title: Rotavirus vaccine and health-care utilization for rotavirus gastroenteritis in Tsu City, Japan.
abstract: BACKGROUND
  Rotavirus vaccines were introduced in Japan in November 2011. We evaluated the subsequent reduction of the health-care burden of rotavirus gastroenteritis.
  
  
  METHODS
  We conducted active surveillance for rotavirus gastroenteritis among children under 5 years old before and after the vaccine introduction. We surveyed hospitalization rates for rotavirus gastroenteritis in children in Tsu City, Mie Prefecture, Japan, from 2007 to 2015 and surveyed the number of outpatient visits at a Tsu City clinic from 2010 to 2015. Stool samples were obtained for rotavirus testing and genotype investigation. We assessed rotavirus vaccine coverage for infants living in Tsu City.
  
  
  RESULTS
  In the pre-vaccine years (2007-2011), hospitalization rates for rotavirus gastroenteritis in children under 5 years old were 5.5, 4.3, 3.1 and 3.9 cases per 1000 person-years, respectively. In the post-vaccine years (2011-2015), the rates were 3.0, 3.5, 0.8 and 0.6 cases per 1000 person-years, respectively. The hospitalization rate decreased significantly in the 2013-2014 and 2014-2015 seasons compared to the average of the seasons before vaccine introduction (P< 0.0001). In one pre-vaccine year (2010-2011), the number of outpatient visits due to the rotavirus infection was 66. In the post-vaccine years (2011-2015), the numbers for each season was 23, 23, 7 and 5, respectively. The most dominant rotavirus genotype shifted from G3P[8] to G1P[8] and to G2P[4]. The coverage of one dose of rotavirus vaccine in Tsu City was 56.5% in 2014.
  
  
  CONCLUSIONS
  After the vaccine introduction, the hospitalization rates and outpatient visits for rotavirus gastroenteritis greatly decreased.
authors.affiliation: Department of Pediatrics, National Hospital Organization Mie Hospital, Tsu, Japan .
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Asada
authors.affiliation: Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Shinjuku, Japan .
authors.forename: Hajime
authors.initials: H
authors.lastname: Kamiya
authors.affiliation: Department of Pediatrics, National Hospital Organization Mie Hospital, Tsu, Japan .
authors.forename: Shigeru
authors.initials: S
authors.lastname: Suga
authors.affiliation: Department of Pediatrics, National Hospital Organization Mie Hospital, Tsu, Japan .
authors.forename: Mizuho
authors.initials: M
authors.lastname: Nagao
authors.affiliation: Department of Pediatrics, National Hospital Organization Mie Hospital, Tsu, Japan.; Department of Pediatrics/Neonatology, Ise Red Cross Hospital, Ise, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Ichimi
authors.affiliation: Department of Pediatrics, National Hospital Organization Mie Hospital, Tsu, Japan .
authors.forename: Takao
authors.initials: T
authors.lastname: Fujisawa
authors.affiliation: Umemoto Children's Clinic, Tsu, Japan .
authors.forename: Masakazu
authors.initials: M
authors.lastname: Umemoto
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki, Japan .
authors.forename: Takaaki
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics, Kameda Medical Center, Kamogawa, Japan .
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Pediatrics, Mie-Chuo Medical Center, Tsu, Japan .
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics, Mie-Chuo Medical Center, Tsu, Japan .
authors.forename: Masaru
authors.initials: M
authors.lastname: Ido
authors.affiliation: Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Japan .
authors.forename: Koki
authors.initials: K
authors.lastname: Taniguchi
authors.affiliation: Department of Pediatrics, National Hospital Organization Mie Hospital, Tsu, Japan .
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ihara
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, Kurashiki, Japan .
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D002675:Child, Preschool; D017281:Cost of Illness; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance; D012401:Rotavirus / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity; D012400:Rotavirus Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics; D022243:Rotavirus Vaccines / Q000627:therapeutic use*
chemical_list: D022243:Rotavirus Vaccines