study of children aged 0-59 months hospitalized for gastroenteritis. A real-time RT-PCR assay was used to identify genogroup II (GII) norovirus in extracted fecal RNA samples. Overall, the weighted percentage of norovirus positive patients was 10.9%. Norovirus positivity was similar in the pre-universal rotavirus immunisation years (2008-2010) and the universal years (2011-2014), the respective average annual incidence of norovirus gastroenteritis was 1.6 (95% CI 0.6-2.3) per 1000 and 1.1 (95% CI 0.8-1.4) per 1000 children. Rotavirus was detected in 36.8% and 19.6% of the patients in the pre-vaccine years and the universal vaccine years, with an estimated incidence of 5.5 (95% CI 3.4-7.6) per 1000 and 2.1 (95% CI 1.6-2.7) per 1000 children, respectively. Most patients (59.1%) with norovirus gastroenteritis were infants aged 0-11 months. Norovirus was detected all year round with a significant 3-month peak from September through November. In conclusion, norovirus continues to be a leading cause of acute gastroenteritis associated with hospitalizations in young children. Future norovirus vaccines should target young infants. There was no evidence of pathogen-replacement by norovirus following the introduction of universal rotavirus immunization in Israel.
在普遍开展轮状病毒免疫接种后，人们开始担心轮状病毒会被诺如病毒取代。本研究旨在检查以色列在普遍开展轮状病毒免疫接种前后诺如病毒胃肠炎的发病率、特征和情况。我们对 2007 年 11 月至 2014 年 12 月期间因胃肠炎住院的 0-59 月龄儿童进行了一项基于医院的前瞻性监测研究，共采集了 1179 份粪便样本。我们使用实时 RT-PCR 检测从提取的粪便 RNA 样本中鉴定出基因 II 组（GII）诺如病毒。总的来说，诺如病毒阳性患者的加权百分比为 10.9%。在普遍开展轮状病毒免疫接种前（2008-2010 年）和普遍开展后（2011-2014 年），诺如病毒阳性率相似，相应的诺如病毒胃肠炎年发病率分别为每 1000 名儿童 1.6（95%CI0.6-2.3）和 1.1（95%CI0.8-1.4）。在疫苗接种前和普遍疫苗接种年份，分别有 36.8%和 19.6%的患者检测到轮状病毒，估计发病率分别为每 1000 名儿童 5.5（95%CI3.4-7.6）和 2.1（95%CI1.6-2.7）。大多数（59.1%）诺如病毒胃肠炎患者为 0-11 月龄婴儿。诺如病毒全年均可检测到，9 月至 11 月呈 3 个月高峰。总之，诺如病毒仍然是导致婴幼儿住院的急性胃肠炎的主要原因。未来的诺如病毒疫苗应针对婴幼儿。在以色列普遍开展轮状病毒免疫接种后，没有证据表明诺如病毒取代了轮状病毒。
