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儿童轮状病毒胃肠炎免疫预防专家共识（2024年版）
儿童轮状病毒胃肠炎专家共识编写组 
作者及单位信息
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DOI： 10.3760/cma.j.cn112150-20231220-00472
Expert consensus on immunoprophylaxis of childhood rotavirus gastroenteritis (2024 version)
Writing Group for Expert Consensus on Rotavirus Gastroenteritis
Duan Zhaojun
Authors Info & Affiliations
Writing Group for Expert Consensus on Rotavirus Gastroenteritis
Duan Zhaojun
Natinal Key Laboratory of Intelligent Tracking and Forecasting for Infection Diseases/NHC Key Laboratory of Medical Virology and Viral Diseases/National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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DOI： 10.3760/cma.j.cn112150-20231220-00472
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摘要
轮状病毒胃肠炎（RVGE）是严重威胁5岁以下儿童健康的全球性公共卫生问题。中国RVGE相关疾病负担重，防控难度大。本共识在《儿童轮状病毒胃肠炎免疫预防专家共识（2020版）》和《世界卫生组织轮状病毒疫苗立场文件—2021年7月》的基础上，系统阐述了RVGE流行病学、已上市轮状病毒（RV）疫苗的安全性、有效性和免疫保护持久性、RV疫苗免疫策略等国内外研究进展，增补了常见的RVGE诊疗方案。本共识旨在从预防为主和医防融合的角度出发，推动落实以疫苗接种为重点的RVGE综合性防控措施，降低儿童RVGE疾病负担，为从事疾病预防控制、疫苗接种、临床诊疗等多领域的工作人员提供参考。
轮状病毒胃肠炎;轮状病毒疫苗;免疫预防;共识
ABSTRACT
Rotavirus gastroenteritis (RVGE) is a global public health challenge that seriously threatens the health of children under 5 years of age. In China, the burden associated with RVGE is substantial and its prevention and control are difficult. On the basis of Expert Consensus on Immunoprophylaxis of Childhood Rotavirus Gastroenteritis (2020 Version) and Rotavirus Vaccines and WHO Position Paper-July 2021, this updated consensus systematically reviewed advances in RVGE epidemiological research, safety, effectiveness/efficacy, and immune persistence of post-marketing rotavirus (RV) vaccines, and RV immunization strategies. It also provided guidance for RVGE diagnosis and treatment. Following the principles of prioritizing prevention and integrating medical and preventive approaches, this consensus aims to facilitate the implementation of comprehensive prevention and control measures focusing on RV vaccination to reduce the childhood RVGE disease burden and provide reference for professionals working for disease control and prevention, vaccination, clinical diagnosis and treatment, and related fields.
Rotavirus gastroenteritis;Rotavirus vaccine;Immunoprophylaxis;Consensus
Duan Zhaojun, Natinal Key Laboratory of Intelligent Tracking and Forecasting for Infection Diseases/NHC Key Laboratory of Medical Virology and Viral Diseases/National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China, Email:
nc.defcdabvi.cdcanihcjznaud
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儿童轮状病毒胃肠炎专家共识编写组. 儿童轮状病毒胃肠炎免疫预防专家共识（2024年版）[J]. 中华预防医学杂志,2024,58(04)：421-453.
DOI:10.3760/cma.j.cn112150-20231220-00472PERMISSIONS
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轮状病毒胃肠炎（rotavirus gastroenteritis，RVGE）是由轮状病毒（rotavirus，RV）感染引起的全球性常见传染病。RVGE在<5岁儿童中高发，几乎每名儿童在3~5岁前至少感染1次RV
［
1
］
。RVGE通常急性起病，以恶心、呕吐、腹泻为主要症状，可伴有发热。严重RVGE患者可因频繁腹泻和呕吐继发水电解质紊乱和酸碱平衡失调，出现多系统并发症，甚至导致死亡。RV感染是<5岁儿童急性胃肠炎（acute gastroenteritis，AGE）住院和重症的首位病因，也是婴幼儿腹泻死亡的主要病因。世界卫生组织（World Health Organization，WHO）估计，在2000年前全球<5岁儿童中每年因RV感染导致52.8万例死亡，在RV疫苗大范围接种后，2016年已降到12.85万例。除导致腹泻外，RV感染引起的肠道外症状（例如神经系统症状等）也受到关注。RV感染对儿童生长发育和身体健康造成的危害不容忽视。
由于尚无特异性的抗RV药物，临床多遵循预防和纠正脱水、维持电解质和酸碱平衡、防治并发症的原则治疗RVGE。已有的研究表明接种RV疫苗是目前预防RVGE的最有效措施。WHO推荐所有国家将RV疫苗纳入国家免疫规划（national immunization program，NIP），并将其作为优先选项，特别是在RVGE相关死亡率较高的国家。WHO同时建议在将RV疫苗引入NIP时，应采取措施保持高接种率和及时接种率。RV疫苗目前在中国属于非免疫规划疫苗，RV疫苗接种率和公众知晓率有待提升，儿童RVGE免疫预防有待进一步推进和加强。鉴于RVGE流行病学和RV疫苗应用研究进展、
WHO 2021
版RV疫苗立场文件的颁布和中国新的RV疫苗上市，《儿童轮状病毒胃肠炎免疫预防专家共识（2020年版）》亟需补充和更新。本共识基于RVGE防控需求和相关进展，对国内外RVGE流行病学和已上市RV疫苗的安全性、有效性、免疫保护持久性、免疫策略等进行了更加系统的回顾和综述，增补了RVGE诊治方案，汇聚分析了病原学、免疫学、临床医学、流行病学、免疫预防等多学科领域的专家意见，强调和更新了中国RV疫苗免疫接种和当前亟需解决的相关问题。本共识的目的是让公共卫生人员和相关医务人员知晓并重视RVGE的危害，了解RVGE预防控制的措施、策略和重要意义，广泛参与促进中国儿童RVGE预防控制措施的落实，保护广大儿童身体健康。
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备注信息
A
段招军，传染病溯源预警与智能决策全国重点实验室 国家卫生健康委员会医学病毒与病毒病重点实验室 中国疾病预防控制中心病毒病预防控制所，北京 102206，Email：
nc.defcdabvi.cdcanihcjznaud
B
儿童轮状病毒胃肠炎专家共识编写组. 儿童轮状病毒胃肠炎免疫预防专家共识（2024年版）[J]. 中华预防医学杂志, 2024, 58(4): 421-453. DOI: 10.3760/cma.j.cn112150-20231220-00472.
C
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