Epidemiology of Rotavirus Infections in Children Less Than 5 Years of Age Germany, 2001-2008

Background: Rotavirus (RV) infection is the leading cause of acute gastroenteritis in young children worldwide. In 2006, 2 live-attenuated RV-vaccines became available for use in infants <= 6 months of age. In Germany, a statutory notification system for RV infection has been in place since 2001 to monitor RV epidemiology. Our objective was to assess RV disease burden in German children <5 years of age. Methods: Detailed descriptive analysis of national RV surveillance data in children <5 years of age collected in Germany between January 2001 and December 2008. Results: Between 2001 and 2008, 72% of all notified RV patients were children <5 years of age. The highest annual incidence (approximately, 200/10,000) was in children <2 years of age. In the <5 years age-group, approximately 50% of reported patients were hospitalized and of those, 9% acquired the infection nosocomially. Since 2004, a total of 8 children <5 years of age were reported as RV-associated deaths, and case fatality due to RV infection was <0.01/10,000. Conclusions: The high incidence of RV infection and RV-associated hospitalization in children <5 years of age results in a high disease burden. Routine childhood RV vaccination would be a measure to reduce the burden in this age-group. However, cost-effectiveness analyses specific to the German setting should be considered in the decision-making process. An RV-surveillance system is in place in Germany that could potentially monitor the effect of an RV-vaccination program once implemented.