Rotavirus vaccination coverage during a rotavirus outbreak resulting in a fatality at a subacute care facility

Details

• Alternative Title:
  J Pediatric Infect Dis Soc
• Personal Author:
  Burke, Rachel M. ; Tate, Jacqueline E. ; Han, George S. ; Quenelle, Rebecca ; Gautam, Rashi ; Wadford, Debra A. ; Bowen, Michael D. ; Parashar, Umesh D.
• Description:
  Background
  
  Rotavirus vaccine introduction in the United States has reduced rotavirus disease burden, but outbreaks still occur. Complete-series rotavirus vaccination coverage is < 75% in the United States; it may be lower among vulnerable populations. We describe clinical characteristics and vaccination status of children during a rotavirus outbreak in a pediatric subacute care facility in 2017.
  
  Methods
  
  Clinical history, signs and symptoms, and vaccination history were abstracted for the 26 patients residing in the facility during the time of the outbreak. A case was defined as a patient experiencing 3 or more loose stools in a period of 24 hours, with onset April 17 – May 17, 2017. Stool samples from 14 resident patients were tested for rotavirus by reverse transcription polymerase chain reaction (RT-PCR).
  
  Results
  
  The median patient age at the facility was 2.9 years. Twenty-two of the 26 resident patients (85%) met the case definition. One child died. Stool samples from 11 cases were RT-PCR-positive for rotavirus. Fifteen cases were unvaccinated against rotavirus; 3 were partially vaccinated and 2 fully vaccinated. Vaccination status could not be completely determined for two cases.
  
  Conclusions
  
  An outbreak of rotavirus affected nearly all resident patients of a subacute care facility and caused one death. Due to recommendations against giving rotavirus vaccines in the intensive care setting, infants requiring prolonged intensive care stays may age out of rotavirus vaccine eligibility (1st dose must be given before 15 weeks, as per ACIP recommendations). This creates a vulnerable population of unvaccinated infants who may later congregate in another care setting.
  
  
• Subjects:
  Child Child, Preschool Disease Outbreaks Feces Female Humans Infant Male Rotavirus Rotavirus Infections Rotavirus Vaccines Skilled Nursing Facilities Subacute Care

  More +
• Source:
  J Pediatric Infect Dis Soc. 9(3):287-292
• Pubmed ID:
  31318031
• Pubmed Central ID:
  PMC6980350
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Place as Subject:
  United States
• Volume:
  9
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:6b5a5e0b38470820c8ce57ea6ae26c064fad96aac33427fc67a194278143febe
• Download URL:
  https://stacks.cdc.gov/view/cdc/84514/cdc_84514_DS1.pdf
• File Type:
  [PDF - 184.56 KB ]