Role of rotavirus vaccination on an emerging G8P[8] rotavirus strain causing an outbreak in central Japan
Role of rotavirus vaccination on an emerging G8P[8] rotavirus strain causing an outbreak in central Japan
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DOI：
10.1016/j.vaccine.2017.11.056
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发表时间：
2018-01-02
期刊：
影响因子：
5.5
通讯作者：
Ushijima, Hiroshi
中科院分区：
文献类型：
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作者：
Hoque, Sheikh Ariful;Kobayashi, Masaaki;Ushijima, Hiroshi
背景：在这项研究中，我们检查了 RV1 和 RV5 疫苗在 G8P[8] 轮状病毒 A 组毒株 (G8P[8]-RVA) 爆发期间的有效性。这些疫苗最初旨在提供针对常见流行毒株引起的严重疾病的保护，而 G8P[81-RVA 仍然是新兴毒株，并且与疫苗具有部分异型性。研究针对 G8P[8]-RVA 的疫苗有效性 (VE) 势在必行，因为该菌株近年来似乎占主导地位，特别是在后疫苗时代。方法：通过聚合酶链式反应 (PCR) 和基于序列的基因分型确认 RVA 感染和基因型。 VE 是在 2017 年 2 月至 7 月日本静冈县 G8P[8]-RVA 暴发期间回顾性确定的，通过使用调整年龄的条件逻辑回归比较“PCR 阳性”和“PCR 阴性”病例中患有急性胃肠炎 (AGE) 的儿童的疫苗接种状况。结果：在 80 名 AGE 儿童中，58 名 (73%) 检测到 RVA，其中 53 名 (66%) 为G8P[81-RVA。 G8P[8]-RVA和其他RVA株的临床特征同样严重。值得注意的是，接种疫苗的儿童 (61.1%) 和未接种疫苗的儿童 (65.5%) 的 G8P[8]-RVA 发病率几乎相似。事实上，针对 G8P[8]-RVA（VE，14% [95% CI：140% 至 70%]）或其他 RVA 菌株（VE，58% [95% CI：20% 至 90%]）对轻度感染没有显着疗效。然而，这些疫苗对中度（VE，75% [95% CI：1% 至 40%]）和重度（VE，92% [95% CI：60% 至 98%]）RVA 感染仍然非常有效。接种疫苗的儿童的疾病严重程度（包括 Vesikari 评分、腹泻持续时间和频率以及体温）显着降低。 结论：这项研究表明，当前的 RV 疫苗对中度和重度感染有效，但对由不寻常的 G8P[8]-RVA 引起的爆发期间的轻度感染无效，而 G8P[8]-RVA 实际上不是疫苗的目标。 (C) 2017 Elsevier Ltd. 保留所有权利。
Background: In this study, we examined the effectiveness of RV1 and RV5 vaccines during an outbreak of G8P[8] rotavirus group A strain (G8P[8]-RVA). These vaccines were originally designed to provide protection against severe diseases caused by common circulating strains, whereas G8P[81-RVA remains emerging strain and partially heterotypic to the vaccines. It is imperative to investigate vaccine effectiveness (VE) against G8P[8]-RVA because this strain appears to be predominant in recent years, particularly, in post-vaccine era.Methods: RVA infection and genotypes were confirmed by polymerase chain reaction (PCR) followed by sequence-based genotyping. VE was determined during an outbreak of G8P[8]-RVA in Shizuoka Prefecture, Japan, in February-July 2017, retrospectively, by comparing vaccination status of children suffering from acute gastroenteritis (AGE) between 'PCR-positive' and 'PCR-negative' cases using conditional logistic regression adjusted for age.Results: Among 80 AGE children, RVA was detected in 58 (73%), of which 53 (66%) was G8P[81-RVA. The clinical characteristics of G8P[8]-RVA and other RVA strains were identically severe. Notably, the attack rates of G8P[8]-RVA in vaccinated (61.1%) and unvaccinated (65.5%) children were almost similar. Indeed, no substantial effectiveness were found against G8P[8]-RVA (VE, 14% [95% CI: 140% to 70%]) or other RVA strains (VE, 58% [95% CI: 20% to 90%]) for mild infections. However, these vaccines remained strongly effective against moderate (VE, 75% [95% CI: 1% to 40%]) and severe (VE, 92% [95% CI: 60% to 98%]) RVA infections. The disease severity including Vesikari score, duration and frequency of diarrhea, and body temperature were significantly lower in vaccinated children.Conclusions: This study demonstrates the effectiveness of current RV vaccines against moderate and severe, but not against the mild infections during an outbreak caused by unusual G8P[8]-RVA, which was virtually not targeted in the vaccines. (C) 2017 Elsevier Ltd. All rights reserved.