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New Rotavirus Vaccine on the Horizon?

© Neal Rolfe Chamberlain

The most common worldwide cause of severe diarrhea and dehydration in children from 3 months to 2 years of age is rotavirus. Rotaviruses infect the cells lining the small intestine and cause severe diarrhea, vomiting and low-grade fever (gastroenteritis). These viruses cause around 500,000 deaths each year in children under 5 years of age. Eighty-five percent of those deaths occur in developing countries. By age 3-4 nearly every child has had a rotavirus infection. In Peru rotaviruses causes 384 000 cases of diarrhea/dehydration, 64, 000 clinic visits, 30, 000 hospitalizations, and 1, 600 deaths per year with a US$ 2.6 million medical care cost. Rotavirus is responsible for 25% of the deaths associated with diarrhea and responsible for 6% of all deaths in children less then 5 years of age (WHO).

In children the first rotavirus infection tends to be the worst. Subsequent infections are usually less severe. Once a person has developed immunity to the common rotaviruses they are rarely a problem for adults. Therefore, older children and adults do not usually have problems with this viral infection.

This virus contains 11 different segments of double-stranded RNA. There are several different types of this virus and immunity to one type does not always protect against infection with a different type of the virus. The virus is quite resistant to drying and many different disinfectants and is highly infectious. Millions of virus particles are present in the fecal material of a patient with rotavirus diarrhea. Even people without symptoms of rotavirus infection can shed the virus in their stools if infected. Most of the time the virus is spread from person-to-person due to lack of adequate hand washing following the changing of a soiled diaper or following a bowel movement. Previous studies have demonstrated that around 33 percent of people do not wash their hands after using the public restrooms.

Even with good sanitary sewer systems rotavirus continues to be a problem. Each year in the United States, rotaviruses cause an estimated 2.7 million cases of gastroenteritis among children aged less than 5 years, resulting in approximately 500,000 outpatient clinic and emergency department visits and 49,000 hospitalizations. In temperate regions of the world rotavirus is a major cause of gastroenteritis in the late fall to early spring. In subtropical and tropical regions rotavirus can occur anytime of the year.

There is no effective treatment for rotavirus infections. The only thing that can be done is to ensure the child gets plenty of fluids to prevent dehydration. Unfortunately, children with rotavirus infections can vomit quite a lot making oral rehydration difficult. In some cases the only way to rehydrate the child is

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