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Rotavirus remains one of the leading causes of acute gastroenteritis in infants and young children. Most cases have a favourable outcome, but in the most vulnerable children it can cause severe diarrhoea, vomiting and dehydration, to the extent that hospital admission may be required.
A study by the National Centre for Microbiology at the Carlos III Health Institute, in collaboration with CIBERESP, CIBERINFEC and several hospitals in Madrid, has analysed more than 600 cases of rotavirus gastroenteritis in the Community of Madrid. The study combines clinical data with genomic surveillance, an approach that is increasingly used to track the evolution of viruses and detect any significant changes.
The results point to two factors that are particularly linked to hospitalisation in children: not being fully vaccinated and having pre-existing conditions. By contrast, the virus genotype was not associated with more severe symptoms or a higher risk of hospitalisation.
This last finding is important because the study did detect a clear predominance of the G3P[8] genotype, particularly in equine-like strains, which accounted for 62.4 per cent of the strains analysed. Even so, this higher prevalence did not result in greater clinical severity.
Genomic surveillance enables this type of analysis to be refined. Not only does it identify which variants are circulating, but it also helps to check whether any changes are emerging that could alter the protection offered by vaccines. In this case, although differences were observed between some circulating strains and those included in the available vaccines, the researchers found no evidence of vaccine escape or of variants associated with a worse clinical outcome.
Spain has had two rotavirus vaccines available since 2006. According to the Ministry of Health’s recommendations document, both vaccines have good safety profiles and an estimated efficacy of between 80% and 95% against severe illness and hospitalization. Since 2019, the Ministry of Health has also recommended rotavirus vaccination for premature infants, as they are a high-risk group.
The study once again highlights the value of cross-referencing clinical, microbiological and genomic data in public health. In this case, the aim is to identify which factors are associated with hospital admissions due to rotavirus and to monitor whether the circulating strains continue to be covered by the vaccines.
Sources
CIBER-ISCIII — Analysis of the genetic diversity of rotavirus and factors associated with paediatric hospitalisation:
https://www.ciberisciii.es/noticias/analizan-la-diversidad-genetica-del-rotavirus-y-los-factores-asociados-a-la-hospitalizacion-infantil
Ministry of Health — Recommendations on vaccination against rotavirus:
https://www.sanidad.gob.es/areas/promocionPrevencion/vacunaciones/comoTrabajamos/docs/Rotavirus_Recomendaciones2024.pdf