Rotavirus strains are diverse, changing
Rotavirus strains are characterized by enormous diversity and capacity for change. [20] In the US from 1996-1999, the most common serotypes were [8]:
- G1
- G2
- G3
- G4
- G9
Changing serotype patterns
Studies in the US and other countries consistently demonstrate the predominance of serotype G1. However, as seen in the table below, other serotypes increase or decrease in prevalence.
Prevalence of rotavirus serotypes in a US city
Rank of secondary serotypes may change by year
n=number of typeable specimens.
Adapted from Clark HF, et al. J Clin Microbiol. 2004;42:1434-1438.
Regional patterns may also exist
The annual prevalence of rotavirus serotypes can vary country to country but also within regions of a country. For instance, in New England, for most of the years between 1982-1991, the predominant serotype was G1. However, in 1984-1985, the predominant serotype in this region was G4, and in 1987-1988, G3. [21]
An Emerging Serotype
The story of the G9 serotype
The G9 serotype illustrates how rotavirus serotype prevalence can change. The G9 serotype was first detected in the 1980s and then sporadically detected for more than a decade. [6,22, 23,24] It is now recognized as one of the predominant rotavirus strains in the United States and worldwide. [24]
In Australia, strains of G9 were 0.6% of all rotavirus strains found in 1997. Five years later, G9 was the most common strain nationally (40.4% of strains). [25]
In Philadelphia, US, G9 caused an outbreak of RGE in 1995-96 winter season. [12]
Indications and Usage
ROTARIX is indicated for the prevention of rotavirus gastroenteritis caused by G1 and non-G1 types (G3, G4, and G9) when administered as a 2-dose series in infants and children.
Important Safety Information
- In clinical studies, common adverse events were fussiness/irritability, cough/runny nose, fever, loss of appetite, and vomiting.
- History of uncorrected congenital malformation of the gastrointestinal tract is a contraindication.
- Previous hypersensitivity to any component of ROTARIX, including latex rubber, should be reviewed prior to administration.
- Administration in infants suffering from acute diarrhea or vomiting should be delayed.
- Safety and effectiveness in infants with chronic gastrointestinal disorders, or with known primary or secondary immunodeficiencies, have not been evaluated.
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![: Only ROTARIX is indicated to protect against G9. [1,2]](/images/callout-4.3.gif)