Evaluating rotavirus vaccination in England and Wales: Part I. Estimating the burden of disease
Section snippets
Background
Rotavirus is a major cause of gastroenteritis in young children [1], [2], [3]. Although in the developed world deaths due to rotavirus infection are rare it remains a considerable cause of illness in young children. With newly available vaccines for rotavirus, countries need to establish the health and economic burden of rotavirus disease using the best available data, to assess whether vaccine introduction is advisable compared with other uses of the same resources. Estimating the burden of
Laboratory reports (LabBase2)
The Health Protection Agency collects voluntary data from laboratories around England and Wales on weekly reports of positive isolates for various organisms [9]. Weekly counts (by date of first specimen) of the number of reports of specimens for the period 1995–2004 was extracted. Causative organisms used in the models were astrovirus, adenovirus, rotavirus, norovirus, salmonellas (excluding typhi and paratyphi), campylobacters, Escherichia coli (non-verocytoxin producing), shigellas, giardia,
Results
Between April 1995 and March 2003 there were 139,728 admissions in children under 5 for infectious intestinal disease and 94,569 admissions for non-infectious intestinal disease in children under 5. Over the same period there were 832,942 positive samples for the specified organisms identified from LabBase2 of which 124,723 were rotavirus. Fig. 1 shows the average seasonal trends of the pathogens from positive samples received on LabBase2 for the time period 1995–2003.
The pathogens exhibited
Discussion
This study suggests that approximately 45% of hospital admissions, 25% of GP consultations and NHS Direct calls and 20% of accident and emergency attendances for gastroenteritis in the under 5s can be attributable to rotavirus. These results were robust to a wide range of different model specifications. The finding that a greater proportion of hospitalisations than GP consultations might be attributable to rotavirus is consistent with other studies [24] and the observation that rotavirus
Acknowledgments
The authors would like to thank Chris Lane, Environmental and Enteric Diseases Department, Centre for Infections, for his work on the GIS section of the paper, and Graeme Hall and Prof. Brent Taylor of University College London Hospitals for providing the data on A&E attendances. We also thank the RCGP and NHS Direct for the use of their data, Mark Chen for advice on classifying drug prescriptions, and Prof. Elizabeth Miller for helpful discussions.
The study benefited from discussions held as
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Viral Gastroenteritis
2017, Principles and Practice of Pediatric Infectious DiseasesImpact of the national rotavirus vaccination programme on acute gastroenteritis in England and associated costs averted
2017, VaccineCitation Excerpt :Rotavirus is the commonest cause of diarrhoea in young children, and results in considerable morbidity and healthcare utilisation [1–3].