Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Protective effect of natural rotavirus infection in an Indian birth cohort
New England Journal of Medicine, Volume 365, No. 4, Year 2011
Notification
URL copied to clipboard!
Description
BACKGROUND: More than 500,000 deaths are attributed to rotavirus gastroenteritis annually worldwide, with the highest mortality in India. Two successive, naturally occurring rotavirus infections have been shown to confer complete protection against moderate or severe gastroenteritis during subsequent infections in a birth cohort in Mexico. We studied the protective effect of rotavirus infection on subsequent infection and disease in a birth cohort in India (where the efficacy of oral vaccines in general has been lower than expected). METHODS: We recruited children at birth in urban slums in Vellore; they were followed for 3 years after birth, with home visits twice weekly. Stool samples were collected every 2 weeks, as well as on alternate days during diarrheal episodes, and were tested by means of enzyme-linked immunosorbent assay and polymerase-chain-reaction assay. Serum samples were obtained every 6 months and evaluated for seroconversion, defined as an increase in the IgG antibody level by a factor of 4 or in the IgA antibody level by a factor of 3. RESULTS: Of 452 recruited children, 373 completed 3 years of follow-up. Rotavirus infection generally occurred early in life, with 56% of children infected by 6 months of age. Levels of reinfection were high, with only approximately 30% of all infections identified being primary. Protection against moderate or severe disease increased with the order of infection but was only 79% after three infections. With G1P[8], the most common viral strain, there was no evidence of homotypic protection. CONCLUSIONS: Early infection and frequent reinfection in a locale with high viral diversity resulted in lower protection than has been reported elsewhere, providing a possible explanation why rotavirus vaccines have had lower-than-expected efficacy in Asia and Africa. (Funded by the Wellcome Trust.) Copyright © 2011 Massachusetts Medical Society. All rights reserved.
Authors & Co-Authors
Muliyil, Jayaprakash
India, Vellore
Christian Medical College, Vellore
Sarkar, Rajiv
India, Vellore
Christian Medical College, Vellore
United States, Houston
Baylor College of Medicine
Rehman, Andrea M.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Jaffar, Shabbar S.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Iturriza-Gómara, Miren
United Kingdom, London
Public Health England
Gray, Jim J.
United Kingdom, Norwich
Norfolk and Norwich University Hospitals Nhs Foundation Trust
United Kingdom, London
Public Health England
Brown, David W.G.
United Kingdom, London
Public Health England
Desselberger, Ulrich
United Kingdom, Cambridge
Addenbrooke's Hospital
John, Jacob Kochukaleekal
India, Vellore
Christian Medical College, Vellore
Babji, Sudhir
India, Vellore
Christian Medical College, Vellore
Estes, Mary Kolb
United States, Houston
Baylor College of Medicine
Kang, Gagandeep
India, Vellore
Christian Medical College, Vellore
Statistics
Citations: 163
Authors: 12
Affiliations: 8
Identifiers
Doi:
10.1056/NEJMoa1006261
ISSN:
00284793
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study