We are grateful to all patients who donated their blood samples f

We are grateful to all patients who donated their blood samples for this study and to Thongchai Hongsrimuang, Sunee Seethamchai, Pannadhat Areekul, Ratiporn Kosuwin, Urassaya Pattanawong, Teerayot Kobasa and the staff of the Bureau of Vector Borne Disease, Department of Disease Control, Ministry of Public Health, Thailand, for assistance in field work. This research was supported by grants from the National Research Council of Thailand and the Thai Government Research Budget

to S.J and C.P.; The Thailand Research Fund (RMU5080002) to C.P.; and from the National Institutes of Health (GM43940) to A.L.H. “
“Rotavirus is the most common cause of acute gastroenteritis in children under 5 years of age [1]. In developed countries, rotavirus gastroenteritis

remains a common AP24534 order cause of hospitalization at great cost to health services [2]. In England and Wales, the annual incidence Natural Product Library of rotavirus hospitalizations is estimated at 4.5 per 1000 children under the age of 5 years and the cost to the National Health Service estimated to be GBP 14.2 million per year [3]. The second generation of live oral rotavirus vaccines have demonstrated safety and efficacy [4] and [5] and are increasingly being used routinely as part of childhood immunization schedules in a number of middle and high income countries [6] and [7]. The Rotarix vaccine, made from the most common human serotype G1P1A[8], is recommended no by WHO as a two-dose schedule to be given at two and four months of age [8]. RotaTeq, a pentavalent vaccine developed from a bovine rotavirus strain and combined with reassorted strains of human serotypes G1, G2, G3, G4

and P1A[8], is WHO-recommended as a three-dose schedule to be given at two, four and six months of age [8]. In the United States, following the introduction of RotaTeq in 2006, there was a delay in the timing of peak incidence in the 2007–2008 season by two to four months and fewer cases overall compared to previous years [6]. This provides the first indication, post-licensure, that rotavirus vaccination reduces the burden of rotavirus disease in a large population and suggests that vaccination may also have an impact on transmission. Other high and middle income countries which have introduced rotavirus vaccination have shown similar effects [7] and [9]. In England and Wales, the introduction of rotavirus vaccination is currently under consideration. This study aims to develop a dynamic model of rotavirus transmission, and apply it to daily case reports of rotavirus disease from England and Wales. Using this model, we examine the potential epidemiological impact of a rotavirus mass vaccination programme. In temperate countries, most rotavirus disease occurs in late winter or early spring [10].

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