Expanded Indian National Rotavirus Surveillance Network in the Context of Rotavirus Vaccine Introduction.

OBJECTIVE To extend a nation-wide rotavirus surveillance network in India, and to generate geographically representative data on rotaviral disease burden and prevalent strains. DESIGN Hospital-based surveillance. SETTING A comprehensive multicenter, multi-state hospital based surveillance network was established in a phased manner involving 28 hospital sites across 17 states and two union territories in India. PATIENTS Cases of acute diarrhea among children below 5 years of age admitted in the participating hospitals. RESULTS During the 28 month study period between September 2012 and December 2014, 11898 children were enrolled and stool samples from 10207 children admitted with acute diarrhea were tested; 39.6% were positive for rotavirus. Highest positivity was seen in Tanda (60.4%) and Bhubaneswar (60.4%) followed by Midnapore (59.5%). Rotavirus infection was seen more among children aged below 2 years with highest (46.7%) positivity in the age group of 12-23 months. Cooler months of September to February accounted for most of the rotavirus associated gastroenteritis, with highest prevalence seen during December to February (56.4%). 64% of rotaviru -infected children had severe to very severe disease. G1 P[8] was the predominant rotavirus strain (62.7%) during the surveillance period. CONCLUSION The surveillance data highlights the high rotaviral disease burden in India. The network will continue to be a platform for monitoring the impact of the vaccine.