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Case-Control Study of Risk Factors for Human Infection with a New Zoonotic Paramyxovirus, Nipah Virus, during a 1998–1999 Outbreak of Severe Encephalitis in Malaysia

An outbreak of encephalitis affecting 265 patients (105 fatally) occurred during 1998–1999 in Malaysia and was linked to a new paramyxovirus, Nipah, that infected pigs, humans, dogs, and cats. Most patients were pig farmers. Clinically undetected Nipah infection was noted in 10 (6%) of 166 community-farm controls (persons from farms without reported encephalitis patients) and 20...

Enteropathogens and Other Factors Associated with Severe Disease in Children with Acute Watery Diarrhea in Lima, Peru

To evaluate enteropathogens and other factors associated with severe disease in children with diarrhea, 381 children <5 years of age with diarrhea and moderate to severe dehydration (in-patients) and 381 age-, sex-, and date-of-visit—matched children with mild diarrhea (out-patients) presenting to a hospital in Peru, were studied. Rotavirus was detected in 52% of the in-patients...

Deaths of Children during an Outbreak of Hand, Foot, and Mouth Disease in Sarawak, Malaysia: Clinical and Pathological Characteristics of the Disease

From April through June 1997, 29 previously healthy children aged <6 years (median, 1.5 years) in Sarawak, Malaysia, died of rapidly progressive cardiorespiratory failure during an outbreak of hand, foot, and mouth disease caused primarily by enterovirus 71 (EV71). The case children were hospitalized after a short illness (median duration, 2 days) that usually included fever (in...

Hospital-Based Study of the Economic Burden Associated with Rotavirus Diarrhea in Hong Kong

Background Rotavirus infection is the most common cause of severe diarrhea in both developed and developing countries.

Traveler's Diarrhea at Sea: Three Outbreaks of Waterborne Enterotoxigenic Escherichia coli on Cruise Ships

Enterotoxigenic Escherichia coli (ETEC) has become the leading bacterial cause of gastroenteritis outbreaks on cruise ships. Investigation of recent outbreaks of ETEC gastroenteritis on 3 cruise ships indicated that all were associated with consuming beverages with ice cubes on board the ship (relative risk [RR], 1.4, 95% confidence interval [CI], 1.0–1.9, P = .02; RR, 1.9, 95...

The Epidemiology of Enteric Caliciviruses from Humans: A Reassessment Using New Diagnostics

In the United States, acute gastroenteritis is one of the most commonly noted illnesses on hospital discharge records and death certificates, yet few of these cases have an etiologic diagnosis. The application of new molecular diagnostic methods has shown caliciviruses (previously referred to as the Norwalk family of viruses or small round structured viruses) to be the most...

A Cohort Study of Health Care Workers to Assess Nosocomial Transmissibility of Nipah Virus, Malaysia, 1999

During 1998–1999, an outbreak of Nipah virus encephalitis occurred in Malaysia. To assess the possibility of nosocomial transmission, 338 health care workers (HCWs) exposed and 288 HCWs unexposed to outbreak-related patients were surveyed, and their serum samples were tested for anti–Nipah virus antibody. Needlestick injuries were reported by 12 (3%) HCWs, mucosal surface...

Epidemiologic and Molecular Trends of “Norwalk-like Viruses” Associated with Outbreaks of Gastroenteritis in the United States

Between July 1997 and June 2000, fecal specimens from 284 outbreaks of nonbacterial gastroenteritis were submitted to the Centers for Disease Control and Prevention for testing for “Norwalk-like viruses” (NLVs). Specimens were examined by reverse-transcription polymerase chain reaction and direct electron microscopy for the presence of NLVs. Adequate descriptive data were...

Development of Candidate Rotavirus Vaccines Derived from Neonatal Strains in India

The need for a rotavirus vaccine in India is based on the enormous burden associated with the >100,000 deaths due to rotavirus diarrhea that occur annually among Indian children. Two rotavirus strains identified during nosocomial outbreaks of rotavirus infection in New Delhi and Bangalore, India, more than a decade ago are being developed as live oral vaccines. Infected newborns...

Estimates of Rotavirus Disease Burden in Hong Kong: Hospital-Based Surveillance

Background We conducted prospective, hospital-based surveillance for rotavirus disease for a 2-year period at 4 of 12 public government (Hospital Authority [HA]) hospitals in Hong Kong. It has been estimated that HA hospitals provide 90% of inpatient care in Hong Kong.

Serotype Diversity and Reassortment between Human and Animal Rotavirus Strains: Implications for Rotavirus Vaccine Programs

The development of rotavirus vaccines that are based on heterotypic or serotype-specific immunity has prompted many countries to establish programs to assess the disease burden associated with rotavirus infection and the distribution of rotavirus strains. Strain surveillance helps to determine whether the most prevalent local strains are likely to be covered by the serotype...

Hospitalizations Associated with Rotavirus Diarrhea in the United States, 1993 through 1995: Surveillance Based on the New ICD-9-CM Rotavirus-Specific Diagnostic Code

The introduction of a specific International Classification of Diseases code for rotavirus diarrhea in 1992 prompted examination of the National Hospital Discharge Survey (NHDS) for trends in rotavirus-associated hospitalizations among US children aged 1 month through 4 years. During 1993–1995, 13.5% of hospitalizations were associated with diarrhea (n = 162,478/year). Rotavirus...

Human Caliciviruses as a Cause of Severe Gastroenteritis in Peruvian Children

To define the role of human caliciviruses (HuCVs) in severe childhood gastroenteritis, fecal and paired serum samples from 233 Peruvian children hospitalized with gastroenteritis (case patients) and fecal samples from 248 control subjects were evaluated. Overall, 128 case patients (55%) demonstrated HuCV infection by either fecal (n=81 [35%]) or np81 serological (n= 96 [41...

Rotavirus Vaccines: Targeting the Developing World

For the past 2 decades, rotavirus infection, the most common cause of severe diarrhea in children, has been a priority target for vaccine development. This decision to develop rotavirus vaccines is predicated on the great burden associated with fatal rotavirus disease (i.e., 440,000 deaths/year), the firm scientific basis for developing live oral vaccines, the belief that...

Multicenter, Hospital-Based Surveillance of Rotavirus Disease and Strains among Indian Children Aged <5 Years

BackgroundCurrent, nationally representative data on rotavirus disease burden and rotavirus strains in India are needed to understand the potential health benefits of rotavirus vaccination MethodsThe Indian Rotavirus Strain Surveillance Network was established with 4 laboratories and 10 hospitals in 7 different regions of India. At each hospital, children aged <5 years who...

Rotavirus Burden among Children in the Newly Independent States of the Former Union of Soviet Socialist Republics: Literature Review and First-Year Results from the Rotavirus Surveillance Network

BackgroundData on rotavirus burden among children in the 15 newly independent states of the former Union of Soviet Socialist Republics, particularly contemporary data from poorer countries, are not widely available. These data are desired by policy makers to assess the value of rotavirus vaccination, especially since the GAVI Alliance approved financial support for the region’s...

Population-Based Incidence of Intussusception and a Case-Control Study to Examine the Association of Intussusception with Natural Rotavirus Infection among Indian Children

BackgroundA rotavirus vaccine previously licensed in the United States was withdrawn because it caused intussusception. Data on background intussusception rates in developing countries are required to plan pre- and postlicensure safety studies for new rotavirus vaccines. Also, it is unclear whether natural rotavirus infection is associated with intussusception MethodsPassive...

Projected Cost-Effectiveness of Rotavirus Vaccination for Children in Asia

Background New rotavirus vaccines may soon be licensed, and decisions regarding implementation of their use will likely be based on the health and economic benefits of vaccination.

Direct and Indirect Effects of Rotavirus Vaccination: Comparing Predictions from Transmission Dynamic Models

Early observations from countries that have introduced rotavirus vaccination suggest that there may be indirect protection for unvaccinated individuals, but it is unclear whether these benefits will extend to the long term. Transmission dynamic models have attempted to quantify the indirect protection that might be expected from rotavirus vaccination in developed countries, but...

Effectiveness of Pentavalent and Monovalent Rotavirus Vaccines in Concurrent Use Among US Children <5 Years of Age, 2009–2011

. Parashar 0 6 0 Received 7 December 2012; accepted 4 March 2013; electronically published 13 March 2013. and Respiratory Diseases, Division of Viral Diseases, Epidemiology Branch, US Centers for Disease