Reduction in gastroenteritis with the use of pentavalent rotavirus vaccine in a primary practice.
OBJECTIVE
Pentavalent rotavirus (RV) vaccine (RV5) was licensed in 2006 and recommended for routine childhood immunization. A significant decrease in the number of RV hospitalizations has been described. The objective of this study was to evaluate the effect of RV5 on acute gastroenteritis (AGE) seen in a primary practice.


METHODS
In July 2004, surveillance was initiated among children who were younger than 5 years and seen in a large pediatric practice in New Orleans for those who presented AGE, as determined by International Classification of Diseases, Ninth Revision codes. Primary care physician office visits, emergency department visits, and hospital admissions were identified by review of records. RV testing was performed only on those who were seen at the hospital.


RESULTS
Approximately 16,000 children who were younger than 5 years were followed in the practice during each year. For 2006-2007, 2007-2008, and 2008-2009, 11.1%, 40.3%, and 45.6% of age-eligible children, respectively, received > or =1 dose of RV5. As compared with 2004-2005 (before RV5), in 2007-2009, there was a significant decrease in all-cause AGE office visits (23%) and hospitalizations (50%). RV-positive cases (emergency department visits or hospitalizations) decreased by 67%. The decrease in RV-positive cases was more evident among children who were younger than 2 years (81%), with a strong trend among those who were aged 2 to <5 years (41%).


CONCLUSIONS
Increased use of RV5 in a pediatric practice was associated with fewer AGE office visits and hospitalizations. The reduction was specific for RV-positive AGE and seen among children who were targeted for immunization as well as older groups, suggesting a herd-immunity effect.
Bégué
Rodolfo E
RE
Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA. rbegue@lsuhsc.edu
Perrin
Keith
K
D002675:Child, Preschool; D003140:Communicable Disease Control / Q000379:methods / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005759:Gastroenteritis / Q000453:epidemiology* / Q000517:prevention & control* / Q000821:virology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D055820:New Orleans / Q000453:epidemiology; D016017:Odds Ratio; D009819:Office Visits / Q000706:statistics & numerical data; D010372:Pediatrics / Q000592:standards / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods; D011331:Private Practice; D018570:Risk Assessment; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage*; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000379:methods; D014613:Vaccines, Attenuated / Q000008:administration & dosage
D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated