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Author Notes:

Aisleen Bennett, Institute of Infection and Global Health, The Ronald Ross Building, University of Liverpool, 8 West Derby Street, Liverpool L69 7BE, UK abennett@sgul.ac.uk

The authors thank all infants and their families who participated, all members of the Rotavirus Response to Immunisation and Transmission Epidemiology (RotaRITE) study team, the Malawi Ministry of Health, and clinical staff at the recruitment sites. Aspects of this work have been presented at the European Society for Paediatric Infectious Diseases (ESPID) meeting, June 2018, Sweden.

K. C. J. is supported by an International Wellcome Trust Training Fellowship (grant number: 201945/Z/16/Z). N. B.-Z. and K. C. J. have received research grant support from GlaxoSmithKline Biologicals for work on rotavirus vaccines. B. L. reports personal fees from Takeda Pharmaceuticals, personal fees from the Centers for Disease Control and Prevention Foundation, and personal fees from Hall Booth Smith PC, all unrelated to rotavirus vaccines. M. I.-G. has received research grant support from GlaxoSmithKline Biologicals and Sanofi Pasteur MSD for work on rotavirus; is affiliated with the National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections at University of Liverpool, in partnership with Public Health England and in collaboration with the University of East Anglia, University of Oxford, and the Quadram Institute; and is based at The University of Liverpool. N. A. C. has received research grant support and honoraria for participation in rotavirus vaccine advisory board meetings from GlaxoSmithKline Biologicals. V. E. P. is a member of the World Health Organization Immunization and Vaccine-Related Implementation Research Advisory Committee and has received reimbursement from Merck for travel expenses to attend a Scientific Input Engagement unrelated to rotavirus vaccines. All other authors report no potential conflicts.

Subjects:

Research Funding:

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:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • Microbiology
  • rotavirus
  • transmission
  • vaccine effectiveness
  • shedding
  • INFECTION
  • DISEASE
  • IMPACT

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

Journal Title:

JOURNAL OF INFECTIOUS DISEASES

Volume:

Volume 222, Number 12

Publisher:

, Pages 2035-2040

Type of Work:

Article | Final Publisher PDF

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.

Copyright information:

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/rdf).
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