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Rotaviruserkrankung und ihre Impfprävention in Deutschland

Rotavirus infections and vaccination prevention in Germany

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Zusammenfassung

Bedeutung von Rotaviruserkrankung

Rotavirusinfektionen (RV-Infektionen) sind weltweit die führende Ursache für Gastroenteritiden im Säuglings- und Kleinkindesalter. Nach dem Infektionsschutzgesetz werden seit 2001 fallbasierte Daten zur Epidemiologie der RV-Gastroenteritiden (RVGE) in Deutschland erfasst. Die höchsten jährlichen Inzidenzen werden bei < 2-Jährigen (1.850/100.000) gemessen. In diesem Alter müssen Kinder, die an RV-Infektionen erkranken, häufig zur Flüssigkeitssubstitution stationär aufgenommen werden. Dies geht mit einer erheblichen medizinischen und ökonomischen Belastung des Gesundheitssystems einher.

Rotavirusimpfung

Seit 2006 sind in Deutschland 2 RV-Impfstoffe zugelassen, die ein gutes Sicherheits- und Wirksamkeitsprofil aufweisen. Mit dem Ziel, primär bei Kindern < 5 Jahren eine stationäre Behandlung aufgrund schwerer RVGE zu verhindern, empfahl die STIKO (Ständige Impfkommission am Robert Koch-Institut) 2013 die routinemäßige Rotavirusimpfung von Säuglingen im Alter < 6 Monaten. Zusätzlich wird erwartet, dass über Herdeneffekte auch nicht geimpfte Personengruppen von der Impfung profitieren können. Monitoringsysteme sind implementiert, um die Auswirkungen der RV-Impfung fortlaufend zu evaluieren.

Abstract

Significance of rotavirus infections

Rotavirus (RV) infections are the leading cause of gastroenteritis (GE) in infants and young children worldwide. Since 2001 case-based data on the epidemiology of RVGE in Germany have been recorded according to the German Protection against Infection Act. The highest annual incidences are observed in children under 2 years of age (1,850/100,000). Children in this age group who suffer from RV often need to be hospitalized for fluid substitution. This causes a significant medical and economic burden on the healthcare system.

Rotavirus vaccination

In 2006 a total of 2 RV vaccines were licensed for use in Germany and have proven to have a good safety and efficacy profile. In 2013 the standing vaccination committee of the Robert Koch Institute (STIKO) recommended the routine RV immunization of infants aged < 6 months. The primary goal of this recommendation is to prevent severe RVGE requiring hospital treatment in children under 5 years of age. It is expected that non-vaccinated individuals may also benefit from vaccination by herd effects. Monitoring systems are implemented to continuously evaluate the impact of RV vaccinations.

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Abbreviations

DRG:

„Diagnosis-related groups“

DTaP:

Impfstoff gegen Diphtherie, Tetanus, Pertussis

EKG:

Elektrokardiogramm

ELISA:

„Enzyme linked immunosorbent assay“

EMA:

„European Medicines Agency“

ESPGHAN:

„European Society of Pediatric Gastroenterology, Hepatology and Nutrition“

FDA:

„Food and Drug Administration“ (US-amerikanische Zulassungsbehörde)

Hep B :

Impfstoff gegen Hepatitis B

Hib:

Impfstoff gegen Haemophilus influenzae Typ B

IPV:

Poliototimpfstoff

HUS:

Hämolytisch-urämisches Syndrom

IfSG:

Infektionsschutzgesetz

KG:

Körpergewicht

KI:

Konfidenzintervall

OR:

„Odds ratio“

ORL:

Orale Rehydratationslösung

PCR:

Polymerasekettenreaktion

RCT:

Randomisierte kontrollierte Studie

RKI:

Robert Koch-Institut

RNA:

Ribonukleinsäure

RV:

Rotavirus

RVGE:

RV-Gastroenteritis

STIKO:

Ständige Impfkommission am RKI

VP:

Virale Strukturproteine

WHO:

Weltgesundheitsorganisation

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Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Koch und B. Rodeck geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Koch, J., Rodeck, B. Rotaviruserkrankung und ihre Impfprävention in Deutschland. Monatsschr Kinderheilkd 161, 1154–1162 (2013). https://doi.org/10.1007/s00112-013-2921-8

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