LB-26. Decline in the Prevalence of Rotavirus in Adults Following Widespread Pediatric Vaccination
Session: Poster Abstract Session: Late Breaker Posters
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • FINAL IDSA Poster Rotavirus 10172011.pdf (148.1 kB)
  • Background: In the spring of 2008, a marked decline was noted in pediatric rotavirus (RV) that suggested indirect vaccine protection of unvaccinated children.  RV occurs as a winter-spring pathogen in adults as well as children.  It is unknown whether indirect protection of unvaccinated adults might occur due to decreased pediatric wild-type RV.

    Method: Stools during Feb – May from 2006 – 2010 that were submitted for bacterial stool culture (BSC) were frozen and later tested with Rotaclone (RC).  In 2006 these were only from hospitalized adults (<72 hrs from admission), but all subsequent yrs included both outpatients and inpatients.  We excluded those from subjects <18 yrs of age and duplicate BSC.  Prevalence in 2006 – 07 was compared to 2008 – 10.  In addition, genotyping of the RV isolates was performed by RT-PCR followed by gel electrophoresis with selective confirmation by sequencing. Clinical data were also compared for RC positive subjects.

    Result: In 2006 – 07 RC detected rotavirus in 4.4% (43/988) of available BSC.  From 2008 – 10 RV was detected in 2.2% (57/2545), a decline of 48.5% (p = 0.0014).  Similar to RV in children, a trend was observed towards the lowest rates occurring in 2008 and 2010.  In contrast, bacterial pathogens in BSC remained stable between these periods (3.3% vs 3.7%, p = 0.69).

    In 64% (64/100) of RC-positive samples both G and P-types were identified. In 2006 no predominant RV type circulated, in 2007 G2P[4] accounted for 78%, in 2008 G1P[8] 63%, in 2009 G3P[8] 48%, and in 2010 G12P[6] accounted for 100% of fully G- and P-typed isolates. 

    Baseline demographic data and outcomes were similar in those RV-positive between 2006 – 07 and 2008 – 10 (p >0.05 for all variables).  30% of RV-positive individuals were immunocompromised (HIV, stem cell transplantation, solid organ transplantation, active cancer, or high-dose steroids) and remained stable over time. 

    Conclusion: A 48.5% decline in the prevalence of RV was observed in adults that coincide with similar declines observed in pediatric RV disease that occurred following widespread pediatric vaccination.  This strongly suggests an indirect effect of pediatric RV vaccination upon adult rotavirus.  We observed substantial year-to-year variation in the most prevalent circulating RV genotype in adults.


    Subject Category: I. Adult and Pediatric Vaccines

    Evan Anderson, MD1,2,3, Deanna Shippee, B.A.2, Melissa Weinrobe, B.A.2,4, Melissa Davila, B.A.4, Ben Katz, MD2,4, Samuel Lee, B.S.2, Yael Simons, B.A.2, Mary Gene Cuyugan, MD2 and Gary Noskin, MD3,4, (1)Nortwestern University Feinberg School of Medicine, Chicago, IL, (2)Children's Memorial Hospital, Chicago, IL, (3)Northwestern Memorial Hospital, Chicago, IL, (4)Northwestern University Feinberg School of Medicine, Chicago, IL

    Disclosures:

    E. Anderson, Merck: Grant Investigator, Research grant
    Medscape: Independent Contractor, Honorarium for writing CME
    Meridian Bioscience, Inc.: Grant Investigator, Grant recipient
    Merck: Scientific Advisor, Consulting fee
    GSK: Scientific Advisor, Consulting fee
    Merck: Speaker's Bureau, Speaker honorarium

    D. Shippee, None

    M. Weinrobe, None

    M. Davila, None

    B. Katz, None

    S. Lee, None

    Y. Simons, None

    M. G. Cuyugan, None

    G. Noskin, None

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