Duration and Density of Fecal Rotavirus Shedding in Vaccinated Malawian Children With Rotavirus Gastroenteritis

• Type of Material: Article
• Authors: Aisleen Bennett, University of Malawi; Louisa Pollock, University of Malawi; Khuzwayo C. Jere, University of Malawi; Virginia E. Pitzer, Yale University; Benjamin Lopman, Emory University; Naor Bar-Zeev, University of Malawi; Miren Iturriza-Gomara, University of Malawi; Nigel A. Cunliffe, University of Malawi
• Language: English
• Date: 2020-12-15
• Publisher: OXFORD UNIV PRESS INC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/infdis/jiz612
• Title of Journal or Parent Work: JOURNAL OF INFECTIOUS DISEASES
• Volume: 222
• Issue: 12
• Start Page: 2035
• End Page: 2040
• Grant/Funding Information: This work was supported by Wellcome Trust Clinical PhD Fellowships (grant numbers 102466/Z/13/A to A. B. and 102464/Z/13/A to L. P.); the Wellcome Trust Programme (grant number 091909/Z/10/Z); the Malawi Liverpool Wellcome Trust (MLW) Programme Core Grant Strategic Award (grant number 101113/Z/13/Z); and the US National Institutes of Health (grant number R01-AI112970 to V. E. P.).
• Keywords: Life Sciences & Biomedicine; Science & Technology; vaccine effectiveness; INFECTION; rotavirus; Infectious Diseases; Immunology; transmission; Microbiology; DISEASE; shedding; IMPACT
• Research Categories: Biology, Microbiology; Health Sciences, Immunology; Biology, Virology

Abstract

Quantifying rotavirus shedding among vaccinated individuals will aid understanding of vaccine indirect effects. Serial stool samples were collected from 196 children who presented with rotavirus gastroenteritis to health facilities in Blantyre, Malawi, and were tested for rotavirus using a VP6 semi-quantitative, real-time polymerase chain reaction. The median duration of fecal shedding was 28 days (95% CI, 19-28). The median copy numbers for peak shedding were 1.99 × 107 (interquartile range, 3.39 × 106 to 6.37 × 107). The fecal viral load was positively associated with disease severity and negatively associated with serum anti-rotavirus immunoglobin A. High and persistent rotavirus shedding among vaccinated children with breakthrough disease may contribute to ongoing transmission in this setting.