A comparison of residues that constitute the 7-1a, 7-1b, and 7-2 epitopes of the Kolkata strains and the vaccine strains is

presented in Table 4. Twenty nine amino acid residues of this antigenic epitope of the VP7 proteins of circulating G1, G2, and G9 RVA strains were compared with the Rotarix-G1, RotaTeq-G1, RotaTeq-G2, and 116E-G9 vaccine strains. Kolkata G1 strains showed mismatches in 94, 100, 123, 291 and 217 positions in 7-1a and 7-2 domains with Rotarix-G1and RotaTeq-G1strains. Kolkata G2 strains also showed mismatches in 4 positions, 87, 291, 213 and 242 in respect to RotaTeq-G2 strains. When VP7 protein of G9 strains were compared with 116E-G9 vaccine strain, it revealed that circulating lineage III G9 strains also GW786034 in vitro differ from 116E strain within antigenic domain at 87, 94, 100, 291, 242, 145 and 221 positions (Table 4). In low income countries of Asia (India, Bangladesh,

Pakistan, Vietnam, China) and Africa, high prevalence (30–40%) of RV has been reported among hospitalized children [17], [44], [45], [46], [47], [48] and [49]. In this study, the incidence was higher in hospitalized children (53.4%) and out-patients (47.5%) than previous reports. The Venetoclax purchase children seeking treatment in outpatient departments may constitute a major source for dissemination of virus. Unlike developed countries where one or two genotypes predominate in a season [54] and [55], a large number of genotypes was observed (G9, G2, G1, G12) at >15% frequency in Kolkata. This agrees with the previous reports from India and Bangladesh only [17] and [44]. Although not demonstrated so far, emergence of new strains, which contributes to genetic diversity, may be one cause of lower vaccine efficacy

in developing countries. Selective pressure resulting from population immunity may drive emergence of strains able to evade vaccine immunity [13]. Moreover for improving efficacy, mass vaccination of children through national immunization program is required, whereas in countries like India, currently only a small proportion of children are vaccinated. Considering the socio-economic structure, high cost of vaccines and the large diversity of strains in low income countries, successful implementation of RV vaccines is still an unfulfilled goal [17], [25] and [50]. Thus to fulfill the lacunae of disease control by vaccination, continuous surveillance for RV is required to monitor incidence, circulating genotypes, emergence of new reassortant strains in population, which will also help in effective disease management and prevention of large scale outbreaks. In addition knowledge of currently circulating strains is needed prior to mass vaccination, for comparison and evaluation during post vaccination studies. As Kolkata has a tropical climate, seasonality of rotavirus infection (Fig.