Rotavirus

Epidemic acute gastroenteritis (AGE) is a major contributor to the global burden of morbidity and mortality. Rotavirus and norovirus epidemics present a significant burden annually, with their predominant impact in temperate climates occurring during winter periods. Annually, epidemic rotavirus causes an estimated 600,000 deaths worldwide, and 70,000 hospitalizations in the US, primarily among children <5 years of age. The US burden from norovirus is estimated at 71,000 hospitalizations annually, with the impact more generally across age groups. Changes in rotavirus vaccine use have significantly reduced the impact of epidemic rotavirus.

Objective 

We describe the initial phase of the ISDS Distribute pilot for monitoring AGE syndromic emergency department visits, and present preliminary analysis of age-specific trends documenting a dramatic shift in AGE consistent with US rotavirus vaccine policy and use.

Calls to NHS Direct (a national UK telephone health advice line) which may be indicative of infection show marked seasonal variation, often peaking during winter or early spring. This variation may be related to the seasonality of common viruses. There is currently no routine microbiological confirmation of the cause of illness in NHS Direct callers. Modelling trends in NHS Direct syndromic call data against laboratory data may help by attributing the likely cause of these calls the and surveillance ‘signals’ generated by syndromic surveillance.

Multiple linear regression has been used previously to estimate the contribution of rotavirus and RSV to hospital admission for infectious intestinal disease and lower respiratory tract infections respectively. We applied a similar regression model to NHS Direct syndromic surveillance data and laboratory reports.

Objective

To provide weekly estimates of the proportions of NHS Direct respiratory calls attributable to common infectious disease pathogens.

Public Health England's syndromic surveillance service monitor presentations for gastrointestinal illness to detect increases in health care seeking behaviour driven by infectious gastrointestinal disease. We use regression models to create baselines for expected activity and then identify any periods of signficant increases. The introduction of a rotavirus vaccine in England during July 2013 (Bawa, Z. et al. 2015) led to a reduction in incidence of the disease, requiring a readjustment of baselines.

Objective:

To adjust modelled baselines used for syndromic surveillance to account for public health interventions. Specifically to account for a change in the seasonality of diarrhoea and vomiting indicators following the introduction of a rotavirus vaccine in England.