title: Active, population-based surveillance for rotavirus gastroenteritis in Chinese children: Beijing Municipality and Gansu Province, China.
abstract: BACKGROUND
  Estimates of population-based incidence for rotavirus inpatient and outpatient visits, as well as their associated medical costs, can provide valuable information to assess the potential benefits of rotavirus vaccination.
  
  
  METHODS
  We conducted active surveillance for rotavirus gastroenteritis at 6 medical institutions for children younger than 5 years from July 2012 to June 2013 in Beijing Municipality and Gansu Province. We collected stool samples of diarrhea patients for testing rotavirus, and epidemiological, clinical and cost data.
  
  
  RESULTS
  The proportion of rotavirus-positive for inpatient and outpatient visits from Beijing was 28.7% (138/481) and 19.4% (133/687); a statistically lower proportion than observed in Gansu among inpatient visits (45.2%, 245/542, P < 0.001) and among outpatient visits (28.8%, 66/229, P = 0.003), respectively. The G9P[8] genotype was most prevalent in Beijing (60.6%) and in Gansu (77.6%). The median Vesikari scale value was 16 for rotavirus inpatients and 15 for nonrotavirus inpatients. Population-based estimated rates of rotavirus-related hospitalizations were 14.4 (95% CI, 13-16) per 10,000 children, and the rate of rotavirus gastroenteritis in the outpatient setting was 149 (95% CI, 145-153) per 10,000 children younger than 5 years. The estimated total number of rotavirus-related inpatient visits were 3790 (95% CI, 2488-3827) cases and 29,101 (95% CI: 27,748-29,279) outpatient visits. The total cost of rotavirus infection was $1.4 million (95% CI, $0.9-1.4 million) for hospitalizations and $4.2 million (95% CI, $4.0-4.2 million) for outpatient visits per year in Beijing and Gansu.
  
  
  CONCLUSIONS
  Rotavirus is the most common cause of severe acute gastroenteritis (AGE) in children younger than 5 years worldwide,accounting for an estimated 25 million clinic visits, 2 million hospitalizations and 453,000 deaths each year. In China, the world's most populous nation, surveillance at sentinel hospitals showed that approximately 48% of AGE hospitalizations among children younger than 5 years were attributed to rotavirus from 2003 to 2007, and 13,387 rotavirus deaths were estimated in China in 2002 alone.The Lanzhou lamb rotavirus vaccine, consisting of serotype G10P[12], was licensed in 2000 but is not included in the National Expanded Program of Immunization vaccine recommendations for Chinese children. License applications for new rotavirus vaccines (Rotarix, produced by GlaxoSmithKline Biologicals, and RotaTeq, produced by Merck and Company) have been submitted for administering these vaccines to Chinese infants [corrected].
authors.affiliation: From the *Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing; †Gansu provincial Center for Disease Control and Prevention, Lanzhou; ‡Beijing Municipality Center for Disease Control and Prevention, Beijing, China; §Division of Viral Disease, Centers for Disease Control and Prevention, Atlanta, GA; and ¶Institute of Viral Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Haixia
authors.initials: H
authors.lastname: Liu
authors.forename: Lei
authors.initials: L
authors.lastname: Jia
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Payne
authors.forename: Aron J
authors.initials: AJ
authors.lastname: Hall
authors.forename: Ziqian
authors.initials: Z
authors.lastname: Xu
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Gao
authors.forename: Zhaorui
authors.initials: Z
authors.lastname: Chang
authors.forename: Baoming
authors.initials: B
authors.lastname: Jiang
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.forename: Lei
authors.initials: L
authors.lastname: Meng
authors.forename: Hongjie
authors.initials: H
authors.lastname: Yu
authors.forename: Zhaojun
authors.initials: Z
authors.lastname: Duan
mesh_terms: D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology; D062665:Epidemiological Monitoring; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology*; D017048:Health Care Costs; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology*; D016019:Survival Analysis
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