title: Disease Burden of Rotavirus Gastroenteritis in Children Residing in Germany: A Retrospective, Hospital-based Surveillance.
abstract: BACKGROUND
  Representative, population-based epidemiologic data for gastroenteritis caused by rotavirus (RV) are rare. RV vaccines were first licensed in Europe in 2006 and recommended in 5 western federal states in 2008 or thereafter. This study establishes a baseline for assessing the impact of vaccination and delineates the RV disease burden in Germany today.
  
  
  METHODS
  Nationwide data obtained from hospitals for children 0 to 10 years of age and transferred to the Federal Statistical Office were analyzed retrospectively. Acute gastroenteritis cases because of RV were identified by the International Classification of Diseases code (ICD-10) combined with the referring diagnosis-related group code. Coding quality was validated by random sampling the patient records (n=1003). Crude and age-standardized rates per 100,000 person-years were calculated. The rate ratios of seasonal effects and recommended immunization adjusted for year, federal state and age were estimated using Poisson regression.
  
  
  RESULTS
  Between 2005 and 2010, 5,843,730 children were hospitalized; 520,606 cases were hospitalized because of acute gastroenteritis. RV caused 152,636 of these cases or an age-standardized rate of 302 hospitalizations per 100,000 person-years. Rates were slightly higher in boys than girls, decreased with age, and differed by federal state, year and season. Rate ratios decreased in those western federal states that recommended immunization and were inversely associated with vaccine doses sold.
  
  
  CONCLUSIONS
  With an average of 25,440 children hospitalized yearly, RV infection has a great impact on the German healthcare system. Our findings indicate that RV immunization will lead to a decline in in-patient treatment and associated costs.
authors.affiliation: From the *Pediatric Department and †Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, Mainz, Germany; ‡Johannes Gutenberg University Mainz, Faculty of Economics, Mainz, Germany; §Klinikum der Landeshauptstadt Wiesbaden HSK, Dr Horst Schmidt Kliniken, Wiesbaden, Germany; ¶Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; ‖Pediatric Department, University Hospital Carl Gustav Carus, Dresden, Germany; **Sanofi Pasteur MSD GmbH, Leimen, Germany; and ††Institute for Community Medicine, University Medicine of the Ernst-Moritz-Arndt University, Greifswald, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Kowalzik
authors.forename: Fred
authors.initials: F
authors.lastname: Zepp
authors.forename: Isabell
authors.initials: I
authors.lastname: Hoffmann
authors.forename: Harald
authors.initials: H
authors.lastname: Binder
authors.forename: Dagmar
authors.initials: D
authors.lastname: Lautz
authors.forename: Reyn
authors.initials: R
authors.lastname: van Ewijk
authors.forename: Markus
authors.initials: M
authors.lastname: Knuf
authors.forename: Tobias
authors.initials: T
authors.lastname: Tenenbaum
authors.forename: Martin
authors.initials: M
authors.lastname: Laass
authors.forename: Thorsten
authors.initials: T
authors.lastname: Reuter
authors.forename: Renate
authors.initials: R
authors.lastname: Schulze-Rath
authors.forename: Manuela
authors.initials: M
authors.lastname: Marron
mesh_terms: D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D062306:Geography, Medical; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D062486:Public Health Surveillance; D012189:Retrospective Studies; D012401:Rotavirus / Q000145:classification / Q000276:immunology; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000276:immunology
chemical_list: D022243:Rotavirus Vaccines