title: Estimating the rotavirus hospitalization disease burden and trends, using capture-recapture methods.
abstract: BACKGROUND
  Rotavirus surveillance is needed to provide estimates of disease burden and to evaluate the effect of vaccination programs. Our objective was to use capture-recapture methods to estimate rotavirus hospitalization rates and to examine trends over time.
  
  
  METHODS
  Children <3 years of age residing in Hamilton County, Ohio hospitalized with acute gastroenteritis, and laboratory-confirmed rotavirus between 1997 and 2008 were identified through 2 independent surveillance systems: an active system with prospective enrollment of children admitted with acute gastroenteritis and a passive system of children identified by rotavirus testing as part of their usual medical care. Capture-recapture methods compared cases from both systems to estimate the number of missed cases from either system. Using census data for Hamilton County, rates per 10,000 with 95% confidence intervals (CI) for rotavirus hospitalizations were estimated.
  
  
  RESULTS
  Overall, 486 cases were identified using active surveillance and 244 using passive surveillance, with 127 cases captured by both. Using capture-recapture methods, the overall rate in children <3 years old was 26.9/10,000; CI: 24.1, 30.6. Rates varied by year: highest in 1998 (48.1/10,000; CI: 32.4, 92.2) and lowest in 2008 (3.2/10,000; CI: 2.1, 6.1) after rotavirus vaccine introduction. Among children <5 years old, rates were highest in <3-month-old children (51.8/10,000; CI: 39.4, 75.1) and lowest in older age groups: 24 to 35 months (20.5/10,000; CI: 14.7, 30.3) and 36 to 59 months (4.1/10,000; CI: 2.9, 7.2). Rates from capture-recapture methods and adjusted active system were comparable.
  
  
  CONCLUSIONS
  Capture-recapture methods were a useful tool to estimate rotavirus disease burden and to monitor trends, especially in the era of rotavirus immunization.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA. mary.staat@cchmc.org
authors.forename: Mary Allen
authors.initials: MA
authors.lastname: Staat
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Rice
authors.forename: Stephanie
authors.initials: S
authors.lastname: Donauer
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Payne
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Bresee
authors.forename: T Christopher
authors.initials: TC
authors.lastname: Mast
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Curns
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Cortese
authors.forename: Beverly
authors.initials: B
authors.lastname: Connelly
authors.forename: Monica
authors.initials: M
authors.lastname: McNeal
authors.forename: Richard L
authors.initials: RL
authors.lastname: Ward
authors.forename: David I
authors.initials: DI
authors.lastname: Bernstein
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.forename: Shelia
authors.initials: S
authors.lastname: Salisbury
mesh_terms: D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000473:pathology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009820:Ohio / Q000453:epidemiology; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000473:pathology*; D022243:Rotavirus Vaccines / Q000276:immunology
chemical_list: D022243:Rotavirus Vaccines