Pediatric Infection and Vaccine

  • 제21권3호
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  • Pages.167-173
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  • 2014
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
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로타바이러스 백신 도입 후 로타바이러스 위장관염의 추이: 일개 3차 병원의 후향적 연구

The Changes in the Outbreak of Rotavirus Gastroenteritis in Children after Introduction of Rotavirus Vaccines: A Retrospective Study at a Tertiary Hospital

  • 박동규 (인제대학교 의과대학 상계백병원 소아과학교실) ;
  • 정주영 (인제대학교 의과대학 상계백병원 소아과학교실)
  • Park, Dong Kyu (Department of Pediatrics, Sanggye Paik Hospital, Inje University, College of Medicine) ;
  • Chung, Ju-Young (Department of Pediatrics, Sanggye Paik Hospital, Inje University, College of Medicine)
  • 투고 : 2014.09.08
  • 심사 : 2014.10.24
  • 발행 : 2014.12.25
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초록

목적: 최근 로타바이러스 백신의 효과 및 안정성에 대한 연구 결과를 바탕으로 전세계적으로 접종이 시행이 되고 있다. 국내에도 로타바이러스 백신 도입 후 5년이 경과되었지만 백신효과에 대한 국내 자료가 매우 드문 실정이다. 로타바이러스 백신 도입을 전후하여 급성위장관염 및 로타바이러스 위장관염 환자의 발생 추이를 알아보고자 하였다. 방법: 2005-2006년, 2011-2012년의 인제대학교 상계백병원 소아청소년과 실입원환자수를 조사하였으며 같은 기간동안 급성위장관염으로 진단되어 인제대학교 상계백병원에 입원한 5세 미만 소아환자 2,840명의 의무기록을 후향적으로 분석하였다. 2005-2006년을 백신 도입 이전, 2011-2012년을 백신 도입 이후로 분류하여 5세 미만 소아 연령에서 급성위장관염 환자와 대변 로타항원 검사 결과로 확인된 로타바이러스 급성위장관염 환자의 입원 양상의 변화를 파악하였다. 결과: 로타바이러스 백신 도입 이전군(2005-2006년)에 비해 이후군(2011-2012년)에서 급성위장관염으로 입원한 5세 미만 환자는 생후 2개월 미만 군을 제외한 모든 월령군에서 유의한 환자수의 감소를 보였다. 로타바이러스 급성위장관염 환자는 생후 2개월 미만 군과 생후 2-5개월 월령군을 제외한 월령군에서 유의한 환자수의 감소를 보였다. 결론: 로타바이러스 백신이 국내에 도입된 이후에 도입 이전에 비해 생후 6-59개월군의 급성위장관염 입원 환자에서 로타바이러스 위장관염이 감소하였다. 향후에도 로타바이러스 백신의 효과 및 안정성에 대한 지속적인 관심과 연구가 필요할 것으로 보인다.

Purpose: This study aimed to examine the changes in the outbreak of acute gastroenteritis, rotavirus gastroenteritis after the introduction of the rotavirus vaccine in Korea. Methods: The current study investigated the number of inpatients in the pediatric ward of Inje University Sanggye Paik Hospital during the periods of 2005-2006 and 2011-2012. A retrospective analysis was conducted on the medical records of 2,840 patients <5 years of age who were hospitalized at Inje University Sanggye Paik Hospital in these time periods. Results: When we compared 2 separate sets of data from before (2005-2006) and after (2011-2012) vaccine introduction, there were statistically significant decreases in the number of patients who were hospitalized for acute gastroenteritis across all of the groups of patients <5 years of age except those <2 months of age. The number of patients with rotavirus gastroenteritis in all age groups declined except for children <2 months of age and those 2-5 months of age. Conclusion: These results show that after the introduction of a rotavirus vaccine in Korea, the incidence of rotavirus gastroenteritis decreased in 6-59-month-old patients hospitalized for acute gastroenteritis.

키워드

참고문헌

  1. Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI. Global illness and deaths caused by rotavirus disease in children. Emerg Infect Dis 2003;9:565-72. https://doi.org/10.3201/eid0905.020562
  2. Matthijnssens J, Ciarlet M, McDonald SM, Attoui H, Banyai K, Brister JR, et al. Uniformity of rotavirus strain nomenclature proposed by the Rotavirus Classification Working Group (RCWG). Arch Virol 2011; 156:1397-413. https://doi.org/10.1007/s00705-011-1006-z
  3. ThanVT, Kim W. Prevalence of rotavirus genotypes in South Korea in 1989-2009: implications for a nationwide rotavirus vaccine program. Korean J Pediatr 2013;56:465-73. https://doi.org/10.3345/kjp.2013.56.11.465
  4. Kang JO, Kim MN, Kim J, Suh HS, Yoon Y, Jang S, et al. Epidemiologic trends of rotavirus infection in the Republic of Korea, July 1999 through June 2002. Korean J Lab Med 2003;23:382-7.
  5. Jeong HS, Lee KB, Jeong AY, Jo MY, Jung SY, Ahn JH, et al. Genotypes of the circulating rotavirus strains in the seven prevaccine seasons from September 2000 to August 2007 in South Korea. Clin Microbiol Infect 2011;17:232-5. https://doi.org/10.1111/j.1469-0691.2010.03232.x
  6. Ruiz-Palacios GM, Perez-Schael I, Velazquez FR, Abate H, Breuer T, Clemens SC, et al. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med 2006;354:11-22. https://doi.org/10.1056/NEJMoa052434
  7. Linhares AC, Velazquez FR, Perez-Schael I, Saez-Llorens X, Abate H, Espinoza F, et al: Efficacy and safety of an oral live attenuated human rotavirus vaccine against rotavirus gastroenteritis during the first 2 years of life in Latin American infants: a randomized, double-blind, placebo-controlled phase III study. Lancet 2008;371:1181-9. https://doi.org/10.1016/S0140-6736(08)60524-3
  8. Vesikari T, Matson DO, Dennehy P, Van Damme P, Santosham M, Rodriquez A, et al. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med 2006;354:23-33. https://doi.org/10.1056/NEJMoa052664
  9. Ruiz-Palacios GM, Perez-Schael I, Velazquez FR, Abate H, Breuer T, Clemens SC, et al. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med 2006;354:11-22. https://doi.org/10.1056/NEJMoa052434
  10. Gastanaduy PA, Curns AT, Parashar UD, Lopman BA. Gastroenteritis hospitalizations in older children and adults in the United States before and after implementation of infant rotavirus vaccination. JAMA 2014;310:851-3.
  11. Desai R, Curns AT, Steiner CA, Tate JE, Patel MM, Parashar UD. All-cause gastroenteritis and rotavius-coded hospitalizations among US children, 2000-2009. Clin Infect Dis 2012;55:e28-e34. https://doi.org/10.1093/cid/cis443
  12. Yen C, Tate JE, Wenk JD, Harris JM, Parashar UD. Diarrhea-associated hospitalizations among US children over 2 rotavirus seasons after vaccine introduction. Pediatrics 2011;127:e9-e15. https://doi.org/10.1542/peds.2010-1393
  13. do Carmo GM, Yen C, Cortes J, Siqueira AA, de Oliveira WK, Cortez-Escalante JJ, et al. Decline in diarrhea mortality and admissions after routine childhood rotavirus immunization in Brazil: a time-series analysis. PLoS Med 2011;8:e10011024.
  14. Lappalainen S, Ylitalo S, Arola A, Halkosalo A, Rasanen S, Vesikari T. Simultaneous presence of human herpesvirus 6 and adenovirus infections in intestinal intussusception of young children. Acta Paediatr 2012;101:663-70. https://doi.org/10.1111/j.1651-2227.2012.02616.x
  15. Aminu M, Ameh EA, Geyer A, Esona MD, Taylor MB, Steele AD. Role of astrovirus in intussusception in Nigerian infants. J Trop Pediatr 2009;55:192-4. https://doi.org/10.1093/tropej/fmn101
  16. Velazquez FR, Luna G, Cedillo R, Torres J, Munoz O. Natural rotavirus infection is not associated to intussusception in Mexican children. Pediatr Infect Dis 2004;23:S173-8. https://doi.org/10.1097/01.inf.0000142467.50724.de
  17. Chang EJ, Zangwill KM, Lee H, Ward JI. Lack of association between rotavirus infection and intussusception: implications for use of attenuated rotavirus vaccines. Pediatr Infect Dis J 2002;21:97-102. https://doi.org/10.1097/00006454-200202000-00003
  18. Bahl R, Saxena M, Bhandari N, Taneja S, Mathur M, Parashar UD, et al. Population-based incidence of intussusception and a case-control study to examine the association of intussusception with natural rotavirus infection among Indian children. J Infect Dis 2009;200:277-81. https://doi.org/10.1086/605045
  19. Robinson CG, Hernanz-Schulman M, Zhu Y, Griffin MR, Gruber W, Edwards KM. Evaluation of anatomic changes in young children with natural rotavirus infection: is intussusception biologically plausible? J Infect Dis 2004;189:1382-7. https://doi.org/10.1086/382655
  20. Belongia EA, Irving SA, Shui IM, Kulldorff M, Lewis E, Yin R, et al. Real-time surveillance to assess risk of intussusception and other adverse events after pentavalent, bovine-derived rotavirus vaccine. Peidatr Infect Dis J 2010;29:1-5. https://doi.org/10.1097/INF.0b013e3181af8605
  21. Shui IM, Baggs J, Patel M, Parashar UD, Rett M, Belongia EA, et al. Risk of intussusception following administration of a pentavalent rotavirus vaccine in US infants. JAMA 2012;307:598-604.
  22. Yih WK, Lieu TA, Kulldorff M, Martin D, McMahil-Walraven CN, Platt R, et al. Intussusception risk after rotavirus vaccination in U.S. infants. N Engl J Med 2014;370:503-12. https://doi.org/10.1056/NEJMoa1303164
  23. Haber P, Patel M, Pan Y, Baggs J, Haber M, Museru O, et al. Intussusception after rotavirus vaccines reported to US VAERS, 2006-2012. Pediatrics 2013;131:1042-9. https://doi.org/10.1542/peds.2012-2554
  24. Patel MM, Lopez-Collada VR, Bulhoes MM, De Oliviera LH, Bautista Marquez A, Flannery B, et al. Intussusception risk and health benefits of rotavirus vaccination in Mexico and Brazil. N Engl J Med 2011;364:2283-92. https://doi.org/10.1056/NEJMoa1012952
  25. Yen C, Tate JE, Steiner CA, Cortese MM, Patel MM, Parashar UD. Trends in intussusception hospitalizations among US infants before and after implementation of the rotavirus vaccination program, 2000-2009. J Infect Dis 2012;206:41-8. https://doi.org/10.1093/infdis/jis314
  26. Desai R, Curns AT, Steiner CA, Tate JE, Patel MM, Parashar UD. All-cause gastroenteritis and rotavirus-coded hospitalizations among US children, 2000-2009. Clin Infect Dis 2012;55:e28-34. https://doi.org/10.1093/cid/cis443
  27. Choi UY, Lee SY, Ma SH, Lee SY, Jang YT, Kim JY, at al. Epidemiological changes in rotavirus gastroenteritis in children under 5 years of age after the introduction of rotavirus vaccines in Korea. Eur J Pediatr 2013;172:947-52. https://doi.org/10.1007/s00431-013-1974-y
  28. Choe YJ, Yang JJ, Park SK, Choi EH, Lee HJ. Comparative estimation of coverage between national immunization program vaccines and non-NIP vaccines in Korea. J Korean Med Sci 2013;1283-8. https://doi.org/10.3346/jkms.2013.28.9.1283
  29. Jacques LP, Kristina N, Nathalie RC. Host-pathogen co-evolution and glycan interactions. Curr Opin Virol 2014;7:88-94. https://doi.org/10.1016/j.coviro.2014.06.001

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