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Search: authors:"Umesh D. Parashar"

84 papers found.
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Increasing Rates of Gastroenteritis Hospital Discharges in US Adults and the Contribution of Norovirus, 1996–2007

Background. Diarrhea remains an important cause of morbidity, but until the mid 1990s, hospital admissions for diarrhea in the US adult population were declining. We aimed to describe recent trends in gastroenteritis hospitalizations and to determine the contribution of norovirus. Methods. We analyzed all gastroenteritis-associated hospital discharges during 1996–2007 from a...

Projected Impact and Cost-Effectiveness of a Rotavirus Vaccination Program in India, 2008

Background. To assess the value of rotavirus vaccination in India, we determined the potential impact and cost-effectiveness of a national rotavirus vaccination program. Methods. We compared the national rotavirus disease and cost burden with and without a vaccination program and assessed the cost-effectiveness of vaccination. Model inputs included measures of disease and cost...

Influence of birth rates and transmission rates on the global seasonality of rotavirus incidence

Rotavirus is a major cause of mortality in developing countries, and yet the dynamics of rotavirus in such settings are poorly understood. Rotavirus is typically less seasonal in the tropics, although recent observational studies have challenged the universality of this pattern. While numerous studies have examined the association between environmental factors and rotavirus...

Norovirus Disease Surveillance Using Google Internet Query Share Data

Google Internet query share (IQS) data for gastroenteritis-related search terms correlated strongly with contemporaneous national (R2 = 0.70) and regional (R2 = 0.74) norovirussurveillance data in the United States. IQS data may facilitate rapid identification of norovirus season onset, elevated peak activity, and potential emergence of novel strains.

Reduction in Acute Gastroenteritis Hospitalizations among US Children After Introduction of Rotavirus Vaccine: Analysis of Hospital Discharge Data from 18 US States

Background. In 2006, RotaTeq (RV5) was recommended for routine vaccination of United States (US) infants. We compared hospitalization rates for acute gastroenteritis among US children aged <5 years during pre-RV5 rotavirus seasons from 2000 through 2006 with those during the post-RV5 2007 and 2008 seasons. Methods. Using 100% hospital discharge data from 18 states, accounting for...

Etiology of Viral Gastroenteritis in Children <5 Years of Age in the United States, 2008–2009

Background. Although rotavirus and norovirus cause nearly 40% of severe endemic acute gastroenteritis (AGE) in children <5 years of age in the United States, there are limited data on the etiologic role of other enteric viruses in this age group. Methods. We conducted active population-based surveillance in children presenting with AGE to hospitals, emergency departments, and...

Severe Outcomes Are Associated With Genogroup 2 Genotype 4 Norovirus Outbreaks: A Systematic Literature Review

Background. Noroviruses (NoVs) are the most common cause of epidemic gastroenteritis; however, the relative impacts of individual factors underlying severe illness are poorly understood. This report reviews published NoV outbreak reports to quantify hospitalization and mortality rates and assess their relationship with outbreak setting, transmission route, and strain. Methods...

Economic Costs of Rotavirus Gastroenteritis and Cost-Effectiveness of Vaccination in Developing Countries

BackgroundRotavirus is the leading cause of severe gastroenteritis in children worldwide. We evaluated the economic burden of rotavirus and the cost-effectiveness of vaccination from the health care perspective MethodsEstimates were based on existing epidemiological data, cost estimates, vaccine coverage, and efficacy data, as well as hypothetical vaccine prices. Outcome measures...

Rotavirus Vaccination: Cost-Effectiveness and Impact on Child Mortality in Developing Countries

BackgroundRotavirus is the leading cause of severe gastroenteritis in children <5 years of age and is responsible for >500,000 deaths annually; ∼85% of this burden is in low-income countries eligible for financial support from the GAVI Alliance. We projected the uptake, health impact, and cost-effectiveness of introducing rotavirus vaccination in GAVI-eligible countries to help...

Oral Rotavirus Vaccines: How Well Will They Work Where They Are Needed Most?

Rotavirus vaccines hold promise to decrease the burden of severe diarrhea in the poorest countries, where 85% of deaths due to rotavirus occur. However, the potency of live oral vaccines is lower in these challenging settings than in middle- and upper-income countries. Many hypotheses have been suggested to explain these differences that could provide clues to improve the...

Projected Impact of the New Rotavirus Vaccination Program on Hospitalizations for Gastroenteritis and Rotavirus Disease among US Children <5 Years of Age during 2006–2015

BackgroundRotavirus causes approximately one-third to one-half (55,000–70,000 hospitalizations per year) of hospitalizations for acute gastroenteritis (AGE) among US children <5 years of age. We forecasted the potential reduction in the number of hospitalizations for rotavirus disease and AGE in US children during 2006–2015 as a result of the new rotavirus vaccine introduced in...

Rotavirus Vaccines for Infants in Developing Countries in Africa and Asia: Considerations from a World Health Organization–Sponsored Consultation

The World Health Organization (WHO) and its international partners have prioritized the development of rotavirus vaccines for the past 3 decades. In November 2005, the WHO’s Strategic Advisory Group of Experts first reviewed the clinical efficacy data from 2 new live attenuated oral rotavirus vaccines, which demonstrated excellent protective efficacy against severe rotavirus...

Monovalent Rotavirus Vaccine Provides Protection Against an Emerging Fully Heterotypic G9P[4] Rotavirus Strain in Mexico

After the introduction of monovalent rotavirus vaccine (RV1) in Mexico in 2006–2007, diarrhea mortality and morbidity declined substantially among Mexican children under 5 years of age. In January 2010, surveillance identified the emergence of a novel G9P[4] rotavirus strain nationwide. We conducted a case-control study to assess the field effectiveness of RV1 against severe...

Symptomatic Infection and Detection of Vaccine and Vaccine-Reassortant Rotavirus Strains in 5 Children: A Case Series

Vaccine or vaccine-reassortant rotavirus strains were detected in fecal specimens from 5 of 106 (4.7%) immunocompetent children who required treatment for rotavirus gastroenteritis at a large pediatric hospital in Texas in 2009–2010. Four strains were related to pentavalent rotavirus vaccine, whereas one was related to monovalent rotavirus vaccine. The contribution of these...

Understanding Reduced Rotavirus Vaccine Efficacy in Low Socio-Economic Settings

Introduction Rotavirus vaccine efficacy ranges from >90% in high socio-economic settings (SES) to 50% in low SES. With the imminent introduction of rotavirus vaccine in low SES countries, understanding reasons for reduced efficacy in these settings could identify strategies to improve vaccine performance. Methods We developed a mathematical model to predict rotavirus vaccine...

A Retrospective Evaluation of Hospitalizations for Acute Gastroenteritis at 2 Sentinel Hospitals in Central Japan to Estimate the Health Burden of Rotavirus

BackgroundTwo rotavirus vaccines have recently been licensed for use in >80 countries worldwide but not in Japan. To assess the value of introducing rotavirus vaccination in Japan, data on the burden of rotavirus disease are needed MethodsTo describe the epidemiology of severe rotavirus disease among Japanese children aged <5 years, we examined retrospective demographic, clinical...

Global Mortality Associated with Rotavirus Disease among Children in 2004

BackgroundAs new rotavirus vaccines are being introduced in immunization programs, global and national estimates of disease burden, especially rotavirus-associated mortality, are needed to assess the potential health benefits of vaccination and to monitor vaccine impact MethodsWe identified 76 studies that were initiated after 1990, lasted at least 1 full year, and examined...

Evaluation of seasonal patterns of Kawasaki Syndrome- and rotavirus-associated hospitalizations in California and New York, 2000-2005

Background Kawasaki Syndrome (KS) is an uncommon childhood disease with unknown etiology. It has been suggested that rotavirus infection may play a causative role in the development of KS. Methods To examine potential temporal associations between KS and rotavirus infection, seasonal patterns of KS- and rotavirus-associated hospitalizations among children in California and New...

Potential Intussusception Risk Versus Health Benefits From Rotavirus Vaccination in Latin America

Background. With the recent postlicensure identification of an increased risk of intussusception with rotavirus vaccine, the 14 Latin American countries currently using rotavirus vaccine must now weigh the health benefits versus risks to assess whether to continue vaccination. To inform policy considerations, we estimated excess intussusception cases and mortality potentially...