Marc-Alain Widdowson

FOODBORNE ILLNESS ACQUIRED IN THE UNITED STATES-MAJOR PATHOGENS

Each year, 31 pathogens caused 9.4 million episodes of foodborne illness, resulting in 55,961 hospitalizations and 1,351 deaths.

Systematic literature review of role of noroviruses in sporadic gastroenteritis.

Noroviruses accounted for 12% of severe gastroenteritis cases among children <5 years of age.

Rotavirus vaccines: current prospects and future challenges

Rotavirus is the most common cause of severe diarrhoea in children worldwide and diarrhoeal deaths in children in developing countries. Accelerated development and introduction of rotavirus vaccines into global immunisation programmes has been a high priority for many international agencies, including WHO and the Global Alliance for Vaccines and Immunizations. Vaccines have been developed that could prevent the enormous morbidity and mortality from rotavirus and their effect should be measurable within 2-3 years. Two live oral rotavirus vaccines have been licensed in many countries; one is derived from an attenuated human strain of rotavirus and the other combines five bovine-human reassortant strains. Each vaccine has proven highly effective in preventing severe rotavirus diarrhoea in children and safe from the possible complication of intussusception. In developed countries, these vaccines could substantially reduce the number and associated costs of child hospitalisations and clinical visits for acute diarrhoea. In developing countries, they could reduce deaths from diarrhoea and improve child survival through programmes for childhood immunisations and diarrhoeal disease control. Although many scientific, programmatic, and financial challenges face the global use of rotavirus vaccines, these vaccines-and new candidates in the pipeline-hold promise to make an immediate and measurable effect to improve child health and survival from this common burden affecting all children.

Molecular and Epidemiologic Trends of Caliciviruses Associated with Outbreaks of Acute Gastroenteritis in the United States, 2000–2004

Between July 2000 and June 2004, fecal specimens from 270 outbreaks of acute gastroenteritis were sent to the Centers for Disease Control and Prevention by local or state health departments for calicivirus testing. Of the 226 outbreaks that met the criteria for inclusion in the present study, caliciviruses were detected in 184 (81%) by reverse-transcription polymerase chain reaction and nucleotide sequencing. Nursing homes, retirement centers, and hospitals were the most frequently reported settings, and person-to-person contact was the most common mode of transmission, followed by foodborne spread. Overall, genogroup II norovirus (NoV) strains were the most abundant (79%), followed by genogroup I NoV strains (19%) and sapovirus (2%). Nucleotide-sequence analysis indicated a great diversity of NoV strains and implicated the emergence of one particular sequence variant in outbreaks occurring between July 2002 and June 2003. The public health impact of caliciviruses will not be fully appreciated, nor will interventions be completely evaluated, until methods to detect these viruses are more routinely used.

Norovirus and foodborne disease, United States, 1991-2000.

Analysis of foodborne outbreaks shows how advances in viral diagnostics are clarifying the causes of foodborne outbreaks and determining the high impact of norovirus infections.

Cost-effectiveness and potential impact of rotavirus vaccination in the United States.

OBJECTIVE. In February 2006, a safe, efficacious, orally administered pentavalent human-bovine reassortant rotavirus vaccine was licensed and recommended for routine immunization of all children in the United States. We assessed the health and economic impacts of a national rotavirus immunization program in the United States. METHODS. Monte Carlo cost-effectiveness analyses, from health care and societal perspectives, of vaccination of a hypothetical US birth cohort of 4010000 children monitored from birth to 59 months of age were performed. We compared the disease and economic burden of rotavirus infection in an unvaccinated cohort of children with one vaccinated at 2, 4, and 6 months with pentavalent human-bovine reassortant rotavirus vaccine. RESULTS. A routine rotavirus immunization program would prevent 13 deaths, 44000 hospitalizations, 137000 emergency department visits, 256000 office visits, and 1100000 episodes requiring only home care for children <5 years of age in the United States. Assuming costs of administration of

Molecular Epidemiology of Genogroup II-Genotype 4 Noroviruses in the United States between 1994 and 2006

10, the break-even price per dose of vaccine was

Burden and epidemiology of rotavirus diarrhea in selected African countries: preliminary results from the African rotavirus surveillance network.

42 from the societal perspective and

Laboratory surveillance of bacterial gastroenteric pathogens in The Netherlands, 1991-2001.

12 from the health care perspective. From the societal perspective, at the manufacturers price of

Norovirus transmission on cruise ship.

62.50 per dose, vaccination would cost