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Article
August 22, 1990

Annual Rotavirus Epidemic Patterns in North AmericaResults of a 5-Year Retrospective Survey of 88 Centers in Canada, Mexico, and the United States

Author Affiliations

From the Viral Gastroenteritis Unit, Division of Viral and Rickettsial Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Ga (Drs LeBaron, Lew, and Glass); the Bureau of Microbiology, Laboratory Centre for Disease Control, Ottawa, Ontario (Dr Weber); and the Instituto Nacional de la Nutricion, Mexico City, Mexico (Dr Ruiz-Palacios). See the acknowledgments for a list of the members of the Rotavirus Study Group.

From the Viral Gastroenteritis Unit, Division of Viral and Rickettsial Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Ga (Drs LeBaron, Lew, and Glass); the Bureau of Microbiology, Laboratory Centre for Disease Control, Ottawa, Ontario (Dr Weber); and the Instituto Nacional de la Nutricion, Mexico City, Mexico (Dr Ruiz-Palacios). See the acknowledgments for a list of the members of the Rotavirus Study Group.

JAMA. 1990;264(8):983-988. doi:10.1001/jama.1990.03450080069033
Abstract

Rotavirus is the major cause of severe diarrhea in children. A recent study of hospitalizations for diarrhea in the United States suggested that the annual rotavirus epidemic may follow a regional sequence from west to east. As part of a program to establish active surveillance of rotavirus prior to the introduction of vaccines, we obtained 5 years of retrospective data on rotavirus detections from 88 centers throughout North America. Analysis of 34 644 detections indicates that the peak of the annual rotavirus epidemic occurs first in Mexico and the Southwest of the United States in late fall, goes systematically across the continent in the winter, and ends in the Northeast United States and the Maritime Provinces of Canada in the spring. When detections are grouped by region, onset of the epidemic follows the same regional sequence as the peak. To our knowledge, this is the only description of a repetitive geographic sequence for the seasonal epidemic activity of a viral agent. Further studies are indicated to determine whether climate, features of the virus itself, or other factors are responsible for this apparently unique pattern. A system of active surveillance can use this pattern to detect natural alterations in the epidemic behavior of rotavirus and to assess the impact of vaccines.

(JAMA. 1990;264:983-988)

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