• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제12권sup1호
• /
• pp.72-76
• /
• 2009

Rotavirus infection is the leading cause of severe diarrhea disease in infants and young children worldwide. Rotavirus infects every child at least once by her/his $5^{th}$ birthday. It has been known that single episode of rotavirus infection can protect or alleviate subsequent illness caused by both homotypic and heterotypic rotaviruses. There are two currently licensed rotavirus vaccines. One is human-bovine rotavirus reassortant pentavalent vaccine ($RotaTeq^{TM}$), which contains five reassortant rotavirus (expressing protein G1, G2, G3, G4 and P[8]) and was licensed in Korea for use among infants in 2007. Another is live-attenuated human rotavirus vaccine ($Rotarix^{TM}$) derived from 89-12 strain which represents the most common of the human rotavirus VP7(G1) and VP4(P[8]) antigens. $Rotarix^{TM}$ was licensed in Korea in 2008. Both live oral rotavirus vaccines are efficacious in preventing severe rotavirus gastroenteritis.

• Pediatric Infection and Vaccine
• /
• 제16권2호
• /
• pp.115-122
• /
• 2009

Diarrhea is one of the most common causes of morbidity and mortality in children worldwide. Rotavirus is the most common cause of infectious diarrhea both in developed and developing countries. However, bacterial causes such as Salmonella typhi and Vibrio cholerae still play an important role in developing countries. Newly developed vaccines for rotavirus, S. typhi, and V. choleae are highly immunogenic and safe in children.

• Pediatric Infection and Vaccine
• /
• 제15권1호
• /
• pp.5-11
• /
• 2008

Primary rotavirus gastroenteritis infection usually occurs in infants under 2 years of age worldwide regardless of level of hygiene, quality of water, food or sanitation or type of behavior. In Korea, the disease mostly occurred in infants under 2 year old, and usually in late fall to early winter with the highest incidence shown in November until early 1990s. However, since then, relatively the age incidence of this infection has increased in children over 2 years old, and it has mainly occurred in late winter to early spring with the highest incidence shown between February and March. And rotavirus gastroenteritis serotypes varied year to year as well as varied by year within the same region in our country. The comparison of severity scores between age groups in Korea showed that severity score was lowest in infants less than 3 months and highest in infants more than 6 months and less than 12 months, and hospitalization period between age groups was longest in infants older than 3 months and less than 3 months and highest in infants more than 6 months and less than 12 months and less than 6 months. In this aspect, rotavirus vaccines should be given to infants less than 2 years of age in whom the incidence of rotavirus gastroenteritis is the highest, and vaccination should be ideally started before 3 months considering hospitalization period and severity of rotavirus gastroenteritis. However, It should be careful for the introduction of new rotavirus vaccine, and the effectiveness of rotavirus vaccines should be assessed by long-term post marketing surveillance. And we guess an multivalent vaccine may be an ideal rotavirus vaccine to prevent primary infection caused by variable rotavirus strains in Korea. In addition, clinical epidemiology studies on rotavirus gastroenteritis which evaluate the age and serotypes related severity should be continuously conducted in various regions.

• Pediatric Infection and Vaccine
• /
• 제25권1호
• /
• pp.26-34
• /
• 2018

목적: 로타바이러스(rotavirus [RV]) 백신 도입에 따른 소아 입원 환자에서의 로타바이러스 장염(rotavirus gastroenteritis [RGE]) 발생 변화와 백신 효과를 추정하였다. 방법: 2014-2015년과 2004-2005년, 두 기간 동안 한양대학교 서울병원 소아청소년과에 급성 장염(acute gastroenteritis [AGE])으로 입원한 환자의 자료를 후향적으로 비교 분석하였다. 백신 효과는 환자 검사-음성 대조군 연구를 통해 추정하였다. 결과: AGE에서의 RGE 비율은 2004-2005년(22.7%)에 비해 2014-2015년(9.0%)에 유의하게 감소하였다(P<0.001). 2014-2015년 RV 백신 완전접종률은 66.0%, 불완전접종률은 6.2%로, 백신의 예방 효과는 완전접종자에서 83.3% (95% confidence interval [CI], 60.5%-92.9%), 불완전접종자에서는 27.4% (95% CI, -163.7%-80.0%)였다. 결론: RV 백신이 도입된 이후 RGE 발생이 뚜렷이 감소하였다. 백신접종률을 향상시킴으로써 RGE로 인한 질병 부담을 더욱 낮출 수 있을 것으로 기대된다.

• 한국동물위생학회지
• /
• 제35권2호
• /
• pp.83-90
• /
• 2012

Porcine rotaviruses are the most common causes of viral gastroenteritis in piglets around the world. The major G genotypes of porcine rotaviruses causing diarrhea were G4, G5 and G11 genotypes. Recently, G9 genotype rotaviruses were problemed at swine farms and frequently recognized from diarrheic piglets. In this study, a porcine rotavirus (PoRV-1) was isolated from piglet showing diarrhea using MA104 cells and confirmed as rotavirus by electron microscopy, genomic RNA electropherotyping and indirect immunofluorescence antibody tests. The nucleotide sequence of the VP7 gene of PoRV-1 was determined and compared with those of other genotype rotavirus strains from other parts of the world. Also, the nucleotide sequences of VP4, VP6 and NSP4 genes of PoRV-1 were determined and compared with those of other rotavirus strains from other countries. The results showed that the PoRV-1 isolate belonged to the G9 genotype and the P, I and E genotypes of PoRV-1 were P[23], I5 and E1, respectively. The Korean G9 PoRV-1 isolate and its nucleotide sequence data would be usefully used for the development of porcine rotavirus vaccines in near future.

• Clinical and Experimental Pediatrics
• /
• 제56권11호
• /
• pp.465-473
• /
• 2013

The epidemiology of human group A rotavirus was analyzed by examining genotypic data acquired from 1989 to 2009 in South Korea. This information was derived from all the available published articles on rotavirus studies in South Korea, retrieved from both the PubMed and KoreaMed databases. Four common G types (G1, G2, G3, and G4) and three common P types (P[8], P[4], and P[6]) accounted for approximately 93% and 99% of the rotavirus reports, respectively. The G9 type was frequently detected after 2000, and because of this prevalence, it is considered to be the fifth most important G type rotavirus after the G1-G4 genotypes. Less common G types of the virus such as G12, G11, and G10 were detected in some geographic settings, and it is important to consider the context of these subtypes and their epidemiological significance. The P[9] virus genotype was observed in the study and has been discussed in many other studies; however, the P[3], P[10] and P[25] genotypes were rarely detected in the epidemiological research. In general, the distributions of the G and P genotypes showed temporal and geographical fluctuations, and a nationwide rotavirus vaccine program that targeted these genotypes demonstrated effectiveness in protecting against the circulating rotavirus strains. However, further analysis is needed to determine the true long-term effectiveness of these vaccines; the analysis should also consider the unexpected effects of vaccinations, such as vaccineinduced diseases, herd immunity, and changes in host susceptibilities.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제3권1호
• /
• pp.41-46
• /
• 2000

목 적: 설사 환아에서 rotavirus 장염의 빈도는 매우 높으며 rotavirs에 대한 예방 접종이 실용화되었으나 국내 rotavirus 혈청형 분포에 대한 체계적인 연구 결과는 매우 드물고, 혈청형의 정확한 분포비율도 아직까지는 알려져 있지 않다. Rotavirus 설사 환아의 G 혈청형 분포를 RT-PCR 기법을 이용하여 조사하였다. 대상 및 방법: 1998년 6월부터 1999년 5월까지 설사를 주소로 내원 또는 입원한 소아 202명을 대상으로 하였다. 설사 시작 후 3일 이내의 대변을 채취하여 영하 $20^{\circ}C$의 냉동고에 보존하였다. EIA(TestPack Rotavirus, Abbott Laboratories)법으로 rotavirus 양성인 검체를 선별하였으며, 양성 반응을 보인 검체를 대상으로하여 RT-PCR을 이용하여 rotavirus G serotype을 결정하였다. 결 과: 총 202 검체 중에서 rotavirus 양성은 95례였으며, 이 중 serotype 판정이 가능했던 것은 50례이었다. G serotype 1이 5례(10%), 2 (G2)가 5례(10%), 3 (G3)가 14례(28%), 4 (G4)가 13례(26%), 9(G9)이 10례(20%)였으며, G1과 G9이 함께 있는 것과, G2과 G9이 함께 있는 것, G4와 G9이 함께 있는 경우가 각 1례씩 있었다. G8은 발견되지 않았다. 결 론: 국내에 기존에는 알려지지 않았던 G9이 상당수 있으며, 일반적으로 제일 많다고 알려진 G1보다 G3, G4가 더 많은 비율을 차지하는 등 이번 연구 결과는 기존에 발표되었던 자료와는 많은 상이점을 보인다. 이는 지역적인 요인 및 시기 상의 일시적인 현상이라고 볼 수도 있으나, 보다 정확한 역학적인 자료를 얻기 위해서는 보다 광범위하고 장기적인 조사가 필요할 것으로 판단된다.

• 보건의료기술평가
• /
• 제6권2호
• /
• pp.148-155
• /
• 2018

Objectives: Rotavirus is one of the main causes of severe diarrhea in children under five. Two types of rotavirus vaccines [$Rotarix^{(R)}$ (RV1) and $Rotateq^{(R)}$ (RV5)] have been introduced and its administration was optional in South Korea. A systematic review (SR) on economic evaluation (EE) of RV was conducted to examine whether the introduction of rotavirus vaccine to national vaccine program (NIP) is cost-effective. Methods: Previous SR studies of EE for RV were searched in August 2017 through databases such as MEDLINE and EMBASE. Additional search was performed to include literatures published after or unincluded in the previous SR studies. Among the 11 SR studies identified, 2 studies were reviewed via inclusion/exclusion criteria. A previous SR study including 104 original articles was selected by A MeaSurement Tool to Assess systematic Reviews. Among the 36 original articles identified through additional search, 10 were selected, resulting in 114 studies included in our analysis. Results: RV1-only, RV5-only, and evaluating-both studies account for about 44%, 22%, and 33%, respectively. Among RV1-only, RV5-only, or evaluating-both studies, 90%, 64%, or 68% of the studies concluded RV as being cost-effective, respectively. RV5-only studies were usually executed in high-income countries (68%), whereas RV1-only studies were executed mostly in lower (32%) and upper (26%) middle-income countries. When classifying studies by their funding sources, RV1-only studies (82%; 28 of 34 studies specifying funding sources) were chiefly supported by non-profit organization, and 100% of these studies were concluded as being cost-effective. RV5-only studies were mostly supported by profit organization (68%; 13 of 19 studies specifying sources), and 92% of these studies concluded as being cost-effective. Conclusion: By reviewing global EE studies for RV, we have learned that about 70% of these studies was shown to be cost-effective and RV1 appeared to be more cost-effective than RV5.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제14권2호
• /
• pp.148-154
• /
• 2011

목적: 저자들은 지역사회에서, 로타바이러스 장염에 걸린 소아들에서 질환의 중증도와 로타바이러스 VP7 유전형과 VP4 유전형의 분포에 대해 알아보고자 하였다. 방법: 2007년 12월부터 2008년 6월까지 로타바이러스 장염으로 병원에 입원한 156명의 소아들에서 대변 샘플을 수집하였다. 모든 환자들에 대한 질환 중증도는 Vesikari 점수를 이용하여 평가하였다. 로타바이러스 ds-RNA를 분리한 후, 역전사 중합효소 연쇄반응과 다중 중합효소 연쇄반응을 이용하여 cDNA를 합성하였다. 마지막으로 유전형을 확인하였다. 결과: 156명의 환자 샘플에서, VP7(G)는 147명(94.2%)에서 확인되었고 VP4(P)는 140명(89.7%)에서 확인되었다. G1 유전형(147명 중 116명; 78.9%)과 P[8] 유전형(140명 중 137명)이 각각 가장 많았다. VP7과 VP4 조합형은 138명에서 확인할 수 있었는데, G1P[8] 조합형이 111명(80.4)으로 가장 많았다. 다른 조합형들은 종류가 다양하였고 분포가 낮았다. 전체 조합형 중 9.4%가 새로운 로타바이러스 백신에 포함되지 않은 것이었다. 로타바이러스 장염의 질환 중중도는 $11.8{\pm}3.3$ ($mean{\pm}2SD$)였다. 전체 환자에서 경증 내지 중등도가 37.8%였고, 중증은 62.2%였다. 결론: 로타바이러스 유전자 조합형 중 가장 흔한 것은 G1P[8]이었다. 새로운 백신에 포함되지 않은 유전자 조합형은 9.4%였다. 로타바이러스 장염으로 입원한 소아들의 질환 중증도분포는 경증과 중등도보다 중증에서 높게 나타났다.

• Pediatric Infection and Vaccine
• /
• 제15권1호
• /
• pp.1-4
• /
• 2008

Immunizations are among the most cost-effective and widely used public health interventions. This is a report a revision of recommendation of immunization for children by Korean Pediatric Society. Immunization. Vaccines were divided into 4 groups. 1) Vaccines that are recommended to all infants and children (BCG, hepatitis B vaccine, DTaP, Td, Polio vaccine, Japanese encephalitis vaccine, MMR, varicella vaccine, influenza vaccine [6-23 months of age], H. influenzae type b vaccine), 2) those that can be administered to all infants and children, but decision of administration is made by parents (pneumococcal conjugate vaccine, hepatitis A vaccine, influenza vaccine [healthy children ${\geq}24$ months of age], rotavirus vaccine, human papilloma virus vaccine), 3) those that should be given to high risk group (pneumococcal polysaccharide vaccine [high risk patients ${\geq}24$ months of age], influenza vaccine [high risk patients ${\geq}24$ months of age], typhoid vaccine), and 4) those administered for control of outbreaks or prevention of emerging infectious diseases. Immunization schedule recommended by Korean Pediatric Society in 2008 is presented.