The Journal of infectious diseases 2017 05 03() doi 10.1093/infdis/jix199
In a multi-country birth cohort study, we describe rotavirus infection in the first two years of life in sites with and without rotavirus vaccination programs.
Children were recruited by 17 days of age and followed to 24 months with collection of monthly surveillance and diarrheal stools. Data on socio-demographics, feeding and illness were collected at defined intervals. Stools were tested for rotavirus and sera for anti-rotavirus immunoglobulins by enzyme immunoassays.
A total of 1,737 children contributed 22,646 surveillance and 7,440 diarrheal specimens. Overall, rotavirus was detected in 5.5% (408/7440) of diarrheal stools, and 344 (19.8%) children ever had rotavirus gastroenteritis. Household overcrowding and a high pathogen load were consistent risk factors for infection and disease. Three prior infections conferred 74% (P<0.001) protection against subsequent infection in sites not using vaccine. In Peru, incidence of rotavirus disease was relatively higher during second year of life despite high vaccination coverage. Conclusions
Rotavirus infection and disease was common, but with significant heterogeneity by site. Protection by vaccination may not be sustained in the second year of life in settings with high burdens of transmission and poor response to oral vaccines.