Burden of rotavirus infections in Liguria, northern Italy: hospitalisations and potential savings by vaccination

  • D. Panatto
  • D. Amicizia
  • R. Giacchino
  • A. Tacchella
  • A. R. Natalizia
  • G. Melioli
  • R. Bandettini
  • P. Di Pietro
  • M. C. Diana
  • R. Gasparini


We evaluated the rates of gastroenteritis admissions to the emergency department and of rotavirus-related hospitalisations in children ≤5 years of age in 2006 at an Italian paediatric hospital. We calculated the number of rotavirus cases avoidable through the universal vaccination of children. Epidemiological data were extracted from the Data Elaboration Centre. To calculate the hospitalisation rate due to rotavirus, the virus was sought in the faeces of children hospitalised for acute gastroenteritis by means of rapid immunochromatographic assay. Emergency department admissions due to gastroenteritis numbered 2,396 (11.58% of the total admissions). Of these, 276 children (11.52%) were examined and then sent home, 1,286 (53.67%) were kept in short observation and 776 (32.38%) were hospitalised. In 27.83% of hospitalised cases, the rotavirus test proved positive. The rotavirus hospitalisation rate was 55 per 10,000 children ≤5 years of age in Genoa in 2006. In 85.6% of hospitalised patients with community-acquired rotavirus infection, the disease was severe. The number of avoidable cases confirmed that the vaccination of children ≤1 year of age could reduce the burden of rotavirus infection, especially with regard to hospitalisation (45 per 10,000 children ≤5 years of age) and admissions to short observation (85 per 10,000), generating benefits for the Italian healthcare system.


Gastroenteritis Short Observation Universal Vaccination Emergency Department Admission Emergency Room Admission 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank: Manuela Rescali for her support in the data collection; Roberto Scali and Roberto Arrighi for their assistance in extracting the epidemiological data; Emanuela Piccotti for the data collection in the Emergency Department; and Paolo Ferrari, Anna Pellettieri, Antonella Formiga, Laura Fenu and Cinzia Gatti for their technical support.

Thanks go to GlaxoSmithKline, who partially supported this study by providing two educational grants.


  1. 1.
    Parashar UD, Gibson CJ, Bresse JS, Glass RI (2006) Rotavirus and severe childhood diarrhea. Emerg Infect Dis 12:304–306PubMedGoogle Scholar
  2. 2.
    Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI (2003) Global illness and deaths caused by rotavirus disease in children. Emerg Infect Dis 9:565–572PubMedGoogle Scholar
  3. 3.
    Dennehy PH (2000) Transmission of rotavirus and other enteric pathogens in the home. Pediatr Infect Dis J 19(Suppl 10):103–105Google Scholar
  4. 4.
    Bernstein DI (2009) Rotavirus overview. Pediatr Infect Dis J 28(Suppl 3):S50–S53PubMedGoogle Scholar
  5. 5.
    Giaquinto C, Callegaro S, Andreola B, Bernuzzi M, Cantarutti L, D’Elia R et al (2008) Prospective study of the burden of acute gastroenteritis and rotavirus gastroenteritis in children less than 5 years of age, in Padova, Italy. Infection 36:351–357PubMedCrossRefGoogle Scholar
  6. 6.
    Fischer TK, Bresee JS, Glass RI (2004) Rotavirus vaccines and the prevention of hospital-acquired diarrhea in children. Vaccine 22(Suppl 1):S49–S54PubMedCrossRefGoogle Scholar
  7. 7.
    Ansari SA, Springthorpe VS, Sattar SA, Tostowaryk W, Wells GA (1991) Comparison of cloth, paper, and warm air drying in eliminating viruses and bacteria from washed hands. Am J Infect Control 19:243–249PubMedCrossRefGoogle Scholar
  8. 8.
    Ansari SA, Springthorpe VS, Sattar SA (1991) Survival and vehicular spread of human rotaviruses: possible relation to seasonality of outbreaks. Rev Infect Dis 13:448–461PubMedCrossRefGoogle Scholar
  9. 9.
    Berner R, Schumacher RF, Hameister S, Forster J (1999) Occurrence and impact of community-acquired and nosocomial rotavirus infections—a hospital-based study over 10 years. Acta Paediatr Suppl 88:48–52PubMedCrossRefGoogle Scholar
  10. 10.
    Charles MD, Holman RC, Curns AT, Parashar UD, Glass RI, Bresee JS (2006) Hospitalizations associated with rotavirus gastroenteritis in the United States, 1993–2002. Pediatr Infect Dis J 25:489–493PubMedCrossRefGoogle Scholar
  11. 11.
    Soriano-Gabarró M, Mrukowicz J, Vesikari T, Verstraeten T (2006) Burden of rotavirus disease in European Union countries. Pediatr Infect Dis J 25(Suppl 1):S7–S11PubMedGoogle Scholar
  12. 12.
    Guarino A, Ansaldi F, Ugazio A, Chiamenti G, Bona G, Correra A et al (2008) Italian Pediatrician’s consensus statement on anti-Rotavirus vaccines. Minerva Pediatr 60:3–16PubMedGoogle Scholar
  13. 13.
    ISTAT 14th Italian Population Census, October 21, 2001. Available online at: Accessed 2 March 2009
  14. 14.
    Coffin SE, Elser J, Marchant C, Sawyer M, Pollara B, Fayorsey R et al (2006) Impact of acute rotavirus gastroenteritis on pediatric outpatient practices in the United States. Pediatr Infect Dis J 25:584–589PubMedCrossRefGoogle Scholar
  15. 15.
    Vesikari T, Karvonen A, Prymula R, Schuster V, Tejedor JC, Cohen R et al (2007) Efficacy of human rotavirus vaccine against rotavirus gastroenteritis during the first 2 years of life in European infants: randomised, double-blind controlled study. Lancet 370:1757–1763PubMedCrossRefGoogle Scholar
  16. 16.
    Ruuska T, Vesikari T (1990) Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrhoeal episodes. Scand J Infect Dis 22:259–267PubMedCrossRefGoogle Scholar
  17. 17.
    Forster J, Guarino A, Parez N, Moraga F, Román E, Mory O et al (2009) Hospital-based surveillance to estimate the burden of rotavirus gastroenteritis among European children younger than 5 years of age. Pediatrics 123:e393–e400PubMedCrossRefGoogle Scholar
  18. 18.
    Marsella M, Raimondi L, Bergamini M, Sprocati M, Bigi E, De Sanctis V et al (2009) Epidemiology of rotavirus-associated hospital admissions in the province of Ferrara, Italy. Eur J Pediatr 168:1423–1427PubMedCrossRefGoogle Scholar
  19. 19.
    López-de-Andrés A, Jiménez-García R, Carrasco-Garrido P, Alvaro-Meca A, Galarza PG, de Miguel AG (2008) Hospitalizations associated with rotavirus gastroenteritis in Spain, 2001–2005. BMC Public Health 8:109PubMedCrossRefGoogle Scholar
  20. 20.
    Waisbourd-Zinman O, Ben-Ziony S, Solter E, Scherf E, Samra Z, Ashkenazi S (2009) Hospitalizations for nosocomial rotavirus gastroenteritis in a tertiary pediatric center: a 4-year prospective study. Am J Infect Control 37:465–469PubMedCrossRefGoogle Scholar
  21. 21.
    Wildi-Runge S, Allemann S, Schaad UB, Heininger U (2009) A 4-year study on clinical characteristics of children hospitalized with rotavirus gastroenteritis. Eur J Pediatr 168:1343–8PubMedCrossRefGoogle Scholar
  22. 22.
    Marchetti F, Assael B, Gabutti G, Guarino A, Lopalco PL, Marocco A et al (2009) Monitoring the rate of hospitalization before rotavirus immunization in Italy utilizing ICD9-CM regional databases. Hum Vaccin 5:172–176PubMedCrossRefGoogle Scholar
  23. 23.
    Rendi-Wagner P, Kundi M, Mikolasek A, Mutz I, Zwiauer K, Wiedermann U et al (2006) Active hospital-based surveillance of rotavirus diarrhea in Austrian children, period 1997 to 2003. Wien Klin Wochenschr 118:280–285PubMedCrossRefGoogle Scholar
  24. 24.
    Le Roux P, Marshall B, Toutain F, Mary JF, Pinon G, Briquet E et al (2004) Nosocomial viral infections in a pediatric service: example of rotaviral gastroenteritis and respiratory syncytial viral bronchiolitis. Arch Pediatr 11:908–915PubMedCrossRefGoogle Scholar
  25. 25.
    Thuret A, Patural H, Berthelot P, Benzait F, Martin I, Jusot JF et al (2004) Prospective follow-up of hospital-acquired diarrhoea in 28 paediatric wards of the south-east part of France during a winter season. Pathol Biol 52:131–137PubMedCrossRefGoogle Scholar
  26. 26.
    Huet F, Largeron N, Trichard M, Miadi-Fargier H, Jasso-Mosqueda G (2007) Burden of paediatric rotavirus gastroenteritis and potential benefits of a universal rotavirus vaccination programme with RotaTeq in France. Vaccine 25:6348–6358PubMedCrossRefGoogle Scholar
  27. 27.
    Panatto D, Amicizia D, Ansaldi F, Marocco A, Marchetti F, Bamfi F et al (2009) Burden of rotavirus disease and cost-effectiveness of universal vaccination in the Province of Genoa (Northern Italy). Vaccine 27:3450–3453PubMedCrossRefGoogle Scholar
  28. 28.
    Centers for Disease Control and Prevention (CDC) (2008) Delayed onset and diminished magnitude of rotavirus activity—United States, November 2007–May 2008. MMWR Morb Mortal Wkly Rep 57:697–700Google Scholar
  29. 29.
    Word Health Organization (WHO) (2009) Rotavirus vaccines: an update. Wkly Epidemiol Rec 84:533–540Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • D. Panatto
    • 1
  • D. Amicizia
    • 1
  • R. Giacchino
    • 2
  • A. Tacchella
    • 2
  • A. R. Natalizia
    • 2
  • G. Melioli
    • 3
  • R. Bandettini
    • 3
  • P. Di Pietro
    • 4
  • M. C. Diana
    • 4
  • R. Gasparini
    • 1
  1. 1.Department of Health ScienceUniversity of GenoaGenoaItaly
  2. 2.Unit of Infectious DiseasesG. Gaslini Children’s HospitalGenoaItaly
  3. 3.Clinical Pathology and Microbiology LaboratoriesG. Gaslini Children’s HospitalGenoaItaly
  4. 4.Emergency Department of PaediatricsG. Gaslini Children’s HospitalGenoaItaly

Personalised recommendations