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Background: Rotavirus infections are a significant cause of severe diarrhea and related illness and death in children under five worldwide. Despite the global introduction of vaccinations for rotavirus over a decade ago, rotavirus infections still result in high deaths annually, mainly in low-income countries, including Ethiopia, and need special attention. This system review and meta-analysis aimed to comprehensively explore the positive proportion of rotavirus at pre- and post-vaccine introduction periods and genotype distribution in children under five with diarrhea in Ethiopia. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Database sources included PubMed, Scopus, EMBASE, and Epistemonikos, focusing on studies published before November 30, 2023. The search targeted rotavirus infection and genotype distribution in Ethiopia before and after the introduction of the Rota vaccine. Data was managed using EndNote 2020 software and stored in an Excel 2010 sheet. A random-effects model determined the pooled estimate of the rotavirus infection rate at 95% confidence intervals. The Q-and I² statistics were used to assess the study heterogeneity, and a funnel plot (Egger test) was used to determine the possibility of publication bias. Results: The analysis included data from nine studies conducted in different regions of Ethiopia. The overall prevalence of rotavirus infection was significant, with a prevalence rate of approximately 22.63% (1362/6039). The most common genotypes identified before the Rota vacation introduction were G1, G2, G3, G12, P [4], P [6], P [8], P [9], and P [10]. Meanwhile, G3 and P [8] genotypes were particularly prevalent after the Rota vaccine introduction. These findings highlight the importance of implementing preventive measures, such as vaccination, to reduce the burden of rotavirus infection in this population. The identified genotypes provide valuable insights for vaccine development and targeted interventions. Conclusion: This study contributes to the evidence base for public health interventions and strategies to reduce the impact of rotavirus infection in children under five in Ethiopia. Despite the rollout of the Rota vaccination in Ethiopia, rotavirus heterogeneity is still high, and thus, enhancing vaccination and immunization is essential. [ABSTRACT FROM AUTHOR]

The objective of this study was to estimate, by a novel spatiotemporal approach in an environment of non-funded rotavirus (RV) vaccines, the RV vaccine effectiveness (VE) to prevent acute gastroenteritis primary care (AGE-PC)–attended episodes, demonstrating how indirect protection leads to underestimation of direct VE under high vaccine coverage (VC). This population-based retrospective cohort study used electronic healthcare registries including all children 2 months–5 years old, born from 2009 to 2018 in the Valencia Region (Spain). Direct RV VE preventing AGE-PC episodes was estimated using propensity score matching and Poisson regressions stratified by VC, adjusted by age and calendar season. Indirect VE was estimated by Poisson regression comparing AGE-PC rates in unvaccinated children among the different VC levels. A total of 563,442 children were included for the RV VC estimation; of them, 360,576 were included in the birth-cohort for VE analysis. RV VC showed strong variability among districts and seasons, rising on average from 21% in 2009/2010 to 55% in 2017/2018. The highest direct VE was found in vaccinated children from districts with 0–30% RV VC (16.4%) and the lowest in those from districts with ≥ 70% RV VC (9.7%). The indirect protection in unvaccinated children raised from 6 to 16.6% for those living with 20–30% and ≥ 70% VC, respectively. Conclusion: Considering that RV is the causative agent in 20% of AGE cases, a direct effectiveness of 82% preventing AGE-PC episodes due to RV could be deduced using a novel spatiotemporal approach. A reduction of 17% of AGE-PC episodes in unvaccinated was observed in areas with VC over 70% because of indirect protection. What is Known: • The effectiveness of RV vaccines preventing hospitalizations due to RV-acute gastroenteritis (RV-AGE) has been extensively studied. However, RV also burdens the primary care (PC) setting, and data on vaccine effectiveness (VE) in preventing AGE-PC visits are scarce. • The RV vaccine distribution in Spain (non-funded), with large differences in vaccine coverage (VC) among healthcare districts, provides an ideal scenario to assess the actual VE in preventing AGE-PC consultations, including the direct and indirect protection. What is New: • A direct effectiveness of 82% preventing AGE-PC episodes due to RV could be deduced using a novel spatiotemporal approach. A reduction of 17% of AGE-PC episodes in unvaccinated was observed in areas with high VC because of indirect protection. • These findings, together with existing data on the impact on hospitalizations due to RV-AGE, offer valuable insights for implementing vaccination initiatives in countries that have not yet commenced such programs. [ABSTRACT FROM AUTHOR]

Abstract Background Rotavirus infections are a significant cause of severe diarrhea and related illness and death in children under five worldwide. Despite the global introduction of vaccinations for rotavirus over a decade ago, rotavirus infections still result in high deaths annually, mainly in low-income countries, including Ethiopia, and need special attention. This system review and meta-analysis aimed to comprehensively explore the positive proportion of rotavirus at pre- and post-vaccine introduction periods and genotype distribution in children under five with diarrhea in Ethiopia. Methods The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Database sources included PubMed, Scopus, EMBASE, and Epistemonikos, focusing on studies published before November 30, 2023. The search targeted rotavirus infection and genotype distribution in Ethiopia before and after the introduction of the Rota vaccine. Data was managed using EndNote 2020 software and stored in an Excel 2010 sheet. A random-effects model determined the pooled estimate of the rotavirus infection rate at 95% confidence intervals. The Q-and I² statistics were used to assess the study heterogeneity, and a funnel plot (Egger test) was used to determine the possibility of publication bias. Results The analysis included data from nine studies conducted in different regions of Ethiopia. The overall prevalence of rotavirus infection was significant, with a prevalence rate of approximately 22.63% (1362/6039). The most common genotypes identified before the Rota vacation introduction were G1, G2, G3, G12, P [4], P [6], P [8], P [9], and P [10]. Meanwhile, G3 and P [8] genotypes were particularly prevalent after the Rota vaccine introduction. These findings highlight the importance of implementing preventive measures, such as vaccination, to reduce the burden of rotavirus infection in this population. The identified genotypes provide valuable insights for vaccine development and targeted interventions. Conclusion This study contributes to the evidence base for public health interventions and strategies to reduce the impact of rotavirus infection in children under five in Ethiopia. Despite the rollout of the Rota vaccination in Ethiopia, rotavirus heterogeneity is still high, and thus, enhancing vaccination and immunization is essential.

The aim – to summarize literature data on the pathogenetic mechanisms of the diarrheal syndrome development in children with rotavirus infection and to determine the role of carbohydrate malabsorption syndrome in it through a complex analysis of literature reviews and empirical studies. Rotavirus infection (RVI) remains the main cause of severe dehydrating gastroenteritis in children under five years of age. One of the most important pathogenetic links of rotavirus gastroenteritis is the development of osmotic diarrhea induced by carbohydrate malabsorption syndrome. Its development is associated with disaccharidase insufficiency and impaired absorption of monosaccharides in the small intestine. Carbohydrate malabsorption syndrome is found in 67.0–98.3 % of children with RVI. Its laboratory manifestations (an increase in levels of fecal carbohydrates and lactose) are observed starting from the first days of the disease, and the maximum indicators are recorded in the period from the fifth to the seventh day. Conclusions. Carbohydrate malabsorption syndrome is observed in the absolute majority of children with RVI, and its maximum severity is noted from the fifth to the seventh day of the disease, being realized mainly due to lactase deficiency. The severity of carbohydrate malabsorption syndrome can be influenced by concomitant pathological conditions, that lead to a decrease in the activity of disaccharidases in the small intestine, and the metabolic activity of the intestinal microbiota.

The suboptimal performance of rotavirus (RV) vaccines in developing countries and in animals necessitates further research on the development of novel therapeutics and control strategies. To initiate infection, RV interacts with cell-surface O-glycans, including histo-blood group antigens (HBGAs). We have previously demonstrated that certain non-pathogenic bacteria express HBGA- like substances (HBGA+) capable of binding RV particles in vitro. We hypothesized that HBGA+ bacteria can bind RV particles in the gut lumen protecting against RV species A (RVA), B (RVB), and C (RVC) infection in vivo. In this study, germ-free piglets were colonized with HBGA+ or HBGA- bacterial cocktail and infected with RVA/RVB/RVC of different genotypes. Diarrhea severity, virus shedding, immunoglobulin A (IgA) Ab titers, and cytokine levels were evaluated. Overall, colonization with HBGA+ bacteria resulted in reduced diarrhea severity and virus shedding compared to the HBGA- bacteria. Consistent with our hypothesis, the reduced severity of RV disease and infection was not associated with significant alterations in immune responses. Additionally, colonization with HBGA+ bacteria conferred beneficial effects irrespective of the piglet HBGA phenotype. These findings are the first experimental evidence that probiotic performance in vivo can be improved by including HBGA+ bacteria, providing decoy epitopes for broader/more consistent protection against diverse RVs. [ABSTRACT FROM AUTHOR]

Objective To analyze and compare the incidence of rotavirus (RV) infection in children with diarrhea before and after the COVID-19 outbreak. Methods A total of 5 793 children with diarrhea admitted to the First Affiliated Hospital of Xi'an Medical University from January 2017 to December 2022 were selected. The period from January 2017 to January 2020 was defined as the time before COVID-19 epidemic, and the period from January 2020 to December 2022 was defined as the time after COVID-19 epidemic. RV infection rate of children with diarrhea before and after the COVID-19 outbreak was compared. Results There were 881 (25. 29%) and 587 (25. 41%) cases of RV infection in diarrheal children before and after COVID-19 outbreak, respectively. There was no significant difference in RV infection in diarrheal children before and after COVID-19 outbreak (P>0. 05) . There was no significant difference in RV infection rate in children with diarrhea of different genders before and after COVID-19 outbreak (P>0. 05) . The age groups with the highest RV infection rate in children with diarrhea before COVID-19 outbreak were ≥1 to < 2 years old, 7 to 12 months old, and ≥2 to < 3 years old, and the age groups with the highest RV infection rate after COVID-19 outbreak were ≥1 to < 2 years old, ≥2 to < 3 years old, and 7 to 12 months old, respectively. There were significant differences in RV infection in children with diarrhea in different ages before and after COVID-19 outbreak (all P<0. 05) . The months with high incidence of RV infection in children with diarrhea before COVID-19 outbreak were December, January and November each year, and the months with high incidence of RV infection in children with diarrhea after COVID-19 outbreak were January, December and February each year, respectively. There were statistically significant differences in RV infection in children with diarrhea in different months before and after COVID-19 outbreak (all P<0. 05) . Conclusions Although the number of children with diarrhea and RV infection drops significantly after COVID-19, RV infection is still the main cause of diarrhea in children. Gender is not an influential factor in RV infection in children with diarrhea. The age of high incidence of RV infection in children with diarrhea is less than 3 years old. In addition to autumn and winter seasons, RV infection may also be high in spring, and RV screening in non-RV season should be vigilant. [ABSTRACT FROM AUTHOR]

Scientific relevance. Rotavirus disease and its consequences remain a leading vaccine-preventable cause of mortality in young children. Russia has not yet included rotavirus immunisation in the national vaccination schedule, but paediatric rotavirus vaccines are provided under several regional immunisation programmes.Aim. The authors aimed to review literature covering Russian clinical evidence of the safety and effectiveness of rotavirus vaccines and to analyse the prospects for the development of the national immunisation programme for young children using the available rotavirus vaccines and considering promising pipeline ones.Discussion. Local epidemiological studies on a range of pathogens suggest that rotaviruses are the most common cause of acute intestinal infections, especially in children under 3 years of age. Since Russia’s first rotavirus vaccine approval in 2012, the healthcare system has acquired sufficient experience with rotavirus vaccines to evaluate the safety and effectiveness of rotavirus immunisation. Long-term monitoring of the rotavirus A genotypes circulating in the country shows that currently available rotavirus vaccines cover the majority of identified rotavirus isolates. Local observational studies confirm the favourable safety profile of rotavirus vaccines and demonstrate notable effectiveness of vaccination. In the regions with high immunisation coverage, the overall morbidity has declined dramatically in vaccinated children compared to unvaccinated children; some of these regions have reported only individual hospital visits or admissions for acute intestinal infections.Conclusion. This review demonstrates that rotavirus immunisation should be included in the Russian National Immunisation Schedule.

The suboptimal performance of rotavirus (RV) vaccines in developing countries and in animals necessitates further research on the development of novel therapeutics and control strategies. To initiate infection, RV interacts with cell-surface O-glycans, including histo-blood group antigens (HBGAs). We have previously demonstrated that certain non-pathogenic bacteria express HBGA- like substances (HBGA+) capable of binding RV particles in vitro. We hypothesized that HBGA+ bacteria can bind RV particles in the gut lumen protecting against RV species A (RVA), B (RVB), and C (RVC) infection in vivo. In this study, germ-free piglets were colonized with HBGA+ or HBGA- bacterial cocktail and infected with RVA/RVB/RVC of different genotypes. Diarrhea severity, virus shedding, immunoglobulin A (IgA) Ab titers, and cytokine levels were evaluated. Overall, colonization with HBGA+ bacteria resulted in reduced diarrhea severity and virus shedding compared to the HBGA- bacteria. Consistent with our hypothesis, the reduced severity of RV disease and infection was not associated with significant alterations in immune responses. Additionally, colonization with HBGA+ bacteria conferred beneficial effects irrespective of the piglet HBGA phenotype. These findings are the first experimental evidence that probiotic performance in vivo can be improved by including HBGA+ bacteria, providing decoy epitopes for broader/more consistent protection against diverse RVs.

Aim: Identifying genes and pathways involved in various stages of rotavirus infection could facilitate the mapping of the interactions between the virus and host. Materials & methods: Weighted gene co-expression network analysis (WGCNA) was employed to construct a co-expression network of genes identified by microarray analysis from samples from children with acute rotavirus infection. Results: Two specific modules were most related to rotavirus infection. The analysis of differentially expressed genes (DEGs) disclosed 393 DEGs between normal and infected individuals. Eighteen novel genes were shared between the modules. Conclusion: The WGCNA revealed novel modules, co-expressed genes and pathways involved in immune responses, cell death/degradation and the nervous system in acute rotavirus infection. Rotaviruses are a type of virus that can cause diarrhea and vomiting, especially in children under 5 years old. In some cases, rotavirus infection can cause neurological disorders like seizures, reduced consciousness and inflammation of the brain. There is no cure for rotavirus infection. Treatment involves drinking plenty of water and symptom relief. To improve our understanding of how rotavirus causes disease, we analyzed the genetic data of children infected with rotavirus and healthy children. We identified genes in infected children that may be linked to rotavirus infection and disease. This information can be useful for identifying new targets for antiviral treatments and vaccines. [ABSTRACT FROM AUTHOR]

Qiuhua Fan Clinical Medical Laboratory Center, Shanxi Children’s Hospital (Shanxi Maternal and Child Health Hospital), Taiyuan, 030000, People’s Republic of ChinaCorrespondence: Qiuhua Fan, Clinical Medical Laboratory Center, Shanxi Children’s Hospital (Shanxi Maternal and Child Health Hospital), Taiyuan, 030000, People’s Republic of China, Tel/Fax +86-13-834209526, Email SXFanqiuhua@outlook.comPurpose: To investigate the prevalence of rotavirus infection and acute diarrhea after immunization and further assess the quality of nursing care provided by the nurses to such patients.Methods: A total of 432 children aged 3– 36 months with acute diarrhea between February 2019 and March 2022 were enrolled, and rotavirus testing was performed within 24 h using a rotavirus enzyme immunoassay kit. Clinical characteristics were evaluated, and regression analysis was performed.Results: Eighty vaccinated children (18.5%) were confirmed to have rotavirus infection out of 432 children. The prevalence of rotavirus positivity was the highest at 20– 28 months (22 cases, 24.44%) and 11– 19 months age group (27 cases, 22.50%). There is a significant association between rotavirus infection and hygiene score (p = 0.009). Based on the association with quality of nursing care, rotavirus infection was association with “appropriate care” (p = 0.001).Conclusion: Rotavirus infection was strongly associated with poor hygiene score which may be due to the hygienic nature of the mother and her family. Nursing care assessments revealed a huge gap between nurses and the guardians, which reflects the behavior of Chinese nurses. Thus, an intervention is required by the policymakers for implementing effective strategies of quality nursing for the improvement of the pediatric patients with rotavirus gastroenteritis.Keywords: rotavirus infection, pediatric population, nursing care, logistic regression

Probiotics represent viable microorganisms which are found within the normal gut microbiota, that exert strain-specific benefits in the management of several gastrointestinal disorders in children, including acute gastroenteritis. This review aims to evaluate the pathogen-specific role of probiotic supplementation in childhood diarrhea. A search of scientific databases was conducted to identify studies which investigated efficacy of probiotics and synbiotics in influencing outcome of acute gastroenteritis of known etiology. We identified 32 studies, most of which analyzed impact of probiotic supplementation in rotavirus gastroenteritis, while a very limited number of these conducted a separate analysis on bacterial diarrhea. Lactobacillus rhamnosus (L. rhamnosus), L. reuteri and S. boulardii still remain the most researched strains, with a proven role in decreasing diarrhea and hospitalization duration, especially in the setting of rotavirus infection. Combined products containing at least one of the aforementioned strains also performed similarly and might also influence rotavirus fecal shedding. Rotavirus immunization status has also been proposed as a significant influencing factor of probiotic use impact. The paucity of research focusing on bacterial etiologies, as well as of clinical trials conducted within ambulatory care units leaves room for further research on the matter, which needs to include larger cohort studies. [ABSTRACT FROM AUTHOR]

The aim. To identify the influence of the latent form of Epstein-Barr virus infection on the clinical picture, parameters of clinical blood analysis and cytokine response of children with rotavirus gastroenteritis. Materials and methods. 56 children were examined. Of them, 33 children (group 1) had no background infection with herpesviruses, and 23 patients (group 2) suffered from rotavirus gastroenteritis against the background of Epstein-Barr virus (EBV) infection. The patients were comparable in terms of sex, age and disease severity. Differences at p <0.05 were considered statistically significant. Results. The analysis of the obtained data showed that the latent form of EBV infection affects the clinical picture, indicators of clinical blood analysis and the reaction of serum cytokines of children with rotavirus gastroenteritis. Сonclusions. A comparative analysis revealed that a latent form of herpesvirus infection in children with rotavirus gastroenteritis is associated with lower temperature reaction and a lower frequency of vomiting in the acute period of the disease against the background of longer persistence of fever, diarrhoea and catarrhal syndromes. On the part of the investigated laboratory indicators, the presence of EBV infection is characterized by a lower level of haemoglobin (р=0,013) against a higher content of neutrophils (p=0.002), eosinophils (p=0.033) and monocytes (p < 0.001) in the acute period of RVI, and a significantly higher content of eosinophils (p=0.001) and monocytes (p < 0.001) against the background of a lower level of the relative content of lymphocytes compared to patients of Group 1 in the period of early convalescence. Changes in the cytokine response in children with mixed infection are characterized by a significantly lower concentration of IL-1β at the onset of RVI and a higher content of IL-4 and TNF-α throughout the disease compared to children with mono-RVI. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 infection in children associates multiple challenges related especially to the diagnosis due to the lack of symptoms or due to the polymorph clinical picture that might occur in these children, and which can often mimic a wider spectrum of pathologies. The Rotavirus infection is one of the most common etiologies of acute gastroenteritis in children which might result in increased mortality rates in small ages or in patients at risk. We report the case of a 2-month-old male infant, without significant personal history admitted to the Pediatrics Clinic 1, COVID Compartment, Targu-Mures, for vomiting, loss of appetite, and diarrhea. The family history revealed that the paternal grandfather was confirmed with SARS-CoV-2 infection. Based on the patient’s symptoms and anamnesis, he was tested and confirmed with SARS-CoV-2 by RT-PCR. The stool viral antigens confirmed also Rotavirus infection. The clinical exam at the time of admission pointed out influenced general status, diminished cutaneous turgor, abdominal tenderness at palpation and accelerated bowel movements. The laboratory tests revealed severe dehydration associated with positive inflammatory biomarkers. Taking into account the small age, the presence of coinfection and the severe dehydration, we initiated supportive treatment with rehydration solutions by vein, antibiotics, anticoagulant and symptomatic treatment. The patient’s evolution was favorable with the previously mentioned treatment. The early diagnosis of a possible coinfection in pediatric ages represents the cornerstone in preventing potential complications.

Introduction: Rotavirus is the leading cause of severe, life threatening gastroenteritis in infants and young children. As rotavirus strains vary between geographic areas, region specific genotyping information is highly vital to study rotavirus epidemiology and to monitor strain variation after vaccine introduction. Aim: To estimate the prevalence of rotavirus diarrhoea and strains causing the infection among children younger than five years of age and to study the clinical profile of rotavirus diarrhoea to ascertain factors associated with rotavirus infection in them. Materials and Methods: This hospital-based cross-sectional study was carried out on 150 children under five years with diarrhoea in the Department of Paediatrics, Government Medical College, Chennai, Tamil Nadu, India from November 2017 to August 2018. The clinical severity was assessed by using Vesikari score. By using PremierTM Rotaclone ELISA Kit rotavirus antigen was detected. Positive samples were tested for RNA identification by Reverese Transcriptase-Polymerase Chain Reaction (RT-PCR). The IBM Statistical Package for the Social Sciences (SPSS) version 22 was used for statistical analysis. Results: The prevalence of rotavirus diarrhoea was 17.3% and positive samples belonged to G3 type. Prevalence of rotavirus diarrhoea among the vaccinated children was less when compared to unvaccinated children (p-value 0.034). Clinical severity score (Vesikari score) indicated that patients infected with rotavirus had severe disease as compared to rotavirus non infected patients (p-value 0.011). The duration of hospital stay was longer in rotavirus-positive children as compared to rotavirus-negative children (p-value <0.001). Conclusion: This study highlights the serotype specific prevalence of rotavirus diarrhoea in under five children. Rotavirus has been found to have more severe and prolonged illness among unimmunised under five children; thereby, reinforcing the need for routine rotavirus vaccination. [ABSTRACT FROM AUTHOR]

Introduction. Rotavirus infection is the leading cause of acute gastroenteritis in young children. Due to the lack of etiotropic treatment of viral gastroenteritis, the interest of scientists and practitioners in the use of antiviral drugs is increasing. Studies of domestic authors have proven that the low molecular weight interferon inductor – meglumine acridonacetate has antiviral, immunoregulatory and anti-inflammatory activity.Aim. Evaluation of the efficacy and safety of the antiviral drug meglumine acridonacenate in the treatment of acute gastroenteritis of rotavirus etiology in children aged 4–7 years in a hospital setting.Materials and methods. A prospective analysis of cases of treatment with meglumine acridonacetate for moderately severe rotavirus gastroenteritis in preschool children (n = 29, group I) was carried out. The comparison group consisted of patients receiving standard therapy (n = 31, group II). The presence of rotavirus infection was confirmed by the detection of the pathogen antigen in the feces. Meglumine acridonacetate was prescribed according to the scheme, parenterally, every other day.Results and discussion. The effectiveness of therapy with an antiviral drug on the 3rd day of treatment of moderately severe rotavirus gastroenteritis was 79.3% (p < 0.05). The elimination of the main clinical symptoms of the disease was noted on days 2–3: a decrease in the symptoms of intoxication, fever, a significant decrease in the duration of vomiting and diarrhea (p < 0.05), a reduction in the pathogen elimination period by 2.67 days (p < 0.01), meglumine acridonacetate was well tolerated, no side effects of the drug were detected.Conclusions. Meglumine acridonacetate can be recommended for the complex treatment of moderate rotavirus infection from the first days of the disease.

The aim is to evaluate the effect of metabolic activity of intestinal microflora on laboratory manifestations of carbohydrate malabsorption syndrome in early-aged children with rotavirus infection by studying the main intestinal metabolites – short-chain fatty acids in faeces. Materials and methods. 60 breastfed children with rotavirus infection aged 1–24 months were examined. The total amount of carbohydrates in faecal samples was determined using Benedict’s test, and the detection of short-chain fatty acids in faeces was carried out using liquid chromatography in the dynamics of the disease – on the 3rd, 5th and 10th day. Results. It was established, that the amount of reducing sugars in faeces decreased with the increasing concentration of intestinal microflora metabolites during the entire period of rotavirus infection. In patients with ≤0.5 % level of carbohydrates in faeces, the total content of short-chain fatty acids was the highest and exceeded by 2.0, 1.8 and 1.7 times the indicators of children with Benedict’s test values >0.5 % on the 3rd, 5th and 10th days of the disease, respectively (p < 0.05). A decrease in the metabolic activity of the intestinal microbiota in the above category of children occurred mainly due to a deficiency in the production of acetic and propionic acids (P < 0.05). In the acute period of the disease, an imbalance in the intestinal microbiota infrastructure was noted towards a deficiency of obligate anaerobes that was expressed in a decrease in the anaerobic index (P < 0.05). The severity of these disorders influenced the severity of carbohydrate malabsorption: with an increase in the level of undigested sugars in faeces >0.5 %, the anaerobic index values were 3 and 5 times lower than at a carbohydrate level ≤0.5 % on the 3rd and 5th days of the disease, respectively (P < 0.05). Conclusions. It has been found that early-aged children with rotavirus infection have structural and functional disorders of the intestinal microflora, which influence the severity of carbohydrate malabsorption syndrome. The lower the saccharolytic activity of intestinal bacteria, the more pronounced the manifestations of this syndrome during the entire period of the disease.

Introduction: Rotavirus is the leading cause of severe, life threatening gastroenteritis in infants and young children. As rotavirus strains vary between geographic areas, region specific genotyping information is highly vital to study rotavirus epidemiology and to monitor strain variation after vaccine introduction. Aim: To estimate the prevalence of rotavirus diarrhoea and strains causing the infection among children younger than five years of age and to study the clinical profile of rotavirus diarrhoea to ascertain factors associated with rotavirus infection in them. Materials and Methods: This hospital-based cross-sectional study was carried out on 150 children under five years with diarrhoea in the Department of Paediatrics, Government Medical College, Chennai, Tamil Nadu, India from November 2017 to August 2018. The clinical severity was assessed by using Vesikari score. By using PremierTM Rotaclone ELISA Kit rotavirus antigen was detected. Positive samples were tested for RNA identification by Reverese Transcriptase-Polymerase Chain Reaction (RT-PCR). The IBM Statistical Package for the Social Sciences (SPSS) version 22 was used for statistical analysis. Results: The prevalence of rotavirus diarrhoea was 17.3% and positive samples belonged to G3 type. Prevalence of rotavirus diarrhoea among the vaccinated children was less when compared to unvaccinated children (p-value 0.034). Clinical severity score (Vesikari score) indicated that patients infected with rotavirus had severe disease as compared to rotavirus non infected patients (p-value 0.011). The duration of hospital stay was longer in rotavirus-positive children as compared to rotavirus-negative children (p-value

The SARS-CoV-2 infection in children associates multiple challenges related especially to the diagnosis due to the lack of symptoms or due to the polymorph clinical picture that might occur in these children, and which can often mimic a wider spectrum of pathologies. The Rotavirus infection is one of the most common etiologies of acute gastroenteritis in children which might result in increased mortality rates in small ages or in patients at risk. We report the case of a 2-month-old male infant, without significant personal history admitted to the Pediatrics Clinic 1, COVID Compartment, Targu-Mures, for vomiting, loss of appetite, and diarrhea. The family history revealed that the paternal grandfather was confirmed with SARS-CoV-2 infection. Based on the patient’s symptoms and anamnesis, he was tested and confirmed with SARS-CoV-2 by RT-PCR. The stool viral antigens confirmed also Rotavirus infection. The clinical exam at the time of admission pointed out influenced general status, diminished cutaneous turgor, abdominal tenderness at palpation and accelerated bowel movements. The laboratory tests revealed severe dehydration associated with positive inflammatory biomarkers. Taking into account the small age, the presence of coinfection and the severe dehydration, we initiated supportive treatment with rehydration solutions by vein, antibiotics, anticoagulant and symptomatic treatment. The patient’s evolution was favorable with the previously mentioned treatment. The early diagnosis of a possible coinfection in pediatric ages represents the cornerstone in preventing potential complications. The SARS-CoV-2 infection in children associates multiple challenges related especially to the diagnosis due to the lack of symptoms or due to the polymorph clinical picture that might occur in these children, and which can often mimic a wider spectrum of pathologies. The Rotavirus infection is one of the most common etiologies of acute gastroenteritis in children which might result in increased mortality rates in small ages or in patients at risk. We report the case of a 2-month-old male infant, without significant personal history admitted to the Pediatrics Clinic 1, COVID Compartment, Targu-Mures, for vomiting, loss of appetite, and diarrhea. The family history revealed that the paternal grandfather was confirmed with SARS-CoV-2 infection. Based on the patient’s symptoms and anamnesis, he was tested and confirmed with SARS-CoV-2 by RT-PCR. The stool viral antigens confirmed also Rotavirus infection. The clinical exam at the time of admission pointed out influenced general status, diminished cutaneous turgor, abdominal tenderness at palpation and accelerated bowel movements. The laboratory tests revealed severe dehydration associated with positive inflammatory biomarkers. Taking into account the small age, the presence of coinfection and the severe dehydration, we initiated supportive treatment with rehydration solutions by vein, antibiotics, anticoagulant and symptomatic treatment. The patient’s evolution was favorable with the previously mentioned treatment. The early diagnosis of a possible coinfection in pediatric ages represents the cornerstone in preventing potential complications. [ABSTRACT FROM AUTHOR]

The aim – to determine the laboratory manifestations of carbohydrate malabsorption syndrome in the dynamics of rotavirus infection in early age children and to identify the factors that influence its severity. Materials and methods. The study included 60 breastfed children aged 1–24 months with rotavirus infection, who underwent pH-metry of feces, semi-quantitative determination of total carbohydrates (Benedict’s method), lactose (Malfatti method) and glucose (test systems Glucophan) in feces on the 2nd, 3rd, 5th, 7th and 10th days of the disease. Results. Carbohydrate malabsorption syndrome was observed in 98.3% of patients. The level of fecal carbohydrates increased on the second-third day to a clinically significant 0.50 [0.20; 1,50] %, reached its maximum in the midst of the disease – from the fifth to the seventh day (0.75 [0.50; 1.65] % and 0.87 [0.40; 1.65] %, respectively), decreasing during convalescence to 0.50 [0.20; 1.50] % (P < 0.05 relative to the 10th day), but remained elevated in 81.7 % of patients (P < 0.05 relative to healthy children). Lactase deficiency and glucose malabsorption (P < 0.05 relative to healthy children) were observed throughout the RVI period. At all stages of RVI there was a strong direct correlation between the total level of carbohydrates and lactose in the feces (on the second, third, fifth, seventh and tenth days r = 0.91; r = 0.86; r = 0.91; r = 0.89, respectively). The age dependence of the severity of laboratory indicators of carbohydrate malabsorption was established. Children in the first 6 months had the highest maximum levels of carbohydrates and fecal lactose – 1.75 [1.00; 2.00] % and 3.50 [2.00; 4.00] + respectively (P < 0.05 relative to 12–24 months children) and significantly higher values of these indicators in the dynamics of RVI (P < 0.05 relative to 12–24 months children) for the second-third, fifth and the tenth day). Children with concomitant food allergies, atopic dermatitis and iron deficiency anemia had 2.0 and 1.5 times higher maximum levels of carbohydrates and lactose in the stool, respectively (P < 0.05), as well as higher values of these indicators in the dynamics of the disease – on the third and fifth days (P < 0.05). Conclusions. The vast majority of young patients with rotavirus infection have carbohydrate malabsorption syndrome, which occurs from the first days of the disease and is most pronounced on the fifth to seventh day (P < 0.05 relative to the 10th day), realized mainly due to lactase deficiency. The most pronounced carbohydrate malabsorption syndrome and lactase deficiency in the dynamics of the disease are present in children of the first six months of life. Factors that increase the severity of carbohydrate malabsorption due to secondary lactase deficiency in the acute period of rotavirus infection are concomitant food allergies, atopic dermatitis and iron deficiency anemia.

Context 18β-Glycyrrhetinic acid (18β-GA), a pentacyclic triterpenoid saponin metabolite of glycyrrhizin, exhibits several biological activities. Objective We investigated the effects of 18β-GA on MA104 cells infected with rotavirus (RV) and its potential mechanism of action. Materials and methods Cell Counting Kit-8 was used to assess tissue culture infective dose 50 (TCID50) and 50% cellular cytotoxicity (CC50) concentration. MA104 cells infected with RV SA11 were treated with 18β-GA (1, 2, 4, and 8 μg/mL, respectively). Cytopathic effects were observed. The virus inhibition rate, concentration for 50% of maximal effect (EC50), and selection index (SI) were calculated. Cell cycle, cell apoptosis, and mRNA and protein expression related to the Fas/FasL pathway were detected. Results TCID50 of RV SA11 was 10−4.47/100 µL; the CC50 of 18β-GA on MA104 cells was 86.92 µg/mL. 18β-GA showed significant antiviral activity; EC50 was 3.14 μg/mL, and SI was 27.68. The ratio of MA104 cells infected with RV SA11 in the G0/G1 phase and the G2/M phase decreased and increased, respectively, after 18β-GA treatment. 18β-GA significantly induced apoptosis in the infected cells. Furthermore, after 18β-GA treatment, the mRNA and protein expression levels of Fas, FasL, caspase 3, and Bcl-2 decreased, whereas the expression levels of Bax increased. Discussion and conclusions The study demonstrates that 18β-GA may be a promising candidate for the treatment of RV SA11 infection and provides theoretical support for the clinical development of glycyrrhizic acid compounds for the treatment of RV infection.

Probiotics represent viable microorganisms which are found within the normal gut microbiota, that exert strain-specific benefits in the management of several gastrointestinal disorders in children, including acute gastroenteritis. This review aims to evaluate the pathogen-specific role of probiotic supplementation in childhood diarrhea. A search of scientific databases was conducted to identify studies which investigated efficacy of probiotics and synbiotics in influencing outcome of acute gastroenteritis of known etiology. We identified 32 studies, most of which analyzed impact of probiotic supplementation in rotavirus gastroenteritis, while a very limited number of these conducted a separate analysis on bacterial diarrhea. Lactobacillus rhamnosus (L. rhamnosus), L. reuteri and S. boulardii still remain the most researched strains, with a proven role in decreasing diarrhea and hospitalization duration, especially in the setting of rotavirus infection. Combined products containing at least one of the aforementioned strains also performed similarly and might also influence rotavirus fecal shedding. Rotavirus immunization status has also been proposed as a significant influencing factor of probiotic use impact. The paucity of research focusing on bacterial etiologies, as well as of clinical trials conducted within ambulatory care units leaves room for further research on the matter, which needs to include larger cohort studies.

Rotavirus infection is ubiquitously distributed and represents a global public health problem. Some studies showed that vaccination with pentavalent oral live vaccine was effective in prevention of severe forms of rotavirus gastroenteritis among children up to 3 years of age. Previous randomized placebo-controlled studies assessing this issue were repeatedly conducted. However, due to the features of the epidemiology of pediatric rotavirus infection in Russia, a metaanalysis was conducted in the risk group — children under the age of 3 years by administering a full vaccination course for a single vaccine registered in the Russian Federation. A search was performed by two independent reviewers covering 1994 to February 2019, without restrictions on language, in five databases on medical and biological publications: Russian Science Citation Index, PubMed, Web of Science, MEDLINE, Scopus, and in contents of thematic journals and bibliographic lists. The meta-analysis included multicenter randomized controlled trials comparing the efficacy of placebo and completed full vaccination course with pentavalent live oral rotavirus vaccine in children under 3 years of age. The primary endpoint of the study was the incidence of severe gastroenteritis among children according to the Vesikari evaluation system. Data processing and generation of forest-plots to evaluate summarized results were carried out by the RevMan 5.3 free software distributed on the Cochrane Community website. The implementation of the “trim and fill” method was performed by using Stata 14.2 software. The meta-analysis consisted of 7 original publications performed as multicenter randomized, placebo-controlled double-blind studies. In the experimental and control group there were enrolled 19,384 and 19,425 subjects, respectively. Three-dose vaccination protocol markedly reduced a risk of infection with severe rotavirus gastroenteritis in the experimental group compared to control group, the odds ratio was 0.34 [95%, CI 0.19—0.60]. Cluster analysis also confirmed the protective effect of the full vaccination course. Group assessment of the vaccination effectiveness against rotavirus infection in countries of Africa and Southeast Asia showed significant protection, the odds ratio was 0.60 [95%, CI 0.52—0.70]. While evaluating the effectiveness of vaccination against rotavirus infection in Finland, the odds ratio was set at the level of statistical significance and reached 0.07 [95%, CI 0.04—0.11]. Thus, a full vaccination course with pentavalent live oral vaccine against rotavirus infection lowers a risk of developing severe rotavirus gastroenteritis in young children.

18β-Glycyrrhetinic acid (18β-GA), a pentacyclic triterpenoid saponin metabolite of glycyrrhizin, exhibits several biological activities. We investigated the effects of 18β-GA on MA104 cells infected with rotavirus (RV) and its potential mechanism of action. Cell Counting Kit-8 was used to assess tissue culture infective dose 50 (TCID50) and 50% cellular cytotoxicity (CC50) concentration. MA104 cells infected with RV SA11 were treated with 18β-GA (1, 2, 4, and 8 μg/mL, respectively). Cytopathic effects were observed. The virus inhibition rate, concentration for 50% of maximal effect (EC50), and selection index (SI) were calculated. Cell cycle, cell apoptosis, and mRNA and protein expression related to the Fas/FasL pathway were detected. TCID50 of RV SA11 was 10−4.47/100 µL; the CC50 of 18β-GA on MA104 cells was 86.92 µg/mL. 18β-GA showed significant antiviral activity; EC50 was 3.14 μg/mL, and SI was 27.68. The ratio of MA104 cells infected with RV SA11 in the G0/G1 phase and the G2/M phase decreased and increased, respectively, after 18β-GA treatment. 18β-GA significantly induced apoptosis in the infected cells. Furthermore, after 18β-GA treatment, the mRNA and protein expression levels of Fas, FasL, caspase 3, and Bcl-2 decreased, whereas the expression levels of Bax increased. The study demonstrates that 18β-GA may be a promising candidate for the treatment of RV SA11 infection and provides theoretical support for the clinical development of glycyrrhizic acid compounds for the treatment of RV infection. [ABSTRACT FROM AUTHOR]

Rotavirus infections cause severe gastroenteritis in small children, with both high morbidity and mortality. The rotavirus vaccine has been recommended by the World Health Organization since 2009 and was being used by 108 countries by 2019. It joined Sweden's national immunisation programme that year, after 5 years of selective regional use. This review summarises the baseline facts and evidence, the most common vaccines and the global direct and indirect effects, with a special focus on Sweden. Conclusion: The vaccine has had a considerable impact on global and Swedish morbidity and mortality, but some indirect effects and socioeconomic differentials need research. [ABSTRACT FROM AUTHOR]

Introduction. Rotavirus infection (RVI) is the most common cause of severe gastroenteritis in infants and young children worldwide: 600,000 children die annually; it accounts for approximately 3 million hospitalizations and 25 million physician visits each year among children. Preventive vaccination is universally recognized as the most effective measure against this infection.The purpose of the study is assessment of reactogenicity, safety and immunogenicity of the pentavalent live vaccine for RVI prevention in childhood immunization.Materials and methods. The first multicenter prospective, randomized, double-blind, placebo-controlled clinical trial of the pentavalent live vaccine for RVI prevention was conducted in Russia among healthy infants aged 2 months at the time of the first vaccination.Results. The vaccine had a satisfactory safety profile and high immunologic activity when administered in a threedose series for childhood immunization. No negative changes in the children’s health condition were detected during the surveillance monitoring.Discussion. The seroconversion rates, the seroconversion factor and the geometric mean antibody titer were consistent with the results obtained during trials of the above vaccine and its equivalents in other countries.

The article deals with the effectiveness of the use of racecadotril preparation as a pathogenetic agent in the treatment of rotavirus infection in children. There were 40 patients under the age of 5 years with rotavirus infection under observation. All children underwent a set of general laboratory studies. To establish the etiological factor, immunochromatographic analysis was used to detect rotavirus antigen, and bacteriological examination of the feces — to study bacterial flora. Comprehensive treatment included basic therapy according to protocols. Children of the main group (n = 20) received the antisecretory drug racecadotril in an age-related dosage from the first day of inpatient treatment. The use of this drug has influenced the main clinical symptoms of rotavirus infection in children — accelerated the elimination of vomi­ting and normalization of the consistency of feces, and also allowed reducing the duration of diarrheal syndrome, which also allowed us to decrease the time of inpatient treatment in an infectious disease hospital.

The rotavirus infection causes acute gastroenteritis and is a major cause of lethal severe dehydrating diarrhoea in children under 5 years of age worldwide. Live attenuated rotavirus vaccines are the only means of preventing severe forms of the disease. The aim of the study was to analyse the twenty-year international experience of prophylactic immunisation against rotavirus infection. The paper summarises safety and efficacy data on the long-term use of Rotarix® (Belgium) and RotaTeq® (USA) for the prevention of rotavirus infection in the WHO European Region, the European Union and other countries. It addresses the development of correlates of immune protection for vaccines as well as evaluation of efficacy and safety of the new vaccines Rotavac® and Rotasiil® (India) in clinical trials. The authors analysed international experience of using the vaccines in countries that do not keep records of infant mortality from diarrhoea. The study summarises the results of clinical studies on the use of new vaccines prequalified by WHO in 2018 in regions with high rates of infant mortality from diarrhoea. It was demonstrated that vaccination not only reduces the rates of hospital admission of immunised children, but also contributes to the development of herd immunity. Rotarix® and RotaTeq® vaccines are authorised or included in the national immunisation schedules of many countries, but this type of vaccination is not mandatory in most of these countries. Vaccination coverage in the EU countries is about 24 %. Alternative vaccination schemes using live attenuated vaccines based on strains derived from newborn children, and parenteral rotavirus vaccines which do not replicate in the intestine may help reduce existing risks. It was concluded that the introduction of live rotavirus vaccines in immunisation schedules should be accompanied by the analysis of incidence of intussusception of the small intestine before and after the introduction of mass immunisation, and by active pharmacovigilance.

Despite, the improved healthcare system, diarrhea is considered as leading cause of child morbidity and mortality. Young children under age of 5 years have more propensity to be affected by water-borne infections particularly diarrhea, according to an estimation over 200,000 mortality of children occur annually by preventable diseases due to poor hygienic conditions, lack of sanitary facilities and contaminated water. Rotavirus is the main causative agent for inducing diarrheal hospitalization. Since 2006, vaccines for rotavirus has introduced by WHO and recommended for countries to make the part of their national immunization program. Generally, 2 licensed vaccines are used internationally and these have high effectiveness. Many other vaccines are still in developing phase. Though, some others pre-qualified vaccines are used in developing countries. Yet, coverage for rotavirus vaccination is not reached to satisfactory level. Except the efforts, certain barriers exist for vaccination including high cost of vaccine, limited perception and knowledge of families and health priorities. To overcome these barriers, there is need of distinguished role of community health workers and pharmacists.

The aim is to assess the intestinal microflora functional and structural disorders in early-aged children in the dynamics of rotavirus infection by studying intestinal metabolites in faeces – short-chain fatty acids (SCFA). Materials and methods. The study included 60 breastfed children aged 1-24 months with rotavirus infection (the study group) and 30 healthy children, representative by age and sex (the comparison group). Determination of SCFA (acetate, propionate, butyrate) in faeces was carried out in all children of the study group three times in the dynamics of the disease (on the 3rd, 5th and 10th day) and in healthy children once. Results. The total concentration of SCFA in children with rotavirus infection was 3 and 2.2 times lower than in healthy children in the acute period of the disease (p

Previously, we constructed a library of Ligilactobacillus salivarius strains from the intestine of wakame-fed pigs and reported a strain-dependent capacity to modulate IFN-β expression in porcine intestinal epithelial (PIE) cells. In this work, we further characterized the immunomodulatory activities of L. salivarius strains from wakame-fed pigs by evaluating their ability to modulate TLR3- and TLR4-mediated innate immune responses in PIE cells. Two strains with a remarkable immunomodulatory potential were selected: L. salivarius FFIG35 and FFIG58. Both strains improved IFN-β, IFN-λ and antiviral factors expression in PIE cells after TLR3 activation, which correlated with an enhanced resistance to rotavirus infection. Moreover, a model of enterotoxigenic E. coli (ETEC)/rotavirus superinfection in PIE cells was developed. Cells were more susceptible to rotavirus infection when the challenge occurred in conjunction with ETEC compared to the virus alone. However, L. salivarius FFIG35 and FFIG58 maintained their ability to enhance IFN-β, IFN-λ and antiviral factors expression in PIE cells, and to reduce rotavirus replication in the context of superinfection. We also demonstrated that FFIG35 and FFIG58 strains regulated the immune response of PIE cells to rotavirus challenge or ETEC/rotavirus superinfection through the modulation of negative regulators of the TLR signaling pathway. In vivo studies performed in mice models confirmed the ability of L. salivarius FFIG58 to beneficially modulate the innate immune response and protect against ETEC infection. The results of this work contribute to the understanding of beneficial lactobacilli interactions with epithelial cells and allow us to hypothesize that the FFIG35 or FFIG58 strains could be used for the development of highly efficient functional feed to improve immune health status and reduce the severity of intestinal infections and superinfections in weaned piglets.

Previously, we constructed a library of Ligilactobacillus salivarius strains from the intestine of wakame-fed pigs and reported a strain-dependent capacity to modulate IFN-β expression in porcine intestinal epithelial (PIE) cells. In this work, we further characterized the immunomodulatory activities of L. salivarius strains from wakame-fed pigs by evaluating their ability to modulate TLR3- and TLR4-mediated innate immune responses in PIE cells. Two strains with a remarkable immunomodulatory potential were selected: L. salivarius FFIG35 and FFIG58. Both strains improved IFN-β, IFN-λ and antiviral factors expression in PIE cells after TLR3 activation, which correlated with an enhanced resistance to rotavirus infection. Moreover, a model of enterotoxigenic E. coli (ETEC)/rotavirus superinfection in PIE cells was developed. Cells were more susceptible to rotavirus infection when the challenge occurred in conjunction with ETEC compared to the virus alone. However, L. salivarius FFIG35 and FFIG58 maintained their ability to enhance IFN-β, IFN-λ and antiviral factors expression in PIE cells, and to reduce rotavirus replication in the context of superinfection. We also demonstrated that FFIG35 and FFIG58 strains regulated the immune response of PIE cells to rotavirus challenge or ETEC/rotavirus superinfection through the modulation of negative regulators of the TLR signaling pathway. In vivo studies performed in mice models confirmed the ability of L. salivarius FFIG58 to beneficially modulate the innate immune response and protect against ETEC infection. The results of this work contribute to the understanding of beneficial lactobacilli interactions with epithelial cells and allow us to hypothesize that the FFIG35 or FFIG58 strains could be used for the development of highly efficient functional feed to improve immune health status and reduce the severity of intestinal infections and superinfections in weaned piglets. [ABSTRACT FROM AUTHOR]

There have been no large-scale studies on the epidemiology of benign convulsions with mild gastroenteritis (CwG) since the introduction of the rotavirus vaccine in South Korea in 2007. This study aimed to analyze the trends in rotavirus gastroenteritis (RVGE) and rotavirus-associated CwG (RaCwG) after rotavirus vaccination. Further, we aimed to analyze changes in norovirus gastroenteritis (NVGE) and norovirus-associated CwG (NaCwG) using nationwide data from the Korean Health Insurance Review and Assessment Service. Between 2007 and 2019, this study analyzed children aged <6 years who were diagnosed with RVGE, NVGE, RaCwG and NaCwG. The changes in the prevalence of each disease and the ratio of CwG to enteritis were analyzed and the effects of age, sex and season were also analyzed. RVGE, RaCwG, NVGE and NaCwG were diagnosed in 273,898, 4246, 35,593 and 337 patients, respectively. The prevalence of RVGE was on a decreasing trend every year, but the prevalence of NaCwG and NVGE was on an increasing trend. There was a significant annual increase in the ratio of CwG to enteritis in both viruses. In order to control the prevalence of RaCwG, measures other than the rotavirus vaccine are required and measures to prevent norovirus are necessary. [ABSTRACT FROM AUTHOR]

Aim. To analyze the epidemiological situation of rotavirus infection in the Orenburg region, taking into account the manifestations of the epidemic process and the molecular genetic characteristics of rotavirus group. Materials and methods. We рresented the results of epidemiological and molecular genetic monitoring of rotavirus infection in the period 2013-2017. Molecular genetic typing was performed in 232 fecal samples of patients under 3 years of age with rotavirus infection. Were used methods of retrospective epidemiological analysis, ELISA, PCR. Results. The incidence of high tear and had a tendency to increase. The most affected were children under 14 years of age. The genetic potential of the rotavirus population in the region was represented by ten main genotypes. The leading significance in the epidemic process were genotypes with the highest frequency of occurrence: G4[P]8 (56,9%), G9[P]8 (12,9%), Mixt (8,6%), G2[P]4 (7,7%), G1[P]8 (6,5%). Conclusion. Were revealed a significant increase in the incidence of rotavirus infection among children. Were revealed the dominant genotypes of rotaviruses, their regional diversity and change during several seasons.

Rotavirus infection is a widespread cause of severe gastroenteritis in children in low-income countries. Specific prophylaxis in young children has become the most important means of combating severe rotavirus gastroenteritis. The review presents current data on the molecular biology and genetic diversity of rotaviruses, interaction of viral proteins with host cell receptors, molecular aspects of infectivity and pathogenesis of rotavirus infection, and the development of immunity. It addresses a new approach to the epidemiology of rotavirus infection which regards it as a manageable infection, it illustrates the specificity of the epidemic process based on data gained from extensive experience in vaccination, and summarises relevant information on the introduction of rotavirus vaccines into the international healthcare practice. The paper summarises risks associated with the use of vaccines based on the analysis of WHO statistics, scientific publications on the epidemiology of rotavirus infection, and the results of vaccination. It analyses approaches of the competent authorities of some countries to the tactics of vaccination against rotavirus infection and the WHO stance on the use of existing vaccines for the prevention of rotavirus infection. A conclusion was made that it is necessary to further improve the tactics of vaccine prevention of rotavirus infection in Russia, to study the incidence of idiopathic intussusception, and to conduct further studies aimed at characterisation of existing and newly emerging genotypes of rotavirus.

Introduction: Rotavirus infection is a major cause of morbidity and mortality in infants and young children with diarrhea throughout the world.

The paper shows the leading etiological role of rotavirus infection among the causes of acute gastroenteritis and secretory diarrhea in childhood. It describes the contribution of rotavirus in the structure of nosocomial gastrointestinal infections. In a temperate climate, the pathogen is characterized by winter seasonality and a certain age dependence (mostly at an early age). The typical clinical features of rotavirus infection are a combination of respiratory and gastrointestinal manifestations in the form of respiratory catarrh and acute gastroenteritis. In recent years, the role of rotavirus in the development of extraintestinal cerebral symptoms (meningoencephalitis, seizures, myositis, and poliomyelitis-like illnesses) has been proved.

It was found that rotavirus infection occupies a large part among infectious gastroenteritis in children, with an increasing the incidences in winter and spring. We have studied the main clinical and diagnostic characteristics of rotavirus gastroenteritis. Dyspeptic disorders, intoxication and dehydration symptoms dominated among the clinical manifestations in children. It was found that none of the hospitalized patients received specific prevention of rotavirus infection, while vaccination is the most effective and safe method of prevention. That is why the ways of vaccination against rotavirus infection in Ukraine should be considered.

Abstract Background Rotavirus (RV) infection in neonates can be mild or even asymptomatic. In RV infection, jaundice is often reported, but the relationship between jaundice and RV infection has not been studied. This study aimed to determine the importance of asymptomatic RV screening in neonates with jaundice. Methods Neonates from the neonatal intensive care unit (NICU) of Chonbuk National University Hospital, those transferred from local obstetrics and gynecology hospitals and outpatient clinics were selected from 2014 to 2017. The study included only infants aged between 3 and 28 days. Jaundice was defined according to gestational age and birth age, in accordance with the American Academy of Pediatrics guidelines criteria. RV infection was confirmed by a stool test, and RV screening and laboratory tests were performed at admission. Results Among 596 patients, 166 patients had jaundice. RV infection was observed in 70 (42%) jaundice patients. There were 36 (22%) jaundice patients with asymptomatic RV infection. Patients with onset of jaundice 3–7 days after birth had a high incidence of RV infection. When the RV test was positive, the risk of jaundice was significantly high [odds ratio (OR) 1.89; 95% confidence interval (CI), 1.20–2.98; p = 0.006]. Conclusions Infants with the onset of jaundice > 3 days after birth were likely to have RV infection. Therefore, we suggest that screening tests for RV infection be included as part of the evaluation of jaundiced infants presenting to NICU.

The incidence of acute intestinal infections in Russia is ranked 3rd 4th among all infectious diseases, and rotavirus is the most frequent etiologic factor in children under 5 years old. Almost 40% of children under the age of two have three episodes of rotavirus infection, the same group undergo the most severe course of the disease. Rotavirus gastroenteritis causes 197,000 annual deaths, 23 children die due to this infection every hour. The high resistance of rotavirus in the environment, the ease of transmission and the large number of asymptomatic carriers predetermine the need for timely vaccination. There are 2 licensed oral live attenuated rotavirus vaccines on the international market, one of which is RotaTeq pentavalent vaccine.