Three Rotavirus Outbreaks in the Postvaccine Era — California, 2017

Rachel M. Burke, PhD; Jacqueline E. Tate, PhD; Nora Barin, MPH; Carly Bock; Michael D. Bowen, PhD; David Chang, MD; Rashi Gautam, PhD; George Han, MD; John Holguin, MPH; Thalia Huynh; Chao-Yang Pan, MPH; Rebecca Quenelle, MPH; Catherine Sallenave, MD; Cindy Torres; Debra Wadford, PhD; Umesh Parashar, MBBS


Morbidity and Mortality Weekly Report. 2018;67(16):470-472. 

In This Article

Outbreak 3: Subacute Care Facility for Children in Santa Clara County

On May 1, 2017, the Santa Clara County Public Health Department (SCCPHD) was notified of an outbreak of AGE at a subacute inpatient care facility for patients aged <21 years with complex medical needs. In consultation with SCCPHD, the facility increased cleaning and disinfection with bleach solution, implemented cohorting and isolation procedures, cancelled group activities, and suspended new admissions. A site visit by SCCPHD confirmed good adherence to hand hygiene and contact precautions. Nonetheless, by the end of the outbreak, 24 of the 25 facility patients and three of 115 staff members had fallen ill. Symptom onset dates ranged from April 24 through May 17, 2017. The median duration of symptoms was 7.5 days; 23 (85%) patients had diarrhea, and 15 (56%) had vomiting. Patient age ranged from 6 months to 39 years (median age = 2 years). Although most cases resolved without major complications, one child aged 22 months with preexisting respiratory failure died; the cause of death was attributed to rotavirus-induced dehydration. This patient, as well as 16 others, had received no doses of rotavirus vaccine; three other patients had received a single dose. Though reasons for nonvaccination were not tracked by the facility, many of the children had been vaccinated according to delayed vaccination schedules and might have aged out of eligibility for rotavirus vaccination.[1]* Laboratory testing by a gastroenteritis multipathogen PCR panel at a local hospital confirmed rotavirus in 11 of 14 samples; no other pathogens were detected. Eight samples forwarded to CDPH VRDL were found to be PCR-positive for rotavirus, and five were then forwarded to CDC for genotyping. Four were genotyped as G12P;[8] one was identified as a G12 virus, but its P type was not identified.

*The maximum ages for initiating and completing the rotavirus vaccination series are 14 weeks 6 days and 8 months, respectively.