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Estimated mortality and hospital admission due to rotavirus infection in the WHO European region

  • C. J. WILLIAMS (a1) (a2), A. LOBANOV (a3) and R. G. PEBODY (a1)

In 2006 two rotavirus vaccines were licensed for use in young children in Europe. This study aimed to estimate the mortality and hospital admissions due to rotavirus in children aged <5 years in the WHO European region using data from routine sources and published literature. We grouped 49/52 countries in the region by their World Bank Gross National Income (GNI) per capita. We obtained for children aged <5 years: populations, hospital discharges for diarrhoeal disease, estimated mortality rates and the percentage of deaths attributable to diarrhoeal disease, from WHO data sources or published literature, and combined them to estimate country-specific diarrhoeal disease mortality. Rotavirus-attributable percentages of hospital admissions due to diarrhoeal disease were obtained through a literature search, and an income-group median applied to countries in each GNI category. In the countries we studied in the WHO European region, rotavirus infection causes an estimated 6550 deaths (range 5671–8989) and 146 287 (range 38 374–1 039 843) hospital admissions each year in children aged <5 years. Hospital admission rates were similar across income groups (medians 2·0, 2·8, 4·2 and 1·9/1000 per year in low-, lower-middle-, upper-middle- and high-income countries, respectively). Seven countries, mostly in the low- and lower-middle-income groups, accounted for 93% of estimated deaths. Disease burden varied dramatically by income level in the European region. Rotavirus vaccination in Azerbaijan, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan and Turkey could potentially prevent 80% of all regional rotavirus deaths. Data from low-income countries is still sparse, and improved disease burden studies are required to better inform regional vaccine policy.

Corresponding author
*Author for correspondence: Dr C. J. Williams, Norfolk, Suffolk and Cambridgeshire Health Protection Unit, Norfolk Office, Healthy Living Centre, Thetford Community Healthy Living Centre, Croxton Road, Thetford IP24 1JD, Norfolk, UK. (Email:
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1. T Djuretic , An estimate of the proportion of diarrhoeal disease episodes seen by general practitioners attributable to rotavirus in children under 5 y of age in England and Wales. Acta Paediatrica (Suppl.) 1999; 88: 3841.

3. UD Parashar , Global illness and deaths caused by rotavirus disease in children. Emerging Infectious Diseases 2003; 9: 565572.

4. GM Ruiz-Palacios , Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. New England Journal of Medicine 2006; 354: 1122.

5. T Vesikari , Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. New England Journal of Medicine 2006; 354: 2333.

30. AK Takala , Economic evaluation of rotavirus vaccinations in Finland: randomized, double-blind, placebo-controlled trial of tetravalent rhesus rotavirus vaccine. Clinical Infectious Diseases 1998; 27: 272282.

22. ET Isakbaeva , Rotavirus disease in Uzbekistan: cost-effectiveness of a new vaccine. Vaccine 2007; 25: 373380.

40. A Karadag , Childhood diarrhoea in Ankara, Turkey: epidemiological and clinical features of rotavirus-positive versus rotavirus-negative cases. Scandinavian Journal of Infectious Diseases 2005; 37: 269275.

42. G Szücs , Burden of human rotavirus-associated hospitalizations in three geographic regions of Hungary. Acta Paediatrica (Suppl.) 1999; 88: 6165.

43. K Banyai , Survey of rotavirus infection in a Hungarian paediatric hospital. A short communication. Acta Microbiologica et Immunologica Hungarica 2004; 51: 431435.

47. A Steyer , The emergence of rotavirus genotype G9 in hospitalised children in Slovenia. Journal of Clinical Virology 2005; 33: 711.

50. J Diez-Domingo , Rotavirus gastroenteritis among children under five years of age in Valencia, Spain. Pediatric Infectious Disease Journal 2006; 25: 455457.

51. G Cilla , Incidence, seasonality and serotypes of rotavirus in Gipuzkoa (Basque Country), Spain. A 14-year study. Epidemiology and Infection 2000; 125: 677683.

52. LE Visser , Impact of rotavirus disease in Spain: an estimate of hospital admissions due to rotavirus. Acta Paediatrica (Suppl.), 1999; 88: 7276.

53. F Sanchez , Diversity of group A human rotavirus types circulating over a 4-year period in Madrid, Spain. Journal of Clinical Microbiology 2004; 42: 16091613.

56. R Berner , RF Schumacher , J Forster . Survey on rotavirus infections in a German pediatric hospital. European Journal of Clinical Microbiology & Infectious Diseases 1997; 16: 479481.

58. MJ Ryan , Hospital admissions attributable to rotavirus infection in England and Wales. Journal of Infectious Diseases 1996; 174 (Suppl. 1): S12S18.

59. T Vesikari , T Rautanen , B Von . Rotavirus gastroenteritis in Finland: burden of disease and epidemiological features. Acta Paediatrica (Suppl.), 1999; 88: 2430.

61. K Johansen , Incidence and estimates of the disease burden of rotavirus in Sweden. Acta Paediatrica (Suppl.), 1999; 88: 2023.

62. TK Fischer . Incidence of hospitalizations due to rotavirus gastroenteritis in Denmark. Acta Paediatrica 2001; 90: 10731075.

63. TK Fischer , Incidence and cost of rotavirus hospitalizations in Denmark. Emerging Infectious Diseases 2007; 13: 855859.

64. M Lynch , Rotavirus in Ireland: national estimates of disease burden, 1997 to 1998. Pediatric Infectious Disease Journal 2001; 20: 693698.

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