Glass R I, Kilgore P E, Holman R C, Jin S, Smith J C, Woods P A, Clarke M J, Ho M S, Gentsch J R
National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Infect Dis. 1996 Sep;174 Suppl 1:S5-11. doi: 10.1093/infdis/174.supplement_1.s5.
The decision to develop rotavirus vaccines was predicated on the extensive burden of rotavirus disease among children worldwide. US reports on nationwide hospitalizations (1979-1992) and deaths (1968-1991) due to diarrhea and weekly reports of rotavirus infection by 74 laboratories were reviewed to estimate the burden of rotavirus disease, identify epidemiologic trends, and consider methods for evaluating an immunization program when a vaccine becomes available. From 1968 to 1985, diarrhea-related deaths among US children <5 years old declined from 1100 to 300/year. This decline was associated with the disappearance of winter peaks for diarrhea-related deaths previously associated with rotavirus infection among children 4-23 months old. From 1979 to 1992, however, hospitalizations for diarrhea averaged 186,000/year and retained their winter peaks, which have been linked to rotavirus infections. Each year an estimated 54,000-55,000 US children are hospitalized for diarrhea, but <40 die with rotavirus. A rotavirus vaccine program will require improved surveillance, including the timely collection of data from sentinel hospitals, in which a diagnosis of rotavirus can be established or ruled out for all children hospitalized for diarrhea.
轮状病毒疫苗的研发决策基于全球儿童轮状病毒疾病的广泛负担。对美国关于全国范围内因腹泻住院（1979 - 1992年）和死亡（1968 - 1991年）的报告以及74个实验室关于轮状病毒感染的每周报告进行了审查，以估计轮状病毒疾病的负担、确定流行病学趋势，并考虑在疫苗可用时评估免疫规划的方法。1968年至1985年期间，美国5岁以下儿童中与腹泻相关的死亡人数从每年1100例降至300例。这种下降与4 - 23个月大儿童中先前与轮状病毒感染相关的腹泻相关死亡的冬季高峰消失有关。然而，1979年至1992年期间，腹泻住院病例平均每年为186,000例，并且仍保持其冬季高峰，这与轮状病毒感染有关。每年估计有54,000 - 55,000名美国儿童因腹泻住院，但死于轮状病毒的不到40人。轮状病毒疫苗计划将需要改进监测，包括及时从哨点医院收集数据，在这些医院中，可以对所有因腹泻住院的儿童确诊或排除轮状病毒感染。
