title: Risk Factors Associated With Rotavirus Gastroenteritis During a Community Outbreak in Chiapas, Mexico During the Postvaccination Era.
abstract: BACKGROUND
  In January 2010, surveillance detected a rotavirus gastroenteritis outbreak in Chiapas, Mexico. We aimed to identify risk and protective factors for developing rotavirus gastroenteritis of any severity among children in the epidemic setting.
  
  
  METHODS
  A case-control study was conducted, comparing case patients (defined as children <36 months of age with acute gastroenteritis of any severity whose stool tested positive for rotavirus by enzyme immunoassay) with age- and municipality-matched controls. Information was obtained through face-to-face interviews on clinical outcome, demographics, breastfeeding history, rotavirus immunization status, and indicators of socioeconomic status.
  
  
  RESULTS
  Eighty-five case patients and 170 controls were enrolled. Factors associated with lower risk of rotavirus gastroenteritis included current breastfeeding, owning a refrigerator, and being immunized with 1 or 2 doses of a live-attenuated monovalent rotavirus vaccine. History of previous diarrheal episodes and living with 7 or more people in the same household were associated with higher risk of developing rotavirus gastroenteritis.
  
  
  CONCLUSIONS
  During this outbreak, dietary, socioeconomic, and environmental factors were independently associated with risk of developing rotavirus disease. Rotavirus vaccine also offered significant protection against rotavirus disease of any severity, emphasizing the value of vaccination as a simple and highly effective public health strategy for prevention of rotavirus illness.
authors.affiliation: National Center for Child and Adolescent Health, Ministry of Health, Mexico City, Mexico.
authors.forename: Edgar
authors.initials: E
authors.lastname: Sánchez-Uribe
authors.affiliation: National Center for Child and Adolescent Health, Ministry of Health, Mexico City, Mexico.
authors.forename: Marcelino
authors.initials: M
authors.lastname: Esparza-Aguilar
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention Epidemic Intelligence Service, Atlanta, Georgia.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Gastañaduy
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention Epidemic Intelligence Service, Atlanta, Georgia.
authors.forename: Rishi
authors.initials: R
authors.lastname: Desai
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention.
authors.forename: Manish
authors.initials: M
authors.lastname: Patel
authors.affiliation: National Center for Child and Adolescent Health, Ministry of Health, Mexico City, Mexico.
authors.forename: Vesta
authors.initials: V
authors.lastname: Richardson
keywords: Disease Outbreaks; Mexico.; Risk Factors; Rotavirus; Rotavirus Vaccines