title: Sibling transmission of vaccine-derived rotavirus (RotaTeq) associated with rotavirus gastroenteritis.
abstract: Although rotavirus vaccines are known to be shed in stools, transmission of vaccine-derived virus to unvaccinated contacts resulting in symptomatic rotavirus gastroenteritis has not been reported to our knowledge. We document here the occurrence of vaccine-derived rotavirus (RotaTeq [Merck and Co, Whitehouse Station, NJ]) transmission from a vaccinated infant to an older, unvaccinated sibling, resulting in symptomatic rotavirus gastroenteritis that required emergency department care. Results of our investigation suggest that reassortment between vaccine component strains of genotypes P7[5]G1 and P1A[8]G6 occurred during replication either in the vaccinated infant or in the older sibling, raising the possibility that this reassortment may have increased the virulence of the vaccine-derived virus. Both children remain healthy 11 months after this event and are without underlying medical conditions.
authors.affiliation: MSPH, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS-A47, Atlanta, GA 30333, USA. dvp6@cdc.gov
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Payne
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Edwards
authors.forename: Michael D
authors.initials: MD
authors.lastname: Bowen
authors.forename: Erin
authors.initials: E
authors.lastname: Keckley
authors.forename: Jody
authors.initials: J
authors.lastname: Peters
authors.forename: Mathew D
authors.initials: MD
authors.lastname: Esona
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Teel
authors.forename: Diane
authors.initials: D
authors.lastname: Kent
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.forename: Jon R
authors.initials: JR
authors.lastname: Gentsch
mesh_terms: D000956:Antigens, Viral / Q000235:genetics; D036022:Capsid Proteins / Q000235:genetics; D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000235:genetics / Q000821:virology*; D006801:Humans; D007223:Infant; D008297:Male; D016865:Reassortant Viruses; D012401:Rotavirus / Q000472:pathogenicity; D012400:Rotavirus Infections / Q000235:genetics / Q000635:transmission*; D022243:Rotavirus Vaccines / Q000009:adverse effects* / Q000145:classification / Q000235:genetics; D035781:Siblings; D014613:Vaccines, Attenuated / Q000009:adverse effects / Q000145:classification / Q000235:genetics; D014774:Virulence; D014779:Virus Replication
chemical_list: D000956:Antigens, Viral; D036022:Capsid Proteins; C492535:RotaTeq; D022243:Rotavirus Vaccines; C050779:VP7 protein, Rotavirus; D014613:Vaccines, Attenuated