482. Suspected Household Transmission of Rotavirus in the United States
Session: Poster Abstract Session: Pediatric Viral Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Wikswo - IDSA poster.pdf (301.6 kB)
  • Background: Rotavirus is a leading cause of acute gastroenteritis (AGE) in children <5 years old and is highly transmissible.  We studied the suspected transmission of rotavirus in households with a pediatric rotavirus case. 

    Methods: During December 2011 – November 2013, children >14 days and <11 years old were enrolled at 7 hospitals and emergency departments.  Parental interviews, medical chart reviews, vaccination records, and stool specimens were collected at enrollment. Stool was tested for rotavirus by enzyme immunoassay (EIA) and confirmed by real-time or conventional reverse transcription-polymerase chain reaction assay or repeated EIA.  Follow-up phone interviews were conducted to assess AGE in household contacts (HHCs).  Households with no AGE in HHCs or in which onset of HHC AGE illness occurred only within day 1-7 after index case AGE onset were included in the analysis.  A mixed-effects multivariate model was used to calculate odds ratios (ORs) for HHC illness. 

    Results: A total of 348 rotavirus-positive (RV+) index cases and 3,507 rotavirus-negative (RV-) subjects were identified.  Households of index RV+ cases were significantly more likely to report AGE illness in ≥1 HHC than RV- households (35% vs. 19%, p<0.01). A total of 1,168 HHCs were identified in the 348 RV+ households, and 164 (14%) reported AGE illness onset in days 1-7 after the index case onset.  Thirty-seven (23%) of these contacts sought some sort of healthcare service, including 5 (3%) hospitalizations.  Multivariate analysis showed that HHCs who were <5 years old (OR 3.4, p=0.004) and HHCs of index cases 5-10 years old (OR 2.1, p=0.04) were significantly more likely to report AGE illness in the week after index onset.  Index case vaccination status, severity score, or presence of vomiting or diarrhea or household size were not significantly associated with HHC illness.

    Conclusion: AGE in children leads to significant disease burden in households.  HHCs of RV+ index cases were significantly more likely to report AGE than contacts of RV- subjects.  HHCs of index cases were also more likely to report illness if the index case was an older child or if the contact was <5 years old.  Prevention of pediatric rotavirus illness, especially through vaccination, may prevent additional illnesses in HHCs.

    Mary E. Wikswo, MPH1, Daniel Payne, PhD, MSPH1, Benjamin Lopman, PhD, MSc1, Rangaraj Selvarangan, PhD2, Parvin H. Azimi, MD3, Julie Boom, MD4, Janet Englund, MD, FIDSA5, Mary Allen Staat, MD MPH6, Natasha Halasa, MD, MPH, FPIDS7, Peter G Szilagyi, MD, MPH8, Michael D. Bowen, PhD1 and Umesh D. Parashar, MBBS, MPH1, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Children's Mercy Hospital, Kansas City, MO, (3)Children's Hospital, Oakland, CA, (4)Texas Children’s Hospital, Houston, TX, (5)Seattle Children's Hospital, Seattle, WA, (6)Cincinnati Children's Hospital Medical Center, Cincinnati, OH, (7)School of Medicine, Vanderbilt University, Nashville, TN, (8)University of Rochester School of Medicine, Rochester, NY

    Disclosures:

    M. E. Wikswo, None

    D. Payne, None

    B. Lopman, None

    R. Selvarangan, None

    P. H. Azimi, None

    J. Boom, None

    J. Englund, None

    M. A. Staat, None

    N. Halasa, Sanofi Pasteur: Grant Investigator , Grant recipient , Research grant and Research support
    Gilead: Grant Investigator , Research support
    Pfizer: Grant Investigator , Grant recipient , Research grant and Research support
    Baxter: Grant Investigator , Grant recipient , Research grant and Research support
    Biocryst: Grant Investigator , Research support

    P. G. Szilagyi, None

    M. D. Bowen, None

    U. D. Parashar, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.