BACKGROUND: Two vaccines to prevent disease from rotavirus among young children were recently approved in the United States. Although previous studies of the burden of rotaviral disease have focused on hospitalizations, the assessment of baseline disease burden in ambulatory settings is useful for evaluating the overall impact of the vaccine.METHODS: Outpatient and emergency department (ED) data for 1994–2006 were analyzed from 2 nationally representative databases: the National Ambulatory Medical Care Survey and the National Hospital Medical Care Survey. Visits by children (younger than 5 years) with acute gastroenteritis (AGE) were identified by using a defined set of International Classification of Diseases, Ninth Revision, Clinical Modification codes. Two previously described methods (the winter-residual-excess [WRE] and Brandt methods) were used to estimate the proportion of AGE attributable to rotavirus and to determine the annual number of visits, annual average visits, and annual visit rates in each setting.RESULTS: The estimated average annual number of rotavirus-associated visits over the 13-year period was 782 453 outpatient visits and 164 261 ED visits from the WRE method and 665 773 outpatient visits and 205 206 ED visits from the Brandt method. This resulted in an average of 39.1 and 33.3 outpatient visits per 1000 children and 8.2 and 10.3 ED visits per 1000 children for both the WRE and Brandt methods, respectively. The average annual proportion of visits for AGE attributed to rotavirus was 34.2% (29.1% from the Brandt method) in the outpatient setting and 21.8% (27.1% from the Brandt method) in the ED, with wide variations in individual years.CONCLUSIONS: Before the rotavirus vaccine, rotavirus seemed to be associated with a large number of outpatient and ED visits among young children. Rotavirus vaccine has the potential to reduce many outpatient and ED visits.
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机译：背景：最近，美国批准了两种预防轮状病毒疾病的疫苗。尽管以前关于轮状病毒疾病负担的研究都集中在住院方面，但对非卧床环境中基线疾病负担的评估对于评估疫苗的总体效果还是有用的。方法：分析了1994-2006年的门诊和急诊科（ED）数据来自2个具有国家代表性的数据库：国家门诊医疗调查和国家医院医疗调查。通过使用一组定义的国际疾病分类（第9版，临床修改）来识别患有急性胃肠炎（AGE）的儿童（5岁以下）的来访。使用两种先前描述的方法（冬季剩余超量[WRE]和Brandt方法）来估算轮状病毒所致AGE的比例，并确定每种情况下的每年就诊次数，年平均就诊次数和年访率。结果：在13年内，轮状病毒相关的就诊年平均估计数是WRE方法的门诊就诊782 453例，ED 164 261 ED诊疗，Brandt方法的665 773例门诊和205 206 ED ED诊疗。对于WRE和Brandt方法，这分别导致每1000名儿童平均39.1和33.3名门诊以及每1000名儿童8.2和10.3名ED就诊。在门诊患者中，轮状病毒引起的AGE的年平均就诊比例在门诊患者中为34.2％（Brandt方法为29.1％），在急诊室为21.8％（Brandt方法为27.1％），各年间差异很大。在使用轮状病毒疫苗之前，轮状病毒似乎与幼儿中的大量门诊和急诊就诊有关。轮状病毒疫苗具有减少许多门诊和急诊就诊的潜力。
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