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Ushijima H, Hoque SA, Akari Y, Pham NTK, Phan T, Nishimura S, Kobayashi M, Sugita K, Okitsu S, Komoto S, Thongprachum A, Khamrin P, Maneekarn N, Hayakawa S. Molecular Evolution of GII.P31/GII.4_Sydney_2012 Norovirus over a Decade in a Clinic in Japan. Int J Mol Sci 2024; 25:3619. [PMID: 38612429 PMCID: PMC11011564 DOI: 10.3390/ijms25073619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Norovirus (NoV) genogroup II, polymerase type P31, capsid genotype 4, Sydney_2012 variant (GII.P31/GII.4_Sydney_2012) has been circulating at high levels for over a decade, raising the question of whether this strain is undergoing molecular alterations without demonstrating a substantial phylogenetic difference. Here, we applied next-generation sequencing to learn more about the genetic diversity of 14 GII.P31/GII.4_Sydney_2012 strains that caused epidemics in a specific region of Japan, with 12 from Kyoto and 2 from Shizuoka, between 2012 and 2022, with an emphasis on amino acid (aa) differences in all three ORFs. We found numerous notable aa alterations in antigenic locations in the capsid region (ORF2) as well as in other ORFs. In all three ORFs, earlier strains (2013-2016) remained phylogenetically distinct from later strains (2019-2022). This research is expected to shed light on the evolutionary properties of dominating GII.P31/GII.4_Sydney_2012 strains, which could provide useful information for viral diarrhea prevention and treatment.
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Affiliation(s)
- Hiroshi Ushijima
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Itabashi, Tokyo 173-8610, Japan
| | - Sheikh Ariful Hoque
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Itabashi, Tokyo 173-8610, Japan
- Cell and Tissue Culture Laboratory, Centre for Advanced Research in Sciences (CARS), University of Dhaka, Dhaka 1000, Bangladesh
| | - Yuki Akari
- Department of Virology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Ngan Thi Kim Pham
- College of Industrial Technology, Nihon University, Narashino, Chiba 275-8575, Japan;
| | - Tung Phan
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | | | | | - Kumiko Sugita
- Sugita Children Clinic, Ibaraki, Osaka 567-0035, Japan
| | - Shoko Okitsu
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Itabashi, Tokyo 173-8610, Japan
| | - Satoshi Komoto
- Department of Virology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
- Center for Infectious Disease Research, Research Promotion Headquarters, Fujita Health University, Toyoake, Aichi 470-1192, Japan
- Division of One Health, Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University, Yufu, Oita 879-5593, Japan
| | | | - Pattara Khamrin
- Department of Microbiology, Faculty of Medicine and Emerging and Re-Emerging Diarrheal Viruses Research Center, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Niwat Maneekarn
- Department of Microbiology, Faculty of Medicine and Emerging and Re-Emerging Diarrheal Viruses Research Center, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Satoshi Hayakawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Itabashi, Tokyo 173-8610, Japan
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La Fauci G, Soldà G, Di Valerio Z, Salussolia A, Montalti M, Scognamiglio F, Capodici A, Fantini MP, Larson HJ, Leask J, Gori D, Lenzi J. Rates and determinants of Rotavirus vaccine uptake among children in Italy: a cross-sectional study within the 2022 OBVIOUS* project. BMC Public Health 2024; 24:770. [PMID: 38475736 DOI: 10.1186/s12889-024-18154-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION The World Health Organization defines rotavirus as among the most severe causes of viral gastroenteritis affecting children under 5 year old. Italy and other European countries do not release disaggregated data on rotavirus vaccination coverage. This study aimed to assess the uptake and drivers of rotavirus vaccination in Italy. METHODS We administered a survey to 10,000 Italian citizens recruited via an online panel and proportionate to key demographic strata. We examined rotavirus vaccine uptake among parents whose youngest child was aged 6 weeks to 4 years, their sociodemographic characteristics, their beliefs about vaccine administration, and who recommended the rotavirus vaccination. RESULTS A total of 711 respondents met the inclusion criteria for the rotavirus vaccine questionnaire. The uptake was estimated at 60.3% nationwide (66.4% among mothers and 50.2% among fathers). Being a mother and living in cities/suburbs was significantly associated with a higher likelihood of vaccine uptake, while fathers were more likely to be uncertain of their children's vaccine status. Living in Central Italy and having friends/relatives opposed to vaccination were found to be significantly associated with a lower likelihood of vaccine uptake, while parents' education level and children's demographics were not found to correlate with any outcomes. In 90.3% of cases, the rotavirus vaccination was recalled as being recommended by a paediatrician. CONCLUSIONS Consistent collection of behavioural preferences and socioeconomic characteristics of recipients of rotavirus vaccine campaigns, their epidemiological information, cost-benefit, and national policy data are crucial for designing effective vaccination strategies in Italy and other European countries with similar social profiles to reach the target uptake.
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Affiliation(s)
- Giusy La Fauci
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Giorgia Soldà
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Zeno Di Valerio
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy.
| | - Aurelia Salussolia
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Marco Montalti
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Francesca Scognamiglio
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Angelo Capodici
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Maria Pia Fantini
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Heidi J Larson
- Institute for Health Metrics & Evaluation (IHME), University of Washington, Seattle, WA, USA
- London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Julie Leask
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Sydney Infectious Diseases Institute, Westmead, NSW, Australia
| | - Davide Gori
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Jacopo Lenzi
- Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
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Di Martino G, Cedrone F, D’Addezio M, Odio C, Di Giovanni P, Trebbi E, Tognaccini L, Romano F, Staniscia T. Incidence of Rotavirus-Related Hospitalizations in an Italian Southern Region from 2015 to 2021. Diseases 2024; 12:26. [PMID: 38248377 PMCID: PMC10814902 DOI: 10.3390/diseases12010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024] Open
Abstract
(1) Background: Rotavirus is one of the leading causes of severe diarrhea and dehydration in infants and young children worldwide. The economic and social burden of rotavirus-related hospitalizations, particularly among children, remains a pressing concern for healthcare systems across the globe. Healthcare infrastructure and access to medical care can vary significantly within the region. Differences in the availability of healthcare facilities and the quality of care may influence the management and outcomes of rotavirus cases. (2) Methods: This was a retrospective study performed in the Abruzzo region, Italy. The study considered all hospitalization due to rotavirus gastroenteritis that occurred in the Abruzzo region from the year 2015 to 2021. Data were extracted from the hospital discharge records. The trend in hospital admissions, hospitalization costs and length of stay were evaluated and analyzed. (3) Results: A total of 664 admissions were reported during the study period. The incident rate grew till year 2019 with an annual percentage change of +13.9% (95%CI 12.6-15.2, p < 0.001). During the pandemic years, the incident rate showed a significant decrease with an annual percentage change of 12.5% (95%CI 15.5-9.3, p = 0.004). The length of stay of admissions was significantly higher among patients aged less than 1 year. (4) Conclusions: Rotavirus admission represents a heavy burden even in a high-income country such as Italy. These findings have the potential to inform targeted public health interventions, including vaccination strategies, and improve the overall well-being of children.
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Affiliation(s)
- Giuseppe Di Martino
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (P.D.G.); (T.S.)
- Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, 65100 Pescara, Italy;
| | - Fabrizio Cedrone
- Hospital Management, Local Health Authority of Pescara, 65100 Pescara, Italy;
| | - Michela D’Addezio
- Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, 65100 Pescara, Italy;
| | - Camillo Odio
- Digital Health Unit, Department of Health, Abruzzo Region, 65100 Pescara, Italy;
| | - Pamela Di Giovanni
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (P.D.G.); (T.S.)
| | - Edoardo Trebbi
- Department of Public Health and Infectious Diseases, “La Sapienza” University of Rome, 00100 Rome, Italy; (E.T.); (L.T.); (F.R.)
| | - Livia Tognaccini
- Department of Public Health and Infectious Diseases, “La Sapienza” University of Rome, 00100 Rome, Italy; (E.T.); (L.T.); (F.R.)
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, “La Sapienza” University of Rome, 00100 Rome, Italy; (E.T.); (L.T.); (F.R.)
| | - Tommaso Staniscia
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (P.D.G.); (T.S.)
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Isonne C, Petrone D, Del Manso M, Iera J, Caramia A, Bandini L, Fadda G, Grossi A, Baccolini V, Costantino C, Pezzotti P, Siddu A, D'Ancona F. The Impact of Rotavirus Vaccination on Discharges for Pediatric Gastroenteritis in Italy: An Eleven Year (2009-2019) Nationwide Analysis. Vaccines (Basel) 2023; 11:1037. [PMID: 37376427 DOI: 10.3390/vaccines11061037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/11/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
In Italy, despite the documented positive effects of rotavirus (RV) vaccination on reducing the burden of RV disease, an updated national assessment of its impact on clinical outcomes is still lacking. This study aims to analyze the implementation of RV vaccination in Italy, evaluating its impact on discharges for acute pediatric gastroenteritis (AGE). A retrospective analysis, including hospital discharge records and data on vaccination coverage for children aged 0-71 months from 2009 to 2019, was conducted. We examined trends in hospital discharge standardized incidence before and after vaccine introduction using a negative binomial mixture model with fixed effects to evaluate the impact of universal vaccination. The percentage of vaccination coverage increased over the years, from <5% between 2009 and 2013 to 26% in 2017, reaching 70% in 2019. The standardized incidence of discharges decreased over the period from 16.6/100,000 inhabitants in 2009-2013 to 9.9/100,000 inhabitants in 2018-2019. In this phase, about 15% of the estimated hospital discharges were avoided compared with those estimated in the first phase. The implementation of RV vaccination reduced AGE incidence discharges in children aged 0-71 months. Further efforts are needed to continue monitoring the vaccination effect over time and to increase vaccination coverage.
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Affiliation(s)
- Claudia Isonne
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
- Department of Statistics, Sapienza University of Rome, 00185 Rome, Italy
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Jessica Iera
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Management and Health Laboratory, Institute of Management-Department EMbeDS, Sant'Anna School of Advanced Studies, 56127 Pisa, Italy
| | - Alessandra Caramia
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
- Policlinico Riuniti Foggia Hospital, Hygiene Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Lorenzo Bandini
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Giulia Fadda
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Adriano Grossi
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Andrea Siddu
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 00144 Rome, Italy
| | - Fortunato D'Ancona
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
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Differentiation between Wild-Type Group A Rotaviruses and Vaccine Strains in Cases of Suspected Horizontal Transmission and Adverse Events Following Vaccination. Viruses 2022; 14:v14081670. [PMID: 36016292 PMCID: PMC9416126 DOI: 10.3390/v14081670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/18/2022] Open
Abstract
Human group A rotaviruses (RVA) are important enteric pathogens, as they are a leading cause of acute gastroenteritis (AGE) in children worldwide. Since 2013, the German Standing Committee on vaccination recommended the routine rotavirus vaccination for infants in Germany. While vaccination has significantly decreased RVA cases and worldwide mortality, in some cases, infants can develop acute gastroenteritis as an adverse reaction after immunization with an attenuated live vaccine. Pediatricians, as well as clinicians and diagnostic laboratories, contacted the Consultant Laboratory for Rotaviruses and inquired whether cases of RVA-positive AGE after vaccination were associated with vaccine or with wild-type RVA strains. A testing algorithm based on distinguishing PCRs and confirmative sequencing was designed, tested, and applied. Diagnostic samples from 68 vaccinated children and six cases where horizontal transmission was suspected were investigated in this study. Using a combination of real-time PCR, fragment-length analysis of amplicons from multiplex PCRs and confirmative sequencing, vaccine-like virus was detected in 46 samples and wild-type RVA was detected in 6 samples. Three mixed infections of vaccine and wild-type RVA were detectable, no RVA genome was found in 19 samples. High viral loads (>1.0 × 107 copies/g stool) were measured in most RVA-positive samples. Furthermore, information on co-infections with other AGE pathogens in the vaccinated study population was of interest. A commercial multiplex PCR and in-house PCRs revealed three co-infections of vaccinated infants with bacteria (two samples with Clostridioides difficile and one sample with enteropathogenic E. coli) and six co-infections with norovirus in a subset of the samples. Human astrovirus was detected in one sample, with suspected horizontal transmission. The cases of suspected horizontal transmission of vaccine RVA strains could not be confirmed, as they either involved wild-type RVA or were RVA negative. This study shows that RVA-positive AGE after vaccination is not necessarily associated with the vaccine strain and provides a reliable workflow to distinguish RVA vaccine strains from wild-type strains.
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