Advances in Therapy

, Volume 22, Issue 5, pp 476–487 | Cite as

Rotavirus gastroenteritis

  • Alexander K. C. Leung
  • James D. Kellner
  • H. Dele Davies


Rotavirus is the single most important cause of severe, dehydrating gastroenteritis in infants and young children worldwide. Rotavirus gastroenteritis is associated with high morbidity in developed countries and significant mortality in developing countries. Virtually all children are infected with rotavirus by 3 years of age. Fecal-oral transmission is the most likely route of virus spread. Group A serotype strains G1 through G4 account for more than 90% of rotavirus gastroenteritis in humans, with G1 being the predominant serotype. The virus preferentially infects the mature small-intestinal enterocytes. Rotavirus gastroenteritis is characterized by fever, vomiting, and diarrhea, with vomiting particularly prominent. Dehydration is a frequent complication because of the severity of the diarrhea and the associated vomiting. Rehydration and maintenance of proper fluid and electrolyte balance remain the mainstay of treatment. Hygienic measures have little effect on the reduction of rotavirus infection rates. The disease can be effectively controlled by universal rotavirus vaccination.


rotavirus gastroenteritis mortality morbidity dehydration vaccine 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bishop RF, Davidson GP, Homes IH, et al. Viral particles in epithelial cells of duodenal mucosa from children with acute non-bacterial gastroenteritis.Lancet. 1973;2:1281–1283.PubMedCrossRefGoogle Scholar
  2. 2.
    Cunliffe NA, Bresee JS, Hart CA. Rotavirus vaccines: development, current issues and future prospects.J Infect. 2002;45:1–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Lee WS, Veerasingam PD, Goh AYT, et al. Hospitalization of childhood rotavirus infection from Kuala Lumpur, Malaysia.J Paediatr Child Health. 2003;39:518–522.PubMedCrossRefGoogle Scholar
  4. 4.
    Leung AK, Pai CH. Rotavirus gastroenteritis.J Diarrhoeal Dis Res. 1988;6:188–207.PubMedGoogle Scholar
  5. 5.
    Parashar UD, Hummelman EG, Breese SS, et al. Global illness and deaths caused by rotavirus disease in children.Emerg Infect Dis. 2003;9:565–572.PubMedGoogle Scholar
  6. 6.
    Ramig RF. Pathogenesis of intestinal and systemic rotavirus infection.J Virol. 2004;78:10213–10220.PubMedCrossRefGoogle Scholar
  7. 7.
    O’Ryan M, Pérez-Schael I, Mamani N, et al. Rotavirus-associated medical visits and hospitalizations in South America: a prospective study at 3 large sentinel hospitals.Pediatr Infect Dis J. 2001;20: 685–693.PubMedCrossRefGoogle Scholar
  8. 8.
    Danovaro-Holliday MC, Wood AL, LeBaron CW. Rotavirus vaccine and the news media, 1987–2001.JAMA. 2002;287:1455–1462.PubMedCrossRefGoogle Scholar
  9. 9.
    Dormitzer PR. Rotaviruses. In: Mandell GL, Bennett JE, Dolin R, eds.Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. New York, NY: Churchill Livingstone; 2005:1902–1913.Google Scholar
  10. 10.
    Matson DO. Rotaviruses. In: Long SS, Pickering LK, Prober CG, eds.Principles and Practice of Pediatric Infectious Diseases. New York, NY: Churchill Livingstone; 2003:1105–1109.Google Scholar
  11. 11.
    Bernstein DI, Ward RL. Rotaviruses. In: Feigin RD, Cherry JD, Demmler GJ, et al, eds.Textbook of Pediatric Infectious Diseases. Philadelphia, Pa: WB Saunders Co; 2004:2110–2133.Google Scholar
  12. 12.
    Coluchi N, Munford V, Manzur J, et al. Detection, subgroup specificity, and genotype diversity of rotavirus strains in children with acute diarrhea in Paraguay.J Clin Microbiol. 2002;40:1709–1714.PubMedCrossRefGoogle Scholar
  13. 13.
    Belhorn T. Rotavirus diarrhea.Curr Probl Pediatr. 1999;29:198–207.PubMedCrossRefGoogle Scholar
  14. 14.
    Prasad BVV, Rothnagel R, Zeng CQY, et al. Visualization of ordered genomic RNA and localization of transcriptional complexes in rotavirus.Nature. 1996;382:471–473.PubMedCrossRefGoogle Scholar
  15. 15.
    Nyquist AC. Rotavirus vaccine.Pediatr Ann. 1999;28:533–539.PubMedGoogle Scholar
  16. 16.
    Lundgren O, Svensson L. Pathogenesis of rotavirus infection.Microbes Infect. 2001;3:1145–1156.PubMedCrossRefGoogle Scholar
  17. 17.
    Katyal R, Rana SV, Singh K. Rotavirus infection.Acta Virol. 2000;44:283–288.PubMedGoogle Scholar
  18. 18.
    Cook N, Bridger J, Kendall K, et al. The zoonotic potential of rotavirus.J Infect. 2004;48:289–302.PubMedCrossRefGoogle Scholar
  19. 19.
    Offit PA, Clark HF. The rotavirus vaccine.Curr Opin Pediatr. 1998;11:9–13.CrossRefGoogle Scholar
  20. 20.
    Abad FX, Pinto RM, Bosch A. Survival of enteric viruses on environmental fomites.Appl Environ Micobiol. 1994;60:3704–3710.Google Scholar
  21. 21.
    Lloyd-Evans N, Springthorpe VS, Sattar SA. Chemical disinfection of human rotavirus-contaminated inanimate surfaces.J Hyg (Lond). 1986;97:163–173.Google Scholar
  22. 22.
    American Academy of Pediatrics. Rotavirus infections. In: Pickering LK, ed.Red Book: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2003:534–536.Google Scholar
  23. 23.
    Kapikian AZ. Viral gastroenteritis.JAMA. 1993;269:627–630.PubMedCrossRefGoogle Scholar
  24. 24.
    Rodriguez WJ, Kim HW, Brandt CD, et al. Longitudinal study of rotavirus infection and gastroenteritis in families served by a pediatric medical practice: clinical and epidemiologic observations.Pediatr Infect J. 1987;6:170–176.CrossRefGoogle Scholar
  25. 25.
    Widdowson MA, van Doornum GJJ, van der Poel WHM, et al. Emerging group-A rotavirus and a nosocomial outbreak of diarrhea.Lancet. 2000;356:1161–1162.PubMedCrossRefGoogle Scholar
  26. 26.
    Nakajima H, Nakagomi T, Kamisawa T, et al. Winter seasonality and rotavirus diarrhoea in adults.Lancet. 2001;357:1950.PubMedCrossRefGoogle Scholar
  27. 27.
    Ardern-Holmes SL, Lennon D, Pinnock R, et al. Trends in hospitalization and mortality from rotavirus disease in New Zealand infants.Pediatr Infect Dis J. 1999;18:614–619.PubMedCrossRefGoogle Scholar
  28. 28.
    Chang HGH, Glass RI, Smith PF, et al. Disease burden and risk factors for hospitalizations associated with rotavirus infection among children in New York State, 1989 through 2000.Pediatr Infect Dis J. 2003;22:808–814.PubMedCrossRefGoogle Scholar
  29. 29.
    Frühwirth M, Heininger U, Ehlken B, et al. International variation in disease burden of rotavirus gastroenteritis in children with community- and nosocomially acquired infection.Pediatr Infect Dis J. 2001;20:784–791.PubMedGoogle Scholar
  30. 30.
    Rivest P, Proulx M, Lonergan G, et al. Hospitalisations for gastroenteritis: the role of rotavirus.Vaccine. 2004;22:2013–2017.PubMedCrossRefGoogle Scholar
  31. 31.
    Bartlett AV, Reves RR, Pickering LK. Rotavirus in infant-toddler day care centers: epidemiology relevant to disease control strategies.J Pediatr. 1988;13:435–441.Google Scholar
  32. 32.
    Ehlken B, Laubereau B, Karmaus W, et al. Prospective population-based study on rotavirus disease in Germany.Acta Paediatr. 2002;91:769–775.PubMedCrossRefGoogle Scholar
  33. 33.
    Ferson MJ, Stringfellow S, McPhie K, et al. Longitudinal study of rotavirus infection in child-care centres.J Paediatr Child Health. 1997;33:157–160.PubMedGoogle Scholar
  34. 34.
    Hjelt K, Paerregaard A, Nielsen OH, et al. Acute gastroenteritis in children attending day-care centers with special reference to rotavirus infections.Acta Paediatr Scand. 1987;76:754–762.PubMedCrossRefGoogle Scholar
  35. 35.
    Pickering LK, Evans DG, DuPont HL, et al. Diarrhea caused byShigella, rotavirus andGiardia in day-care centres: prospective study.J Pediatr. 1981;99:51–56.PubMedCrossRefGoogle Scholar
  36. 36.
    Cook SM, Glass RI, LeBaron CW, et al. Global seasonality of rotavirus infections.Bull World Health Organ. 1990;68:171–177.PubMedGoogle Scholar
  37. 37.
    Clemens J, Rao M, Ahmed F, et al. Breast-feeding and the risk of life-threatening rotavirus diarrhea: prevention or postponement?Pediatrics. 1993;92:680–684.PubMedGoogle Scholar
  38. 38.
    Espinoza F, Paniagua M, Hallander H, et al. Rotavirus infections in young Nicaraguan children.Pediatr Infect Dis J. 1997;16:564–571.PubMedCrossRefGoogle Scholar
  39. 39.
    Mitra AK, Mahalanabis D, Ashraf H, et al. Hyperimmune cow colostrum reduces diarrhoea due to rotavirus: a double-blind, controlled clinical trial.Acta Paediatr. 1995;84:996–1001.PubMedCrossRefGoogle Scholar
  40. 40.
    Newburg DS, Peterson JA, Ruiz-Palacios GM, et al. Role of human-milk lactadherin in protection against symptomatic rotavirus infection.Lancet. 1998;351:1160–1164.PubMedCrossRefGoogle Scholar
  41. 41.
    Pickering LK, Morrow AL. Factors in human milk that protect against diarrheal disease.Infection. 1993;21:355–357.PubMedCrossRefGoogle Scholar
  42. 42.
    Lewis HM, Parry JV, Davies HA, et al. A year’s experience of the rotavirus syndrome and its association with respiratory illness.Arch Dis Child. 1979;54:339–346.PubMedGoogle Scholar
  43. 43.
    Santosham M, Yolken RH, Wyatt RG, et al. Epidemiology of rotavirus diarrhea in a prospectively monitored American Indian population.J Infect Dis. 1985;152:778–783.PubMedGoogle Scholar
  44. 44.
    Zheng BJ, Chang RX, Ma GZ, et al. Rotavirus infection of the oropharynx and respiratory tract in young children.J Med Virol. 1991;34:29–37.PubMedCrossRefGoogle Scholar
  45. 45.
    Santosham M, Yolken RH, Quiroz E, et al. Detection of rotavirus in respiratory secretions of children with pneumonia.J Pediatr. 1983;103:583–585.PubMedCrossRefGoogle Scholar
  46. 46.
    Fang ZY, Yang H, Qi J, et al. Diversity of rotavirus strains among children with acute diarrhea in China: 1998–2000 surveillance study.J Clin Microbiol. 2002;40:1875–1878.PubMedCrossRefGoogle Scholar
  47. 47.
    Gomez J, Estes MK, Matson DO, et al. Serotyping of human rotaviruses in Argentina by ELISA with monoclonal antibodies.Arch Virol. 1990;112:249–259.PubMedCrossRefGoogle Scholar
  48. 48.
    Woods PA, Gentsch J, Gouvea V, et al. Distribution of serotypes of human rotavirus in different populations.J Clin Microbiol. 1992;30:781–785.PubMedGoogle Scholar
  49. 49.
    Cunliffe NA, Dove W, Jiang B, et al. Detection of group C rotavirus in children with acute gastroenteritis in Blantyre, Malawi.Pediatr Infect Dis J. 2001;20:1088–1090.PubMedCrossRefGoogle Scholar
  50. 50.
    Haffejee IE. The epidemiology of rotavirus infections: a global perspective.J Pediatr Gastroenterol Nutr. 1995;20:275–286.PubMedGoogle Scholar
  51. 51.
    Hung T, Chen GM, Wang CG, et al. Waterborne outbreak of rotavirus diarrhoea in adults in China caused by a novel rotavirus.Lancet. 1984;1:1139–1142.PubMedGoogle Scholar
  52. 52.
    Sood M, Booth IW. Is prolonged rotavirus infection a common cause of protracted diarrhoea?Arch Dis Child. 1999;80:309–310.PubMedGoogle Scholar
  53. 53.
    Singh N, Rodriguez WJ. Rotavirus. In: Jenson HB, Baltimore RS, eds.Pediatric Infectious Diseases: Principles and Practice. Philadelphia, Pa: WB Saunders Co; 2002:898–900.Google Scholar
  54. 54.
    Staat MA, Azimi PH, Berke T, et al. Clinical presentations of rotavirus infection among hospitalized children.Pediatr Infect Dis J. 2002;21:221–227.PubMedCrossRefGoogle Scholar
  55. 55.
    Clark HF, Bernstein DI, Dennehy PH, et al. Safety, efficacy, and immunogenicity of a live, quadrivalent human bovine reassortant rotavirus vaccine in healthy infants.J Pediatr. 2004;144: 184–190.PubMedCrossRefGoogle Scholar
  56. 56.
    Huicho L, Sanchez D, Contreras M, et al. Occult blood and fecal leukocytes as screening tests in childhood infectious diarrhea: an old problem revisited.Pediatr Infect Dis J. 1993;12:474–477.PubMedGoogle Scholar
  57. 57.
    Poulton J, Tarlow MJ. Diagnosis of rotavirus gastroenteritis by smell.Arch Dis Child. 1987;62: 851–852.PubMedGoogle Scholar
  58. 58.
    Leung AK, Kao CP. Clay-coloured stool.Can J Diagn. 2003;20:59–66.Google Scholar
  59. 59.
    Morishima T, Yamaguchi H, Nagayoshi S, et al. Course of rotavirus gastroenteritis in a closed community.Arch Dis Child. 1980;55:147–149.PubMedCrossRefGoogle Scholar
  60. 60.
    Zheng BJ, Lo SKF, Tam JSL, et al. Prospective study of community-acquired rotavirus infection.J Clin Microbiol. 1989;27:2083–2090.PubMedGoogle Scholar
  61. 61.
    Velazquez FR, Matson DO, Calva JJ, et al. Rotavirus infection in infants as protection against subsequent infections.N Engl J Med. 1996;335:1022–1028.PubMedCrossRefGoogle Scholar
  62. 62.
    Fischer TK, Valentiner-Branth P, Steinsland H, et al. Protective immunity after natural rotavirus infection: a community cohort study of newborn children in Guinea-Bissau, West Africa.J Infect Dis. 2002;186:593–597.PubMedCrossRefGoogle Scholar
  63. 63.
    Ho L, Bradford BJ. Hypernatremic dehydration with rotavirus enteritis.Clin Pediatr. 1995;34: 440–441.CrossRefGoogle Scholar
  64. 64.
    Kovacs A, Chan L, Hotrakitya C, et al. Rotavirus gastroenteritis: clinical and laboratory features and use of the Rotazyme test.Am J Dis Child. 1987;141:161–166.PubMedGoogle Scholar
  65. 65.
    Khoshoo V, Bhan MK, Jayashree S, et al. Rotavirus infection and persistent diarrhea in young children.Lancet. 1990;2:1314–1315.CrossRefGoogle Scholar
  66. 66.
    Konno T, Suzuki H, Kutsuzawa T, et al. Human rotavirus and intussusception.N Engl J Med. 1977;297:945.PubMedGoogle Scholar
  67. 67.
    Rotbart HA, Nelson WL, Glode MP, et al. Neonatal rotavirus-associated necrotizing enterocolitis: case control study and prospective surveillance during an outbreak.J Pediatr. 1988;112:87–93.PubMedCrossRefGoogle Scholar
  68. 68.
    Sharma R, Garrison RD, Tapas JJ III, et al. Rotavirus-associated necrotizing enterocolitis: an insight into a potentially preventable disease?J Pediatr Surg. 2004;39:453–457.PubMedCrossRefGoogle Scholar
  69. 69.
    Matsuno S, Utagawa E, Sugiura A. Association of rotavirus infection with Kawasaki syndrome.J Infect Dis. 1983;148:177.PubMedGoogle Scholar
  70. 70.
    Devulapalli CS. Rotavirus gastroenteritis possibly causing Reye syndrome.Acta Paediatr. 2000; 89:613–619.PubMedCrossRefGoogle Scholar
  71. 71.
    Grunow JE, Dunton SF, Waner JL. Human rotavirus-like particles in a hepatic abscess.J Pediatr. 1985;106:73–76.PubMedCrossRefGoogle Scholar
  72. 72.
    Nigro G. Pancreatitis with hypoglycemia-associated convulsions following rotavirus gastroenteritis.J Pediatr Gastroenterol Nutr. 1991;12:280–282.PubMedGoogle Scholar
  73. 73.
    Hattori H, Torii S, Nagafuji H, et al. Benign acute myositis associated with rotavirus gastroenteritis.J Pediatr. 1992;121:748–749.PubMedCrossRefGoogle Scholar
  74. 74.
    Nishimura S, Ushijima H, Shiraishi H, et al. Detection of rotavirus in cerebrospinal fluid and blood of patients with convulsions and gastroenteritis by means of the reverse transcription polymerase chain reaction.Brain Dev. 1993;15:457–459.PubMedCrossRefGoogle Scholar
  75. 75.
    Pang XL, Joensuu J, Vesikari T. Detection of rotavirus RNA in cerebrospinal fluid in a case of rotavirus gastroenteritis with febrile seizures.Pediatr Infect Dis J. 1996;15:543–545.PubMedCrossRefGoogle Scholar
  76. 76.
    Lynch M, Lee B, Azimi P, et al. Rotavirus and central nervous system symptoms: cause or contaminant? Case reports and review.Clin Infect Dis. 2001;33:932–938.PubMedCrossRefGoogle Scholar
  77. 77.
    Goldwater PN, Rowland K, Power P, et al. Rotavirus encephalopathy: pathogenesis reviewed.J Paediatr Child Health. 2001;37:206–209.PubMedCrossRefGoogle Scholar
  78. 78.
    Yoshida A, Kawamitu T, Tanaka R, et al. Rotavirus encephalitis: detection of the virus genomic RNA in the cerebrospinal fluid of a child.Pediatr Infect Dis J. 1995;14:914–916.PubMedCrossRefGoogle Scholar
  79. 79.
    Chou IC, Tsai CH, Tsai FJ. Rotavirus associated with poliomyelitis-like syndrome.Pediatr Infect Dis J. 1998;17:930–931.PubMedCrossRefGoogle Scholar
  80. 80.
    Gregorio L, Sutton CL, Lee DA. Central pontine myelinolysis in a previously healthy 4-year-old child with acute rotavirus gastroenteritis.Pediatrics. 1997;99:738–743.PubMedCrossRefGoogle Scholar
  81. 81.
    Blutt SE, Kirkwood CD, Parreno V, et al. Rotavirus antigenaemia and viraemia: a common event?Lancet. 2003;362:1445–1449.PubMedCrossRefGoogle Scholar
  82. 82.
    Gilger MA, Matson DO, Conner ME, et al. Extraintestinal rotavirus infections in children with immunodeficiency.J Pediatr. 1992;120:912–917.PubMedCrossRefGoogle Scholar
  83. 83.
    Hodes HL. Gastroenteritis with special reference to rotavirus.Adv Pediatr. 1980;27:195–245.PubMedGoogle Scholar
  84. 84.
    Richardson S, Grimwood K, Gorrell R, et al. Extended excretion of rotavirus after severe diarrhoea in young children.Lancet. 1998;351:1846–1848.CrossRefGoogle Scholar
  85. 85.
    Robertson DM, Harrison M, Hosking CS, et al. Rapid diagnosis of rotavirus infection: comparison of electron microscopy and enzyme linked immunosorbent assay (ELISA).Aust Paediatr J. 1979; 15:229–232.Google Scholar
  86. 86.
    Leung AK, Robson WL. Acute diarrhea in children: what to do and what not to do.Postgrad Med. 1989;86:161–174.PubMedGoogle Scholar
  87. 87.
    Leung AK, Darling P, Auclair C. Oral rehydration: a review.J R Soc Health. 1987;107:64–67.PubMedCrossRefGoogle Scholar
  88. 88.
    Issenman RM, Leung AK. Oral and intravenous rehydration of children.Can Fam Physician. 1993;39:2129–2136.PubMedGoogle Scholar
  89. 89.
    Leung AK, Taylor PG, Geoffroy L, et al. Efficacy and safety of two oral solutions as maintenance therapy for acute diarrhea: a double-blind, randomized, multicenter trial.Clin Pediatr. 1988;27: 359–364.CrossRefGoogle Scholar
  90. 90.
    Provisional Committee on Quality Improvement, Subcommittee on Acute Gastroenteritis, American Academy of Pediatrics. Practice parameter: the management of acute gastroenteritis in young children.Pediatrics. 1996;97:424–435.Google Scholar
  91. 91.
    World Health Organization. Treatment and prevention of dehydration in diarrheal disease. A guide for use at the primary level. Geneva, Switzerland: Meeting of the World Health Organization; August, 1976.Google Scholar
  92. 92.
    Thillainayagam AV, Hunt JB, Farthing MJ. Enhancing clinical efficacy of oral rehydration therapy: is low osmolarity the key?Gastroenterology. 1998;114:197–210.PubMedCrossRefGoogle Scholar
  93. 93.
    Nalin DR, Harland E, Ramlal A, et al. Comparison of low and high sodium and potassium content in oral rehydration solutions.J Pediatr. 1980;97:848–853.PubMedCrossRefGoogle Scholar
  94. 94.
    Walker SH. Hypernatremia from oral electrolyte solutions in infantile diarrhea.N Engl J Med. 1981;304:1238.PubMedGoogle Scholar
  95. 95.
    Hahn S, Kim Y, Garner P. Reduced osmolarity oral rehydration solution for treating dehydration caused by acute diarrhea in children.Cochrane Database Syst Rev. 2002;CD 002847.Google Scholar
  96. 96.
    World Health Organization. Report on reduced osmolarity oral rehydration salts (ORS) formulation. Available at: NEWS/Statement.htm. Accessed August 30, 2004.Google Scholar
  97. 97.
    Nutrition Committee, Canadian Paediatric Society. Treatment of diarrheal disease.Paediatr Child Health. 2003;8:455–457.Google Scholar
  98. 98.
    Sandhu BK, for the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Working Group on Acute Diarrhea. Rationale for early feeding in childhood gastroenteritis.J Pediatr Gastroenterol Nutr. 2001;33(suppl 2):S13-S16.PubMedCrossRefGoogle Scholar
  99. 99.
    Farthing MJ. Diarrhea, a significant worldwide problem.Int J Antimicrob Agents. 2000;14:65–69.PubMedCrossRefGoogle Scholar
  100. 100.
    Salazar-Lindo E, Santisteban-Ponce J, Chea-Woo E, et al. Racecadotril in the treatment of acute watery diarrhea in children.N Engl J Med. 2000;343:463–467.PubMedCrossRefGoogle Scholar
  101. 101.
    Schwartz JC. Racecadotril: a new approach to the management of diarrheal disease. Symposium.Int J Antimicrob Agents. 2000;14:75–79.PubMedCrossRefGoogle Scholar
  102. 102.
    Guandalini S, Pensabene L, Zikri MA, et al.Lactobacillus GG administration in oral rehydration solution to children with acute diarrhea: a multicenter European trial.J Pediatr Gastroenterol Nutr. 2000;30:54–60.PubMedCrossRefGoogle Scholar
  103. 103.
    Saavedra JM, Bauman NA, Oung I, et al. Feeding ofBifidobacterium bifidum andStreptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus.Lancet. 1994;344:1046–1049.PubMedCrossRefGoogle Scholar
  104. 104.
    Szajewska H, Kotowska M, Mrukowicz JZ, et al. Efficacy ofLactobacillus GG in prevention of nosocomial diarrhea in infants.J Pediatr. 2001;138:361–365.PubMedCrossRefGoogle Scholar
  105. 105.
    Van Neil CW, Feudtner C, Garrison MM, et al.Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis.Pediatrics. 2002;109:678–684.CrossRefGoogle Scholar
  106. 106.
    Jiang B, Gentsch JR, Glass RJ. The role of serum antibodies in the protection against rotavirus disease: an overview.Clin Infect Dis. 2002;34:1351–1361.PubMedCrossRefGoogle Scholar
  107. 107.
    Bern C, Martines J, de Zoysa I, et al. The magnitude of the global problem of diarrhoeal disease: a ten year update.Bull World Health Organ. 1992;70:705–714.PubMedGoogle Scholar
  108. 108.
    Marwick C. Rotavirus vaccine a boon to children.JAMA. 1998;278:489–490.CrossRefGoogle Scholar
  109. 109.
    Vesikari T. Rotavirus vaccines against diarrhoeal disease.Lancet. 1997;350:1538–1541.PubMedCrossRefGoogle Scholar
  110. 110.
    American Academy of Pediatrics, Committee on Infectious Disease. Prevention of rotavirus disease: guidelines for use of rotavirus vaccine.Pediatrics. 1998;102:1483–1491.CrossRefGoogle Scholar
  111. 111.
    Centers for Disease Control and Prevention. Rotavirus vaccine for the prevention of rotavirus gastroenteritis among children. Recommendations of the Advisory Committee on Immunization Practices (ACIP).MMWR Morb Mortal Wkly Rep. 1999;48(RR-2):1–20.Google Scholar
  112. 112.
    Centers for Disease Control and Prevention. Intussusception among recipients of rotavirus vaccine: United States, 1998–1999.MMWR Morb Mortal Wkly Rep. 1999;48:577–581.Google Scholar
  113. 113.
    Centers for Disease Control and Prevention. Withdrawal of rotavirus vaccine recommendation.MMWR Morb Mortal Wkly Rep. 1999;48:1107.Google Scholar
  114. 114.
    Glass RI, Bresee JS, Parashar UD, et al. The future of rotavirus vaccines: a major setback leads to new opportunities.Lancet. 2004;363:1547–1550.PubMedCrossRefGoogle Scholar
  115. 115.
    Roberts L. Rotavirus vaccines’ second chance.Science. 2004;305:1890–1893.PubMedCrossRefGoogle Scholar
  116. 116.
    De Vos B, Vesikari T, Linhares AC, et al. A rotavirus vaccine for prophylaxis of infants against rotavirus gastroenteritis.Pediatr Infect Dis J. 2004;23:S179-S182.PubMedCrossRefGoogle Scholar
  117. 117.
    Molholland EK. Global control of rotavirus disease.Adv Exp Med Biol. 2004;549:161–168.Google Scholar
  118. 118.
    Vesikari T, Karvonen A, Korhonen T, et al. Safety and immunogenicity of RIX4414 live attenuated human rotavirus vaccine in adults, toddlers and previously uninfected infants.Vaccine. 2004;22: 2836–2842.PubMedCrossRefGoogle Scholar
  119. 119.
    Vesikari T, Karvonen A, Puustinen L, et al. Efficacy of RIX4414 live attenuated human rotavirus vaccine in Finnish infants.Pediatr Infect Dis J. 2004;23:937–943.PubMedCrossRefGoogle Scholar

Copyright information

© Health Communications Inc 2005

Authors and Affiliations

  • Alexander K. C. Leung
    • 1
  • James D. Kellner
    • 1
  • H. Dele Davies
    • 2
    • 3
  1. 1.Department of PediatricsUniversity of Calgary Alberta Children’s HospitalCalgaryCanada
  2. 2.Department of PediatricsMichigan State UniversityEast Lansing
  3. 3.Department of Human DevelopmentMichigan State UniversityEast Lansing

Personalised recommendations