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Rotavirus and norovirus are the leading causes of acute gastroenteritis worldwide. Both viruses share features such as low infectious dose, high stool concentration and prolonged survival in the environment, including water. However, they differ in several aspects, reflecting potential differences in their interactive capacities with the environment and host. This work, which is a 13-month prospective study in a developing country with high rotavirus vaccine coverage demonstrated a high (44%) PCR detection of norovirus in 84 wastewater samples compared with a relatively low (11%) detection of rotavirus. These results suggest that rotavirus circulation may be positively affected by vaccination and support the use of enteric viral detection in wastewaters as a useful tool to measure the impact of specific interventions.

Rotarix(®) was first licensed in 2004 and rapidly introduced into private and public markets worldwide. In a previous 2009 article, we reviewed the impact of rotavirus-associated disease, the rationale for different vaccines, prelicensure efficacy studies and cost-effectiveness studies for Rotarix. As of September 2011, Rotarix had been licensed in 123 countries in the Americas, Europe, Australia, Africa and Asia, of which 27 have incorporated the vaccine into national or regional immunization programs. The current review intends to provide the reader with further insight into this vaccine, focusing mainly on the new information obtained after a 6-year postlicensure period. This review will provide only a brief summary of prelicensure studies extensively discussed in the previous publication and refer, in more depth, to the worldwide experience with the vaccine, vaccine impact, and safety observed in effectiveness and observational studies, including a particular analysis on protection against rotavirus G2P[4].