Outbreak of rotavirus gastroenteritis with high mortality, Nicaragua, 2005 Brote de gastroenteritis por rotavirus con alta mortalidad, Nicaragua, 2005

• Main Authors: Juan José Amador, Andrea Vicari, Reina M. Turcios-Ruiz, Ana Christian Melendez D., Mark Malek, Fabiana Michel, Sylvain Aldighieri, Tara Kerin, Joseph S. Bresee, Roger I. Glass, Jon K. Andrus
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2008
• Subjects: Rotavirus; gastroenteritis; epidemiología; vacunas contra rotavirus; Nicaragua; epidemiology; rotavirus vaccines; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Alta
• Online Access: https://doaj.org/article/18f7e4a440794621a2aa29ded0ce8b21

OBJECTIVES: We investigated a nationwide outbreak of severe rotavirus gastroenteritis in Nicaragua in children under 5 years old, leading to many consultations, hospitalizations, and deaths. We questioned whether a vaccine might have prevented these illnesses and deaths, sought to identify risk factors for death, and developed a clinical profile of children hospitalized with diarrhea. METHODS: We conducted a case-control study to determine whether children who died had access to routine immunizations, a proxy predicting access to a rotavirus vaccine. We identified risk factors for death among children who died in the outbreak compared with surviving age-matched controls with diarrhea. We collected stools, clinical data, and immunization data on children hospitalized for diarrhea to test for rotavirus, develop the profile, and forecast future access to a rotavirus vaccine. RESULTS: The outbreak from February to April 2005 caused 47 470 consultations and 52 deaths. Approximately 80% of cases and controls and 60% of children hospitalized with diarrhea had access to routine immunizations and would likely have had access to a rotavirus vaccine. With a vaccine efficacy of 85%, up to 51% of severe rotavirus cases and up to 68% of deaths could have been prevented if a rotavirus vaccine were available as part of routine child-hood immunizations. Study of 35 case-control pairs indicated that severe illnesses, malnutrition, and care by traditional healers were risk factors for death. Rotavirus was found in 42% of samples from hospitalized children and was associated with severe disease and dehydration. CONCLUSIONS: The impact of the seasonal outbreaks of rotavirus disease could be diminished with a rotavirus vaccine, improvements in oral rehydration programs, and training of traditional healers in the proper management of children with acute diarrhea. OBJETIVOS: Se investigó un brote nacional de gastroenteritis grave por rotavirus en niños menores de 5 años de edad que provocó numerosas consultas, hospitalizaciones y ...