To estimate the global illness and deaths caused by rotavirus disease, we reviewed studies published from 1986 to 2000 on deaths caused by diarrhea and on rotavirus infections in children. We assessed rotavirus-associated illness in three clinical settings (mild cases requiring home care alone, moderate cases requiring a clinic visit, and severe cases requiring hospitalization) and death rates in countries in different World Bank income groups. Each year, rotavirus causes approximately 111 million episodes of gastroenteritis requiring only home care, 25 million clinic visits, 2 million hospitalizations, and 352,000–592,000 deaths (median, 440,000 deaths) in children <5 years of age. By age 5, nearly every child will have an episode of rotavirus gastroenteritis, 1 in 5 will visit a clinic, 1 in 60 will be hospitalized, and approximately 1 in 293 will die. Children in the poorest countries account for 82% of rotavirus deaths. The tremendous incidence of rotavirus disease underscores the urgent need for interventions, such as vaccines, to prevent childhood deaths in developing nations.

/pdf/global-illness-and-deaths-caused-by-rotavirus-disease-in-4r3lieayv1.pdf

Global Illness and Deaths Caused by Rotavirus Disease in Children

Background The safety and efficacy of an attenuated G1P[8] human rotavirus (HRV) vaccine were tested in a randomized, double-blind, phase 3 trial. Methods We studied 63,225 healthy infants from 11 Latin American countries and Finland who received two oral doses of either the HRV vaccine (31,673 infants) or placebo (31,552 infants) at approximately two months and four months of age. Severe gastroenteritis episodes were identified by active surveillance. The severity of disease was graded with the use of the 20-point Vesikari scale. Vaccine efficacy was evaluated in a subgroup of 20,169 infants (10,159 vaccinees and 10,010 placebo recipients). Results The efficacy of the vaccine against severe rotavirus gastroenteritis and against rotavirus-associated hospitalization was 85 percent (P<0.001 for the comparison with placebo) and reached 100 percent against more severe rotavirus gastroenteritis. Hospitalization for diarrhea of any cause was reduced by 42 percent (95 percent confidence interval, 29 to 53 percen...

https://www.nejm.org/doi/pdf/10.1056/NEJMoa052434

Safety and Efficacy of an Attenuated Vaccine against Severe Rotavirus Gastroenteritis

The problem of searching the elements of a set that are close to a given query element under some similarity criterion has a vast number of applications in many branches of computer science, from pattern recognition to textual and multimedia information retrieval. We are interested in the rather general case where the similarity criterion defines a metric space, instead of the more restricted case of a vector space. Many solutions have been proposed in different areas, in many cases without cross-knowledge. Because of this, the same ideas have been reconceived several times, and very different presentations have been given for the same approaches. We present some basic results that explain the intrinsic difficulty of the search problem. This includes a quantitative definition of the elusive concept of "intrinsic dimensionality." We also present a unified view of all the known proposals to organize metric spaces, so as to be able to understand them under a common framework. Most approaches turn out to be variations on a few different concepts. We organize those works in a taxonomy that allows us to devise new algorithms from combinations of concepts not noticed before because of the lack of communication between different communities. We present experiments validating our results and comparing the existing approaches. We finish with recommendations for practitioners and open questions for future development.

http://disi.unitn.it/~bernardi/Courses/DL/Extra/extra_CBIR_Similarity_search.pdf

Searching in metric spaces

A safe and effective rotavirus vaccine is urgently needed, particularly in developing countries. Critical to vaccine development and implementation is a knowledge base concerning the epidemiology of rotavirus G and P serotypes/genotypes throughout the world. The temporal and geographical distribution of human rotavirus G and P types was reviewed by analysing a total of 45571 strains collected globally from 124 studies reported from 52 countries on five continents published between 1989 and 2004. Four common G types (G1, G2, G3 and G4) in conjunction with P[8] or P[4] represented over 88% of the strains analysed worldwide. In addition, serotype G9 viruses associated with P[8] or P[6] were shown to have emerged as the fourth globally important G type with the relative frequency of 4.1%. When the global G and/or P type distributions were divided into five continents/subcontinents, several characteristic features emerged. For example, the P[8]G1 represented over 70% of rotavirus infections in North America, Europe and Australia, but only about 30% of the infections in South America and Asia, and 23% in Africa. In addition, in Africa (i) the relative frequency of G8 was as high as that of the globally common G3 or G4, (ii) P[6] represented almost one-third of all P types identified and (iii) 27% of the infections were associated with rotavirus strains bearing unusual combinations such as P[6]G8 or P[4]G8. Furthermore, in South America, uncommon G5 virus appeared to increase its epidemiological importance among children with diarrhea. Such findings have (i) confirmed the importance of continued active rotavirus strain surveillance in a variety of geographical settings and (ii) provided important considerations for the development and implementation of an effective rotavirus vaccine (e.g. a geographical P-G type adjustment in the formulation of next generation multivalent vaccines).

Global distribution of rotavirus serotypes/genotypes and its implication for the development and implementation of an effective rotavirus vaccine.

A very promising idea for fast searching in traditional and multimedia databases is to map objects into points in k-d space, using k feature-extraction functions, provided by a domain expert [25]. Thus, we can subsequently use highly fine-tuned spatial access methods (SAMs), to answer several types of queries, including the 'Query By Example' type (which translates to a range query); the 'all pairs' query (which translates to a spatial join [8]); the nearest-neighbor or best-match query, etc.However, designing feature extraction functions can be hard. It is relatively easier for a domain expert to assess the similarity/distance of two objects. Given only the distance information though, it is not obvious how to map objects into points.This is exactly the topic of this paper. We describe a fast algorithm to map objects into points in some k-dimensional space (k is user-defined), such that the dis-similarities are preserved. There are two benefits from this mapping: (a) efficient retrieval, in conjunction with a SAM, as discussed before and (b) visualization and data-mining: the objects can now be plotted as points in 2-d or 3-d space, revealing potential clusters, correlations among attributes and other regularities that data-mining is looking for.We introduce an older method from pattern recognition, namely, Multi-Dimensional Scaling (MDS) [51]; although unsuitable for indexing, we use it as yardstick for our method. Then, we propose a much faster algorithm to solve the problem in hand, while in addition it allows for indexing. Experiments on real and synthetic data indeed show that the proposed algorithm is significantly faster than MDS, (being linear, as opposed to quadratic, on the database size N), while it manages to preserve distances and the overall structure of the data-set.

/pdf/fastmap-a-fast-algorithm-for-indexing-data-mining-and-1b3mcd8xtt.pdf

FastMap: a fast algorithm for indexing, data-mining and visualization of traditional and multimedia datasets

Background Rotaviruses are the principal known etiologic agents of severe diarrhea among infants and young children worldwide. Although a rhesus rotavirus–based quadrivalent vaccine is highly effective in preventing severe diarrhea in developed countries, in developing countries its efficacy has been less impressive. We thus conducted a catchment study in Venezuela to assess the efficacy of the vaccine against dehydrating diarrhea. Methods In this randomized, double-blind, placebo-controlled trial, 2207 infants received three oral doses of the quadrivalent rotavirus vaccine (4×105 plaque-forming units per dose) or placebo at about two, three, and four months of age. During approximately 19 to 20 months of passive surveillance, episodes of gastroenteritis were evaluated at the hospital. Results The vaccine was safe, although 15 percent of the vaccinated infants had febrile episodes (rectal temperature, >38.1°C) during the six days after the first dose, as compared with 7 percent of the controls (P<0.001). ...

https://www.nejm.org/doi/pdf/10.1056/NEJM199710233371701

Efficacy of the rhesus rotavirus-based quadrivalent vaccine in infants and young children in Venezuela

We present a new data structure, called the fixed-queries tree, for the problem of finding all elements of a fixed set that are close, under some distance function, to a query element. Fixed-queries trees can be used for any distance function, not necessarily even a metric, as long as it satisfies the triangle inequality. We give an analysis of several performance parameters of fixed-queries trees and experimental results that support the analysis. Fixed-queries trees are particularly efficient for applications in which comparing two elements is expensive.

Proximity Matching Using Fixed-Queries Trees

Protection against severe rotavirus diarrhoea by rhesus rotavirus vaccine in venezuelan infants

The efficacy of a rhesus rotavirus vaccine (MMU 18006, serotype 3) against infantile diarrhea was evaluated by active home surveillance of a group of 320 children 1–10 months of age in Caracas, Venezuela. During a 1 year period following oral administration of vaccine or placebo under a double-masked code, over 600 diarrheal episodes were detected. Etiologic studies revealed that heat-stable toxin (ST) producing enterotoxigenic E. coli (ETEC) was the most common diarrheal agent detected (34%) followed by enteropathogenic E. coli (EPEC, 10.9%), heat-labile toxin (LT) producing ETEC (7.6%), rotavirus (6.9%), Cryptosporidium (4.8%) and Campylobacter (1.3%). ST-producing ETEC were also recovered from over 20% of control stool specimens obtained during diarrhea-free periods, whereas EPEC, rotavirus, Cryptosporidium, and Campylobacter were rarely detected in such control specimens. Rotavirus was responsible for about one-half of the more severe cases of diarrhea. Twenty-two of 151 infants who received placebo (14.6%) and eight of 151 receiving a 104 PFU dose of vaccine (5.3%) had rotavirus diarrhea during the follow-up period for an efficacy level of 64% against any rotavirus diarrhea. However, vaccine efficacy reached 90% against the more severe cases of rotavirus diarrhea and was notably high in the 1–4 month age group. Serotypic analysis of the rotaviruses detected suggests that the resistance induced by the vaccine was type specific since significant protection was only evident against serotype 3 rotaviruses. A 103 PFU dose tested initially in 18 children did not appear to protect against rotavirus diarrhea.

Walter Cunto

Papers

Efficacy of the rhesus rotavirus-based quadrivalent vaccine in infants and young children in Venezuela

Proximity Matching Using Fixed-Queries Trees

Protection against severe rotavirus diarrhoea by rhesus rotavirus vaccine in venezuelan infants

Prospective study of diarrheal diseases in Venezuelan children to evaluate the efficacy of rhesus rotavirus vaccine.

Comparison of reactogenicity and antigenicity of M37 rotavirus vaccine and rhesus-rotavirus-based quadrivalent vaccine.