Changing molecular epidemiology of rotavirus infection after introduction of monovalent rotavirus vaccination in Scotland

Indrani Mukhopadhya, Heather Murdoch, Susan Berry, Alison Hunt, Miren Iturriza-Gomara, Alison Smith-Palmer, J Claire Cameron, Georgina L Hold

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Rotaviruses (RV) are the leading cause of gastroenteritis in children less than five years of age worldwide. Rotarix®, a live attenuated monovalent vaccine containing a RV strain of G1P[8] specificity has been included in the childhood immunisation schedule from June 2013 in Scotland. This study aimed to characterise the prevalent RV strains in Scotland before and after the introduction of the RV vaccine.

METHODS: RV positive faecal samples from Scottish virology laboratories covering the years 2012-2015 were genotyped. Viral RNA was extracted from faecal suspensions. VP7 and VP4 gene specific primers were used for multiplex hemi-nested PCRs and sequencing. Mann-Whitney U test and Chi-square test were used for statistical comparison.

RESULTS: There was a decrease in RV positive samples from the Scottish virology laboratories from 7409 samples in the pre-vaccination years (2009-2013) to 760 in 2014-2015, with an annual reduction of RV infections by 74.4% (RR-3.95; 95%-CI, 3.53-4.42, p<0.001). 362 samples from the pre-vaccination period and 278 samples from the post-vaccination were genotyped. There was a drop in prevalence of G1P[8] strains (72.1%, 95%-CI, 67.42-76.33 to 15%, 95%-CI, 11.38-19.79) after introduction of the vaccine. In the post-vaccination period G2P[4] was the dominant strain in Scotland (21.9%, 95%-CI, 17.48-27.17) with increase in G9P[8] (12.9%, 95%-CI, 9.50-7.41), G12P[8] (12.2%, 95%-CI, 8.89-16.60) and G3P[8] (11.9%, 95%-CI, 8.58-16.20) infections. Phylogenetic analysis of the VP7 and VP4 genes showed no major differences between the pre and post-vaccination G1P[8] strains.

CONCLUSION: This laboratory based surveillance study shows significant reduction in reported RV cases and a shift in proportion from G1P[8] to G2P[4] strains after introduction of RV vaccination in Scotland. The genotyping data from a subset of the total reported RV cases will be used to ascertain cross protection against strains and identify vaccine induced RV strain shifts in the years to come.

Original languageEnglish
Pages (from-to)156-163
Number of pages8
JournalVaccine
Volume35
Issue number1
Early online date18 Nov 2016
DOIs
Publication statusPublished - 3 Jan 2017

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Rotavirus Infections
molecular epidemiology
Molecular Epidemiology
Rotavirus
Scotland
Vaccination
vaccination
infection
Rotavirus Vaccines
Virology
virology
live vaccines
vaccines
Cross Protection
Immunization Schedule
Attenuated Vaccines
sampling
Viral RNA
Gastroenteritis
Chi-Square Distribution

Keywords

  • Rotavirus
  • Genotyping
  • Rotavirus vaccine
  • Rotarix®®
  • Scotland

Cite this

Changing molecular epidemiology of rotavirus infection after introduction of monovalent rotavirus vaccination in Scotland. / Mukhopadhya, Indrani; Murdoch, Heather; Berry, Susan; Hunt, Alison; Iturriza-Gomara, Miren; Smith-Palmer, Alison; Cameron, J Claire; Hold, Georgina L.

In: Vaccine, Vol. 35, No. 1, 03.01.2017, p. 156-163.

Research output: Contribution to journalArticle

Mukhopadhya, Indrani ; Murdoch, Heather ; Berry, Susan ; Hunt, Alison ; Iturriza-Gomara, Miren ; Smith-Palmer, Alison ; Cameron, J Claire ; Hold, Georgina L. / Changing molecular epidemiology of rotavirus infection after introduction of monovalent rotavirus vaccination in Scotland. In: Vaccine. 2017 ; Vol. 35, No. 1. pp. 156-163.
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title = "Changing molecular epidemiology of rotavirus infection after introduction of monovalent rotavirus vaccination in Scotland",
abstract = "BACKGROUND: Rotaviruses (RV) are the leading cause of gastroenteritis in children less than five years of age worldwide. Rotarix{\circledR}, a live attenuated monovalent vaccine containing a RV strain of G1P[8] specificity has been included in the childhood immunisation schedule from June 2013 in Scotland. This study aimed to characterise the prevalent RV strains in Scotland before and after the introduction of the RV vaccine.METHODS: RV positive faecal samples from Scottish virology laboratories covering the years 2012-2015 were genotyped. Viral RNA was extracted from faecal suspensions. VP7 and VP4 gene specific primers were used for multiplex hemi-nested PCRs and sequencing. Mann-Whitney U test and Chi-square test were used for statistical comparison.RESULTS: There was a decrease in RV positive samples from the Scottish virology laboratories from 7409 samples in the pre-vaccination years (2009-2013) to 760 in 2014-2015, with an annual reduction of RV infections by 74.4{\%} (RR-3.95; 95{\%}-CI, 3.53-4.42, p<0.001). 362 samples from the pre-vaccination period and 278 samples from the post-vaccination were genotyped. There was a drop in prevalence of G1P[8] strains (72.1{\%}, 95{\%}-CI, 67.42-76.33 to 15{\%}, 95{\%}-CI, 11.38-19.79) after introduction of the vaccine. In the post-vaccination period G2P[4] was the dominant strain in Scotland (21.9{\%}, 95{\%}-CI, 17.48-27.17) with increase in G9P[8] (12.9{\%}, 95{\%}-CI, 9.50-7.41), G12P[8] (12.2{\%}, 95{\%}-CI, 8.89-16.60) and G3P[8] (11.9{\%}, 95{\%}-CI, 8.58-16.20) infections. Phylogenetic analysis of the VP7 and VP4 genes showed no major differences between the pre and post-vaccination G1P[8] strains.CONCLUSION: This laboratory based surveillance study shows significant reduction in reported RV cases and a shift in proportion from G1P[8] to G2P[4] strains after introduction of RV vaccination in Scotland. The genotyping data from a subset of the total reported RV cases will be used to ascertain cross protection against strains and identify vaccine induced RV strain shifts in the years to come.",
keywords = "Rotavirus, Genotyping, Rotavirus vaccine, Rotarix{\circledR}{\circledR}, Scotland",
author = "Indrani Mukhopadhya and Heather Murdoch and Susan Berry and Alison Hunt and Miren Iturriza-Gomara and Alison Smith-Palmer and Cameron, {J Claire} and Hold, {Georgina L}",
note = "Acknowledgement The study was funded by Health Protection Scotland. The authors thank the Scottish regional virology departments of Aberdeen, Dundee, Inverness, Fife, Glasgow, Glasgow paediatric (Yorkhill) and Edinburgh for their participation in this study and providing the RV positive faecal samples.",
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}

TY - JOUR

T1 - Changing molecular epidemiology of rotavirus infection after introduction of monovalent rotavirus vaccination in Scotland

AU - Mukhopadhya, Indrani

AU - Murdoch, Heather

AU - Berry, Susan

AU - Hunt, Alison

AU - Iturriza-Gomara, Miren

AU - Smith-Palmer, Alison

AU - Cameron, J Claire

AU - Hold, Georgina L

N1 - Acknowledgement The study was funded by Health Protection Scotland. The authors thank the Scottish regional virology departments of Aberdeen, Dundee, Inverness, Fife, Glasgow, Glasgow paediatric (Yorkhill) and Edinburgh for their participation in this study and providing the RV positive faecal samples.

PY - 2017/1/3

Y1 - 2017/1/3

N2 - BACKGROUND: Rotaviruses (RV) are the leading cause of gastroenteritis in children less than five years of age worldwide. Rotarix®, a live attenuated monovalent vaccine containing a RV strain of G1P[8] specificity has been included in the childhood immunisation schedule from June 2013 in Scotland. This study aimed to characterise the prevalent RV strains in Scotland before and after the introduction of the RV vaccine.METHODS: RV positive faecal samples from Scottish virology laboratories covering the years 2012-2015 were genotyped. Viral RNA was extracted from faecal suspensions. VP7 and VP4 gene specific primers were used for multiplex hemi-nested PCRs and sequencing. Mann-Whitney U test and Chi-square test were used for statistical comparison.RESULTS: There was a decrease in RV positive samples from the Scottish virology laboratories from 7409 samples in the pre-vaccination years (2009-2013) to 760 in 2014-2015, with an annual reduction of RV infections by 74.4% (RR-3.95; 95%-CI, 3.53-4.42, p<0.001). 362 samples from the pre-vaccination period and 278 samples from the post-vaccination were genotyped. There was a drop in prevalence of G1P[8] strains (72.1%, 95%-CI, 67.42-76.33 to 15%, 95%-CI, 11.38-19.79) after introduction of the vaccine. In the post-vaccination period G2P[4] was the dominant strain in Scotland (21.9%, 95%-CI, 17.48-27.17) with increase in G9P[8] (12.9%, 95%-CI, 9.50-7.41), G12P[8] (12.2%, 95%-CI, 8.89-16.60) and G3P[8] (11.9%, 95%-CI, 8.58-16.20) infections. Phylogenetic analysis of the VP7 and VP4 genes showed no major differences between the pre and post-vaccination G1P[8] strains.CONCLUSION: This laboratory based surveillance study shows significant reduction in reported RV cases and a shift in proportion from G1P[8] to G2P[4] strains after introduction of RV vaccination in Scotland. The genotyping data from a subset of the total reported RV cases will be used to ascertain cross protection against strains and identify vaccine induced RV strain shifts in the years to come.

AB - BACKGROUND: Rotaviruses (RV) are the leading cause of gastroenteritis in children less than five years of age worldwide. Rotarix®, a live attenuated monovalent vaccine containing a RV strain of G1P[8] specificity has been included in the childhood immunisation schedule from June 2013 in Scotland. This study aimed to characterise the prevalent RV strains in Scotland before and after the introduction of the RV vaccine.METHODS: RV positive faecal samples from Scottish virology laboratories covering the years 2012-2015 were genotyped. Viral RNA was extracted from faecal suspensions. VP7 and VP4 gene specific primers were used for multiplex hemi-nested PCRs and sequencing. Mann-Whitney U test and Chi-square test were used for statistical comparison.RESULTS: There was a decrease in RV positive samples from the Scottish virology laboratories from 7409 samples in the pre-vaccination years (2009-2013) to 760 in 2014-2015, with an annual reduction of RV infections by 74.4% (RR-3.95; 95%-CI, 3.53-4.42, p<0.001). 362 samples from the pre-vaccination period and 278 samples from the post-vaccination were genotyped. There was a drop in prevalence of G1P[8] strains (72.1%, 95%-CI, 67.42-76.33 to 15%, 95%-CI, 11.38-19.79) after introduction of the vaccine. In the post-vaccination period G2P[4] was the dominant strain in Scotland (21.9%, 95%-CI, 17.48-27.17) with increase in G9P[8] (12.9%, 95%-CI, 9.50-7.41), G12P[8] (12.2%, 95%-CI, 8.89-16.60) and G3P[8] (11.9%, 95%-CI, 8.58-16.20) infections. Phylogenetic analysis of the VP7 and VP4 genes showed no major differences between the pre and post-vaccination G1P[8] strains.CONCLUSION: This laboratory based surveillance study shows significant reduction in reported RV cases and a shift in proportion from G1P[8] to G2P[4] strains after introduction of RV vaccination in Scotland. The genotyping data from a subset of the total reported RV cases will be used to ascertain cross protection against strains and identify vaccine induced RV strain shifts in the years to come.

KW - Rotavirus

KW - Genotyping

KW - Rotavirus vaccine

KW - Rotarix®®

KW - Scotland

U2 - 10.1016/j.vaccine.2016.11.028

DO - 10.1016/j.vaccine.2016.11.028

M3 - Article

VL - 35

SP - 156

EP - 163

JO - Vaccine

JF - Vaccine

SN - 0264-410X

IS - 1

ER -