This document discusses rotavirus prevention and control. It provides an overview of rotavirus epidemiology, transmission, clinical presentation, diagnosis and treatment. It discusses infection control measures including handwashing and vaccination. Two oral rotavirus vaccines are described and their efficacy, safety and use in HIV-infected infants is summarized. Surveillance efforts in South Africa and Africa are outlined. WHO recommendations for rotavirus vaccination through routine immunization programs are also mentioned.
Rotavirus is a major cause of diarrhea in infants and young children worldwide. It spreads easily between people through contaminated food or surfaces. The virus causes infection and inflammation of the intestinal tract, leading to diarrhea and dehydration. Diagnosis involves detecting the virus in stool samples using tests like ELISA or electron microscopy. Treatment focuses on rehydration through oral rehydration therapy. Handwashing and sanitation can help prevent transmission. Two live, oral rotavirus vaccines provide protection against severe diarrhea from the most common strains.
Rotavirus is a common virus that causes severe diarrhea in infants and young children. It infects the intestines and causes inflammation of the stomach and bowels. The main symptoms are watery diarrhea, vomiting, fever and dehydration. It is transmitted through the fecal-oral route. Diagnosis involves detecting the virus or its proteins in stool samples. Treatment focuses on preventing dehydration through oral rehydration. Vaccines have been developed to help prevent rotavirus infection and reduce its global impact.
Rotavirus is the leading cause of severe diarrhea in children worldwide. In India, it results in 100,000-150,000 child deaths per year. The virus is highly prevalent in India and symptoms include non-bloody diarrhea, vomiting, and dehydration. It is spread through the fecal-oral route. While the infection itself is self-limiting, treatment focuses on fluid replacement to prevent dehydration. Handwashing and vaccination are important for control and prevention.
Rotavirus is a common cause of diarrhea in infants and children worldwide. It is spread through fecal-oral transmission and causes gastroenteritis. Nearly all children have been infected by rotavirus by age 5. The virus attaches to and damages cells lining the intestines, causing watery diarrhea that can lead to dehydration. Replacing lost fluids and electrolytes is the primary treatment for rotavirus diarrhea. Vaccines are available to help prevent rotavirus infection in children.
Rotavirus is a virus that causes gastroenteritis in infants and young children. It is estimated that nearly all children will be infected with rotavirus by age 5. Rotavirus causes about half of all cases of gastroenteritis in children under 5. India will soon have a locally manufactured low-cost rotavirus vaccine as part of its universal immunization program. The vaccine from Bharat Biotech is expected to be available at almost one-fifteenth the current market price and could be launched in 2015. Recent research has studied rotavirus infections and strains in small ruminants and the potential for interspecies transmission.
#Rubella #German measles
Rubella is also known as German measles because the disease was first described by German physicians, Friedrich Hoffmann, in the mid-eighteenth century.
Rotavirus is a major cause of diarrhea in infants worldwide. It spreads easily through fecal-oral transmission, especially in settings like daycares where children are in close contact. The virus infects and destroys cells in the small intestine, causing diarrhea, fluid loss, and dehydration. Diagnosis involves detecting the virus in stool samples using tests like ELISA. Treatment focuses on oral rehydration therapy. Two live, oral rotavirus vaccines provide protection against the most common strains causing severe childhood rotavirus diarrhea.
Hepatitis E is caused by the hepatitis E virus (HEV) and spreads primarily through contaminated drinking water. It was first identified during an outbreak in India in 1955. Dr. Balayan helped discover HEV in 1983 while investigating an outbreak in Central Asia. HEV has three overlapping genes and infects the liver, with symptoms including jaundice. Pregnant women are particularly at risk, with mortality rates as high as 20% in the third trimester. Prevention focuses on proper sanitation and hygiene. A vaccine has been developed in China but is not yet widely available.
Rotavirus is a major cause of diarrhea in infants and young children worldwide. It spreads easily between people through contaminated food or surfaces. The virus causes infection and inflammation of the intestinal tract, leading to diarrhea and dehydration. Diagnosis involves detecting the virus in stool samples using tests like ELISA or electron microscopy. Treatment focuses on rehydration through oral rehydration therapy. Handwashing and sanitation can help prevent transmission. Two live, oral rotavirus vaccines provide protection against severe diarrhea from the most common strains.
Rotavirus is a common virus that causes severe diarrhea in infants and young children. It infects the intestines and causes inflammation of the stomach and bowels. The main symptoms are watery diarrhea, vomiting, fever and dehydration. It is transmitted through the fecal-oral route. Diagnosis involves detecting the virus or its proteins in stool samples. Treatment focuses on preventing dehydration through oral rehydration. Vaccines have been developed to help prevent rotavirus infection and reduce its global impact.
Rotavirus is the leading cause of severe diarrhea in children worldwide. In India, it results in 100,000-150,000 child deaths per year. The virus is highly prevalent in India and symptoms include non-bloody diarrhea, vomiting, and dehydration. It is spread through the fecal-oral route. While the infection itself is self-limiting, treatment focuses on fluid replacement to prevent dehydration. Handwashing and vaccination are important for control and prevention.
Rotavirus is a common cause of diarrhea in infants and children worldwide. It is spread through fecal-oral transmission and causes gastroenteritis. Nearly all children have been infected by rotavirus by age 5. The virus attaches to and damages cells lining the intestines, causing watery diarrhea that can lead to dehydration. Replacing lost fluids and electrolytes is the primary treatment for rotavirus diarrhea. Vaccines are available to help prevent rotavirus infection in children.
Rotavirus is a virus that causes gastroenteritis in infants and young children. It is estimated that nearly all children will be infected with rotavirus by age 5. Rotavirus causes about half of all cases of gastroenteritis in children under 5. India will soon have a locally manufactured low-cost rotavirus vaccine as part of its universal immunization program. The vaccine from Bharat Biotech is expected to be available at almost one-fifteenth the current market price and could be launched in 2015. Recent research has studied rotavirus infections and strains in small ruminants and the potential for interspecies transmission.
#Rubella #German measles
Rubella is also known as German measles because the disease was first described by German physicians, Friedrich Hoffmann, in the mid-eighteenth century.
Rotavirus is a major cause of diarrhea in infants worldwide. It spreads easily through fecal-oral transmission, especially in settings like daycares where children are in close contact. The virus infects and destroys cells in the small intestine, causing diarrhea, fluid loss, and dehydration. Diagnosis involves detecting the virus in stool samples using tests like ELISA. Treatment focuses on oral rehydration therapy. Two live, oral rotavirus vaccines provide protection against the most common strains causing severe childhood rotavirus diarrhea.
Hepatitis E is caused by the hepatitis E virus (HEV) and spreads primarily through contaminated drinking water. It was first identified during an outbreak in India in 1955. Dr. Balayan helped discover HEV in 1983 while investigating an outbreak in Central Asia. HEV has three overlapping genes and infects the liver, with symptoms including jaundice. Pregnant women are particularly at risk, with mortality rates as high as 20% in the third trimester. Prevention focuses on proper sanitation and hygiene. A vaccine has been developed in China but is not yet widely available.
This document provides information on arboviruses and dengue fever. It discusses:
1) Arboviruses belong to three virus families including Togaviruses, Bunyaviruses, and Flaviviruses. Dengue fever is caused by any one of four related flaviviruses.
2) Dengue is the biggest arbovirus problem worldwide, transmitted by Aedes mosquitoes. It causes dengue fever and the potentially lethal dengue hemorrhagic fever/dengue shock syndrome.
3) Diagnosis involves serology to detect IgM and IgG antibodies or isolation of the virus. There is no vaccine or antiviral treatment, so management focuses on supportive care and
- Zika virus is an emerging mosquito-borne virus first identified in 1947 in Uganda. It spread widely in 2015-2016 throughout South and Central America and the Caribbean.
- It is transmitted primarily via the bite of infected Aedes mosquitoes. While most cases are asymptomatic, it can cause mild fever and rash. A major concern is its link to microcephaly in babies born to infected mothers.
- There is no vaccine or treatment. Prevention focuses on avoiding mosquito bites through protective clothing and repellents, especially for pregnant women considering travel to outbreak areas.
Rhinovirus is the most common cause of the common cold. It is a non-enveloped, positive sense RNA virus that primarily infects the upper respiratory tract. Rhinovirus infections are most frequent and widespread during fall and winter. Symptoms include runny nose, sore throat, coughing, sneezing, and body aches. While the common cold is usually self-limiting, complications can occasionally occur such as sinusitis, ear infections, or pneumonia. There is no vaccine or cure for the common cold. Treatment focuses on relieving symptoms through rest, hydration, analgesics, and in some cases decongestants.
This document provides information about Hepatitis A Virus. It discusses that Hepatitis A is a picornavirus that infects humans and is transmitted through the fecal-oral route. While symptoms are usually mild and self-limiting, there can be complications in some cases including fulminant hepatitis. Prevention strategies include vaccination, improved sanitation and hygiene. The vaccine is effective but underutilized in many developing countries due to cost considerations.
Influenza viruses are enveloped viruses with segmented, single-stranded RNA genomes that cause influenza in humans and some animals. There are four main types of influenza viruses: A, B, C, and D. Types A and B cause seasonal epidemics in humans. Influenza A viruses bind to host cells using hemagglutinin and release from cells using neuraminidase. They replicate in the nucleus and bud from the cell surface. Seasonal epidemics are driven by antigenic drift, while pandemics arise through antigenic shift. Influenza spreads through respiratory droplets and causes fever, cough, and muscle aches. Diagnosis is through viral culture, rapid tests, or PCR. Vaccination and antiv
Hepatitis B is caused by the hepatitis B virus (HBV) and is a serious infectious disease affecting the liver. It is transmitted through contact with infected blood or bodily fluids. The virus can cause both acute and chronic infections. Diagnosis involves testing for hepatitis B surface antigen and antibodies. There is no cure for chronic hepatitis B but vaccination provides effective prevention.
This document provides information about Hepatitis A virus (HAV) and Hepatitis A disease. It states that HAV is the causative agent of Hepatitis A, an acute infectious disease. The virus is transmitted primarily through the fecal-oral route. Symptoms include fever, jaundice, and fatigue. While the disease is usually self-limiting, vaccination and improved sanitation can help prevent transmission.
Adenoviridae is a group of medium sized, non-enveloped, double stranded DNA viruses that replicate and produce disease in the eye and in the respiratory, gastrointestinal and urinary tracts;
Parvoviruses are the smallest DNA viruses, including human parvovirus B19. B19 is pathogenic in humans, infecting erythroid progenitor cells and causing fifth disease in children characterized by a rash. It can also cause aplastic crisis, hydrops fetalis in fetuses, and chronic anemia in immunocompromised patients. Diagnosis involves detecting IgG and IgM antibodies by ELISA or PCR to detect the virus. There is no treatment, though a vaccine is in clinical trials.
This document provides information on rubella (German measles), including:
- It is a viral disease that mainly affects children and causes a rash and lymph node swelling.
- The virus was isolated in the 1960s and a live attenuated vaccine was developed in 1967.
- Infection during pregnancy can cause congenital rubella syndrome in the baby.
- Transmission is via respiratory droplets and the infection is usually mild but can cause birth defects if a woman is infected during pregnancy.
- Rubella vaccination is recommended to control the disease.
Poliovirus is an enterovirus in the Picornaviridae family that causes the disease poliomyelitis. It has a positive-sense RNA genome and protein capsid. There are three serotypes of poliovirus that share 36-52% genetic homology. Poliovirus is usually transmitted through the fecal-oral route or oral-oral contact with infected stool or respiratory secretions. It infects the gastrointestinal tract and in rare cases enters the central nervous system, where it can cause paralysis. Symptoms include fever, sore throat, headache, and muscle weakness. Treatment involves vaccination with the inactivated Salk vaccine or attenuated Sabin vaccine to prevent the spread of polio.
This document provides information about Hepatitis C, including how it is transmitted, symptoms, diagnosis, treatment, and prevention. Some key points:
- Hepatitis C is a contagious liver disease caused by the hepatitis C virus that can range from mild to serious and lifelong.
- It is mostly transmitted through exposure to infectious blood, such as through contaminated medical equipment or injecting drug use.
- Most infected people do not show symptoms, though some may experience fatigue, abdominal pain, and jaundice. Chronic infection can lead to cirrhosis or liver cancer.
- Diagnosis involves antibody and RNA testing to confirm. People at high risk should be screened.
- Treatment involves antiviral therapy with
Rotavirus is the leading cause of severe diarrhea in infants and young children worldwide. Two oral rotavirus vaccines, Rotarix and RotaTeq, were licensed in the 2000s and introduced in national immunization programs. Rotarix is a live-attenuated monovalent G1P[8] human strain, while RotaTeq is a pentavalent human-bovine reassortant vaccine. Both vaccines have shown high efficacy rates against severe rotavirus gastroenteritis in clinical trials. Efforts are ongoing to develop more affordable rotavirus vaccines, such as the Indian vaccine Rotavac, which is currently in phase III trials.
This document discusses rotavirus, a common cause of diarrhea in infants and young children. It provides information on signs and symptoms, risk factors, transmission, prevention and vaccines. The key points are:
- Rotavirus is highly contagious and usually causes fever, vomiting and watery diarrhea for 4-8 days. It is spread through fecal-oral transmission.
- Infants and children under 2 are most at risk, as they are more vulnerable to dehydration from rotavirus infection.
- Prevention strategies include handwashing, vaccination and oral rehydration solutions. There are three rotavirus vaccines available which provide protection from severe diarrhea.
Measles is a highly contagious viral infection.
It is exanthematous disease with fewer, cough, coryza (rhinitis) and conjunctivitis.
Before the widespread use of measles vaccines, it was estimated that measles caused between 5 million and 8 million deaths worldwide each year.
Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild with half of the people not realizing that they are infected. A rash may start around two weeks after exposure and last for three days.
Viruses are a common cause of respiratory infections. Influenza virus is an RNA virus that causes influenza and can evolve through antigenic drift or shift, resulting in seasonal epidemics or pandemics. Other respiratory viruses include rhinoviruses, coronaviruses, parainfluenza viruses, respiratory syncytial virus (RSV), and adenoviruses. These viruses are diagnosed through antigen detection, virus isolation, or serology and treated symptomatically, though vaccines exist for some viruses. SARS is a coronavirus that emerged in 2002 and can cause severe respiratory illness.
Rotavirus is a major cause of diarrhea in infants and young children worldwide. It spreads easily between people through the fecal-oral route. Diagnosis is made through enzyme immunoassays detecting the virus in stool samples. Treatment focuses on fluid replacement through oral rehydration therapy. Two oral rotavirus vaccines provide protection against the most common strains causing infection. Development of an indigenous rotavirus vaccine called Rotavac could help reduce the 100,000 annual child deaths from rotavirus in India.
Rotavirus vaccine presentation Rotateq 28 june 2013Gaurav Gupta
This document discusses rotavirus, a leading cause of severe diarrhea among children under 5 years old globally. It provides an overview of the disease burden in India, differences between the two available rotavirus vaccines (Rotarix and RotaTeq), challenges with vaccine serotype diversity and efficacy, and recommendations from WHO and IAPCOI to include rotavirus vaccination in national immunization programs in developing countries due to the potential for significant impact even with moderate vaccine efficacy.
Rotavirus is a leading cause of severe diarrhea in children under 5 globally. Two rotavirus vaccines, Rotarix and RotaTeq, have proven safe and effective in reducing severe rotavirus disease and deaths. Based on evidence from trials in developing countries showing significant public health impact, WHO now strongly recommends that rotavirus vaccines be included in all national immunization programs worldwide. The first dose should be given between 6-15 weeks of age.
This document provides information on arboviruses and dengue fever. It discusses:
1) Arboviruses belong to three virus families including Togaviruses, Bunyaviruses, and Flaviviruses. Dengue fever is caused by any one of four related flaviviruses.
2) Dengue is the biggest arbovirus problem worldwide, transmitted by Aedes mosquitoes. It causes dengue fever and the potentially lethal dengue hemorrhagic fever/dengue shock syndrome.
3) Diagnosis involves serology to detect IgM and IgG antibodies or isolation of the virus. There is no vaccine or antiviral treatment, so management focuses on supportive care and
- Zika virus is an emerging mosquito-borne virus first identified in 1947 in Uganda. It spread widely in 2015-2016 throughout South and Central America and the Caribbean.
- It is transmitted primarily via the bite of infected Aedes mosquitoes. While most cases are asymptomatic, it can cause mild fever and rash. A major concern is its link to microcephaly in babies born to infected mothers.
- There is no vaccine or treatment. Prevention focuses on avoiding mosquito bites through protective clothing and repellents, especially for pregnant women considering travel to outbreak areas.
Rhinovirus is the most common cause of the common cold. It is a non-enveloped, positive sense RNA virus that primarily infects the upper respiratory tract. Rhinovirus infections are most frequent and widespread during fall and winter. Symptoms include runny nose, sore throat, coughing, sneezing, and body aches. While the common cold is usually self-limiting, complications can occasionally occur such as sinusitis, ear infections, or pneumonia. There is no vaccine or cure for the common cold. Treatment focuses on relieving symptoms through rest, hydration, analgesics, and in some cases decongestants.
This document provides information about Hepatitis A Virus. It discusses that Hepatitis A is a picornavirus that infects humans and is transmitted through the fecal-oral route. While symptoms are usually mild and self-limiting, there can be complications in some cases including fulminant hepatitis. Prevention strategies include vaccination, improved sanitation and hygiene. The vaccine is effective but underutilized in many developing countries due to cost considerations.
Influenza viruses are enveloped viruses with segmented, single-stranded RNA genomes that cause influenza in humans and some animals. There are four main types of influenza viruses: A, B, C, and D. Types A and B cause seasonal epidemics in humans. Influenza A viruses bind to host cells using hemagglutinin and release from cells using neuraminidase. They replicate in the nucleus and bud from the cell surface. Seasonal epidemics are driven by antigenic drift, while pandemics arise through antigenic shift. Influenza spreads through respiratory droplets and causes fever, cough, and muscle aches. Diagnosis is through viral culture, rapid tests, or PCR. Vaccination and antiv
Hepatitis B is caused by the hepatitis B virus (HBV) and is a serious infectious disease affecting the liver. It is transmitted through contact with infected blood or bodily fluids. The virus can cause both acute and chronic infections. Diagnosis involves testing for hepatitis B surface antigen and antibodies. There is no cure for chronic hepatitis B but vaccination provides effective prevention.
This document provides information about Hepatitis A virus (HAV) and Hepatitis A disease. It states that HAV is the causative agent of Hepatitis A, an acute infectious disease. The virus is transmitted primarily through the fecal-oral route. Symptoms include fever, jaundice, and fatigue. While the disease is usually self-limiting, vaccination and improved sanitation can help prevent transmission.
Adenoviridae is a group of medium sized, non-enveloped, double stranded DNA viruses that replicate and produce disease in the eye and in the respiratory, gastrointestinal and urinary tracts;
Parvoviruses are the smallest DNA viruses, including human parvovirus B19. B19 is pathogenic in humans, infecting erythroid progenitor cells and causing fifth disease in children characterized by a rash. It can also cause aplastic crisis, hydrops fetalis in fetuses, and chronic anemia in immunocompromised patients. Diagnosis involves detecting IgG and IgM antibodies by ELISA or PCR to detect the virus. There is no treatment, though a vaccine is in clinical trials.
This document provides information on rubella (German measles), including:
- It is a viral disease that mainly affects children and causes a rash and lymph node swelling.
- The virus was isolated in the 1960s and a live attenuated vaccine was developed in 1967.
- Infection during pregnancy can cause congenital rubella syndrome in the baby.
- Transmission is via respiratory droplets and the infection is usually mild but can cause birth defects if a woman is infected during pregnancy.
- Rubella vaccination is recommended to control the disease.
Poliovirus is an enterovirus in the Picornaviridae family that causes the disease poliomyelitis. It has a positive-sense RNA genome and protein capsid. There are three serotypes of poliovirus that share 36-52% genetic homology. Poliovirus is usually transmitted through the fecal-oral route or oral-oral contact with infected stool or respiratory secretions. It infects the gastrointestinal tract and in rare cases enters the central nervous system, where it can cause paralysis. Symptoms include fever, sore throat, headache, and muscle weakness. Treatment involves vaccination with the inactivated Salk vaccine or attenuated Sabin vaccine to prevent the spread of polio.
This document provides information about Hepatitis C, including how it is transmitted, symptoms, diagnosis, treatment, and prevention. Some key points:
- Hepatitis C is a contagious liver disease caused by the hepatitis C virus that can range from mild to serious and lifelong.
- It is mostly transmitted through exposure to infectious blood, such as through contaminated medical equipment or injecting drug use.
- Most infected people do not show symptoms, though some may experience fatigue, abdominal pain, and jaundice. Chronic infection can lead to cirrhosis or liver cancer.
- Diagnosis involves antibody and RNA testing to confirm. People at high risk should be screened.
- Treatment involves antiviral therapy with
Rotavirus is the leading cause of severe diarrhea in infants and young children worldwide. Two oral rotavirus vaccines, Rotarix and RotaTeq, were licensed in the 2000s and introduced in national immunization programs. Rotarix is a live-attenuated monovalent G1P[8] human strain, while RotaTeq is a pentavalent human-bovine reassortant vaccine. Both vaccines have shown high efficacy rates against severe rotavirus gastroenteritis in clinical trials. Efforts are ongoing to develop more affordable rotavirus vaccines, such as the Indian vaccine Rotavac, which is currently in phase III trials.
This document discusses rotavirus, a common cause of diarrhea in infants and young children. It provides information on signs and symptoms, risk factors, transmission, prevention and vaccines. The key points are:
- Rotavirus is highly contagious and usually causes fever, vomiting and watery diarrhea for 4-8 days. It is spread through fecal-oral transmission.
- Infants and children under 2 are most at risk, as they are more vulnerable to dehydration from rotavirus infection.
- Prevention strategies include handwashing, vaccination and oral rehydration solutions. There are three rotavirus vaccines available which provide protection from severe diarrhea.
Measles is a highly contagious viral infection.
It is exanthematous disease with fewer, cough, coryza (rhinitis) and conjunctivitis.
Before the widespread use of measles vaccines, it was estimated that measles caused between 5 million and 8 million deaths worldwide each year.
Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild with half of the people not realizing that they are infected. A rash may start around two weeks after exposure and last for three days.
Viruses are a common cause of respiratory infections. Influenza virus is an RNA virus that causes influenza and can evolve through antigenic drift or shift, resulting in seasonal epidemics or pandemics. Other respiratory viruses include rhinoviruses, coronaviruses, parainfluenza viruses, respiratory syncytial virus (RSV), and adenoviruses. These viruses are diagnosed through antigen detection, virus isolation, or serology and treated symptomatically, though vaccines exist for some viruses. SARS is a coronavirus that emerged in 2002 and can cause severe respiratory illness.
Rotavirus is a major cause of diarrhea in infants and young children worldwide. It spreads easily between people through the fecal-oral route. Diagnosis is made through enzyme immunoassays detecting the virus in stool samples. Treatment focuses on fluid replacement through oral rehydration therapy. Two oral rotavirus vaccines provide protection against the most common strains causing infection. Development of an indigenous rotavirus vaccine called Rotavac could help reduce the 100,000 annual child deaths from rotavirus in India.
Rotavirus vaccine presentation Rotateq 28 june 2013Gaurav Gupta
This document discusses rotavirus, a leading cause of severe diarrhea among children under 5 years old globally. It provides an overview of the disease burden in India, differences between the two available rotavirus vaccines (Rotarix and RotaTeq), challenges with vaccine serotype diversity and efficacy, and recommendations from WHO and IAPCOI to include rotavirus vaccination in national immunization programs in developing countries due to the potential for significant impact even with moderate vaccine efficacy.
Rotavirus is a leading cause of severe diarrhea in children under 5 globally. Two rotavirus vaccines, Rotarix and RotaTeq, have proven safe and effective in reducing severe rotavirus disease and deaths. Based on evidence from trials in developing countries showing significant public health impact, WHO now strongly recommends that rotavirus vaccines be included in all national immunization programs worldwide. The first dose should be given between 6-15 weeks of age.
El rotavirus es una enfermedad viral que causa diarrea y vómitos en bebés y niños pequeños, pudiendo causar deshidratación. Se transmite a través de las heces fecales de personas infectadas por contacto directo o a través de superficies u objetos contaminados. Sus síntomas principales son diarrea que puede venir acompañada de fiebre y vómitos, y su tratamiento consiste en mantener la hidratación a través de la alimentación y la preparación de suero oral en casa.
Este documento describe el rotavirus, el cual causa diarrea infantil en todo el mundo. Pertenece a la familia Reoviridae y al género Rotavirus, con siete grupos. Es un virus esférico de doble capa proteica que contiene 11 segmentos de ARN bicatenario. Se transmite por la vía fecal-oral y causa diarrea y deshidratación al replicarse en el intestino delgado. Existen vacunas que ayudan a prevenir la infección y sus síntomas graves.
Los rotavirus son la causa principal de diarrea grave en niños pequeños a nivel mundial. Se transmiten por vía fecal-oral y sobreviven en el ambiente. La infección causa deshidratación grave por la pérdida de líquidos y electrolitos en la diarrea y los vómitos. Las vacunas orales actuales como Rotarix y RotaTeq han demostrado ser seguras y efectivas para prevenir la enfermedad causada por los rotavirus.
This document summarizes information about rotavirus, which is a leading cause of severe diarrhea in young children worldwide. It discusses the disease burden of rotavirus, describing it as responsible for over 600,000 childhood deaths annually, especially in low-income countries like India. The document also reviews rotavirus virology, epidemiology, clinical manifestations, preventive measures, challenges, and two available oral vaccines - Rotarix and RotaTeq. It emphasizes that while improvements in hygiene and sanitation can help reduce transmission, vaccination is needed to significantly reduce the mortality and morbidity caused by rotavirus diarrhea.
El rotavirus es la causa más común de diarrea grave en bebés y niños pequeños. Se transmite a través de las heces y causa una inflamación en el intestino delgado que resulta en síntomas como vómitos, diarrea acuosa y fiebre leve. Aunque la mayoría de los niños se infectan al menos una vez antes de los 5 años, el sistema inmunitario se fortalece con cada infección posterior haciéndolas más leves. El diagnóstico y tratamiento se centran en controlar los síntomas e hidr
The document discusses diarrheal diseases, including definitions, causes, and approaches. It covers acute diarrhea, which is usually infectious and self-limited, as well as chronic diarrhea, which is often non-infectious. For acute diarrhea, fluid and electrolyte replacement is important. Evaluation involves stool analysis. Antibiotics may reduce severity and duration. Chronic diarrhea has many potential causes including secretory, osmotic, steatorrheal, inflammatory, dysmotile, and iatrogenic factors.
El rotavirus es un patógeno viral ubicuo que causa diarrea aguda, principalmente en niños menores de 2 años. Se transmite por la vía fecal-oral y puede provocar deshidratación grave e incluso la muerte si no se trata adecuadamente. Los síntomas incluyen diarrea acuosa severa, vómitos y fiebre. El diagnóstico se realiza detectando el antígeno viral en las heces mediante pruebas de inmunocromatografía. El tratamiento se enfoca en la rehidratación oral o
Rotavirus is the most common cause of severe diarrhea in children under 5 globally. It results in over 500,000 child deaths annually, mostly in developing countries. Two live, oral rotavirus vaccines have been developed and recommended by WHO for inclusion in national immunization programs worldwide due to their safety and efficacy in trials. Vaccination has significantly reduced the burden of severe rotavirus diarrhea in countries that have adopted routine childhood immunization against rotavirus. Further research is still needed to optimize vaccine benefits in developing countries where the impact could be greatest.
The document discusses viruses with large and small DNA genomes as well as positive-strand and negative-strand RNA viruses. Herpesviruses have very large DNA genomes up to 235 kbp that encode many enzymes. Adenoviruses and phages like lambda have smaller genomes between 30-54 kbp. Animal viruses like parvoviruses and polyomaviruses have even smaller genomes around 5 kbp that tightly pack genes. Picornaviruses, togaviruses, and flaviviruses have single-stranded RNA genomes between 7-11 kbp. Coronaviruses have the largest RNA genomes around 30 kbp. Segmentation allows larger coding capacity for viruses like influenza and gemin
Rotavirus is the leading cause of severe gastroenteritis in children under 5 years old globally. Two rotavirus vaccines, RotaTeq and Rotarix, were found to be safe and highly effective in clinical trials in 2006. Since their introduction in the US in 2006-2008 and other countries, significant reductions in rotavirus hospitalizations and deaths have been observed. For example, Mexico saw a 66% reduction in rotavirus hospitalizations in children under 1 year and an 85% reduction in children 1-3 years old following vaccine introduction. The global distribution of the estimated 527,000 annual rotavirus deaths in young children was also presented.
Mini dissertation_FINAL _Fulufhelo M _08-01-2016Dr-fm Matshox
This document is a mini dissertation submitted by Mr. Fulufhelo Matshonyonge for the degree of BSC HONOURS IN MEDICAL VIROLOGY. It analyzes the evolution of human rotavirus strains G4P[6] and G4P[8] circulating in Southern Africa between 1985 and 2011. The dissertation finds that the disappearance of G4 genotypes is mainly due to changes in antigenicity from mutations at the nucleotide level and genetic reassortment. It also finds a direct evolutionary relationship between emerging RVA strains and currently disappearing G4 genotypes. Most variable regions within the 11 RVA genome segments in the 3 study strains were conserved, with minor amino acid changes. This substantiates that evolution resulting
The MRC Diarrhoeal Pathogens Research Unit (DPRU) was established in 1996 at MEDUNSA to address diarrhoeal diseases in South Africa and Africa. Diarrhoeal diseases are a leading cause of death in children under 5 in Africa. The DPRU studies microbial agents associated with childhood diarrhoea, investigates rotavirus epidemiology and pathogenesis, supports vaccine development, and promotes training and collaboration. It has grown to become a premier research center conducting groundbreaking rotavirus research, training, and vaccine trials to help introduce vaccines in Africa. The DPRU works to reduce childhood mortality from diarrhoea and monitors the impact of the rotavirus vaccine in South Africa as the WHO Regional Rotavirus
Asthma in children can usually be diagnosed based on a detailed clinical history and physical examination in over 95% of cases. Spirometry may help diagnose bronchodilator-responsive airway obstruction, though results are not reliable in children under 5 years old. Impulse oscillometry can also measure airway resistance and reversibility. Chest imaging and other tests are not routinely needed but may help evaluate other potential causes of wheezing in difficult cases. An asthma diagnosis is made based on recurrent symptoms, family history of atopy, and response to bronchodilator treatment.
Rotavirus is a virus that causes acute gastroenteritis, or stomach and intestinal inflammation, usually in infants and young children. It is the most common cause of severe diarrhea in this age group. Symptoms include watery diarrhea, vomiting, fever, and abdominal pain. The virus is transmitted through the fecal-oral route. While it is possible to become infected more than once by rotavirus, good hygiene practices and rotavirus vaccines can help prevent and treat the disease.
This document categorizes and summarizes various viral families, their important genera, the diseases they cause, how they are transmitted, and methods for diagnosis. It covers both DNA and RNA viruses, including those that are single-stranded, double-stranded, enveloped, and non-enveloped. Many common viral diseases are discussed such as influenza, hepatitis, HIV, measles, Ebola, rabies, as well as less known illnesses. Diagnostic approaches include cell culture, serology, PCR, antigen detection, and visualization of viral structures.
ORS is used to treat dehydration from diarrhea. It works by promoting absorption of sodium, glucose, and water in the intestines. The standard ORS contains sodium, chloride, potassium, citrate and glucose. Reduced osmolarity ORS is now recommended, containing less sodium and glucose. ORS is effective for all causes of diarrhea, safe for all ages, and can treat over 90% of cases when administered correctly. It has significantly reduced mortality from diarrhea worldwide.
Parvovirus is a small, single-stranded DNA virus that causes diseases like fifth disease and aplastic anemia. It is around 22 nm in diameter with an icosahedral capsid but no envelope. Symptoms of parvovirus infection include fever, chills, and a bright red, raised "slap cheek" rash on the face and lacy rash on the extremities. Treatment focuses on supportive care with ibuprofen for fever as a vaccine remains in trials.
This document discusses rotavirus prevention and control. It begins with an introduction stating that rotavirus is the leading cause of severe diarrhea in children under 5 globally, resulting in over 500,000 child deaths annually. The majority of these deaths occur in low-income countries.
It then covers the epidemiology and disease burden, describing rotavirus as the top cause of death in children under 5 worldwide. Clinical presentation is discussed, outlining the typical timeline and symptoms of rotavirus infection.
Prevention and control methods are summarized as infection control practices and vaccination. Two oral rotavirus vaccines currently available are described and their efficacy and safety are discussed. WHO recommendations for rotavirus vaccination through national immunization
Rotavirus RV is a disease that is extremely spreadable in children whose age ranges between 3'5 years. Rotavirus vaccination RVV is an effective method for combating the diarrhoea disease as rotavirus is the leading cause of diarrhoea worldwide. For fulfilling the aim of reducing the burden of RV caused in children under 5 years for diarrhoea mortality. World Health Organization WHO recommends introducing RVVs worldwide. Globally three RVVs are licensed for local use two monovalent vaccines Rotarix, and Rotavac and a pentavalent vaccine RotaTeq. Safety and efficacy of these vaccines have been proved, however, they require cold chain storage at or below 2oto 8oC before use. In this article, a detailed profile of Rotarix vaccine is being emphasized. Rotavirus Vaccines are in high demand for introduction by many low income countries, but limitations such as price, poor supply and insufficient cold chain capacity at distant delivery points, have restricted their introduction. A. A Bhosale | Dr. V. U Barge "Illustrative Review on Rotavirus Vaccines" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-1 , December 2019, URL: https://www.ijtsrd.com/papers/ijtsrd29552.pdfPaper URL: https://www.ijtsrd.com/biological-science/biotechnology/29552/illustrative-review-on-rotavirus-vaccines/a-a-bhosale
Prevention of rotavirus in india is vaccination the only strategy.Dr. Dharmendra Gahwai
Rotavirus is a major cause of diarrhea in young children in India, resulting in approximately 300,000 deaths per year. While oral rehydration solution can treat dehydration, rotavirus infection has no specific treatment. Rotavirus vaccines have been shown to significantly reduce rotavirus disease and deaths in other countries. For India, introducing an affordable rotavirus vaccine into its national immunization program could cost-effectively prevent thousands of rotavirus-related deaths annually, though overall immunization coverage would need to increase to maximize its impact.
This document discusses several viruses that cause gastroenteritis in humans. Rotavirus is identified as the leading cause of severe diarrhea in children under 5 years old worldwide. Latex agglutination testing is described as a rapid method for detecting rotavirus in stool samples. The study found a higher prevalence of rotavirus infection in HIV-positive patients compared to HIV-negative patients presenting with diarrhea. Enteric adenoviruses, norovirus, and sapovirus are also discussed as important causes of viral gastroenteritis. Electron microscopy, enzyme immunoassays, and PCR-based methods are described for laboratory diagnosis of these viruses from stool specimens.
This document discusses rotavirus, which is the leading cause of severe diarrhea among children under 5 years old globally. It covers the virology of rotavirus, including that it is resistant to destruction and has multiple serotypes. However, natural infection protects against future infections regardless of serotype. The document also reviews scary statistics about rotavirus' impact, being responsible for 5% of child deaths and over 100,000 deaths annually in India alone. It discusses how rotavirus diarrhea can be clinically diagnosed and the importance of vaccination to prevent rotavirus, given hand washing and sanitation are ineffective due to its resistant nature. Two available vaccines, Rotarix and RotaTeq, provide strong efficacy against severe rotavirus disease.
Rotavirus is a major cause of childhood diarrhea and mortality globally, disproportionately affecting children in developing countries. While two vaccines are available, they have shown reduced effectiveness in developing countries possibly due to differences in strain diversity, malnutrition, and breastfeeding practices. New vaccine candidates targeting regional strains are in development. A holistic approach considering economic constraints, alternative interventions, and long-term solutions like infrastructure and nutrition improvements may maximize the public health impact of rotavirus prevention efforts.
This study analyzed 103 stool samples from infants under 12 months old with diarrhea in Iraq. Rapid immunochromatography tests found that 52 samples (50.5%) were positive for rotavirus, 30 (29.1%) for norovirus, and 21 (20.4%) for adenovirus. The most affected age group was 1-4 months. Rural infants had higher rates of viral diarrhea than urban infants. Mixed feeding was associated with more cases than breastfeeding alone. Common symptoms included watery stool, fever, weakness, abdominal pain, and vomiting. The major causes of infantile diarrhea in the study area were identified as rotavirus, followed by norovirus and adenovirus.
Diarrea aguda infecciosa en pediatria, epidemiologia, prevencion y tratamientofranklinaranda
This document discusses acute diarrheal disease in children. It notes that diarrhea is a leading cause of morbidity and mortality in children worldwide, responsible for 2-3 million deaths per year. In the US, acute diarrhea accounts for 9% of pediatric hospitalizations. The causes of acute diarrhea vary but include viruses like rotavirus and norovirus, as well as bacterial and parasitic pathogens. Treatment focuses on fluid replacement and management, while prevention efforts include vaccination against rotavirus.
1) Diarrhoea is a major cause of mortality in children under 5 years old, killing over 500,000 children annually. It is caused by various pathogens including rotavirus, ETEC, Salmonella, Shigella, and Cryptosporidium.
2) Oral rehydration therapy is the primary treatment for diarrhoea and involves replacing lost fluids and electrolytes through oral rehydration salts. Intravenous fluids may be required for severe dehydration.
3) Prevention strategies include improved access to clean water and sanitation, breastfeeding, and vaccination. Diarrhoea control programs promote oral rehydration therapy and preventive measures.
Peste des-ruminants-is-a-rinderpest.doc pdfGudyne Wafubwa
Peste des petits ruminant virus (PPRV) is a disease mostly affecting goats and sheep. Since its first discovery, it has caused massive economic loss to most small pastoralists in Africa and other developing countries. It is the integral role of all stakeholders to join hands so as to eradicate the disease.
This document discusses viruses that cause diarrhea. It focuses on rotavirus as the most common cause of diarrhea in children. Rotavirus is a double-stranded RNA virus that infects and destroys cells lining the small intestine. It is classified into groups based on antigenic variation and currently globally common strains include G1P[8]. The virus is transmitted through the fecal-oral route. Clinical features include vomiting and watery diarrhea. Treatment involves oral rehydration and prevention centers around vaccination and improved hygiene. The document also briefly outlines other viruses like norovirus, adenovirus, astrovirus and their roles in viral gastroenteritis.
This document summarizes common infectious diseases among pediatric patients from a public health perspective using evidence-based methodology. It discusses major causes of childhood morbidity and mortality historically and currently in Saudi Arabia such as rotavirus, adenovirus, respiratory syncytial virus, influenza, and healthcare-associated infections. It also covers recent updates on management including vaccines, antibiotic practices, emerging pathogens like MERS, and infection control measures.
This document provides an overview of polio and polio vaccination. It discusses:
- A brief history of polio and the development of polio vaccines including the inactivated polio vaccine (IPV) and oral polio vaccine (OPV)
- Issues with OPV including suboptimal efficacy, vaccine-associated paralytic poliomyelitis (VAPP), and vaccine-derived polio viruses (VDPVs)
- Recommendations that IPV be introduced in addition to OPV to address these issues and aid global polio eradication efforts while transitioning away from OPV.
aids and hiv in children. it is the topic in child health nursing. it include definition, etiology, types, signs and symptoms, pathophysiology, clinical stages, diagnosis and management of pediatric hiv or aids.
This document provides information on the care of children with HIV/AIDS. It discusses what HIV is, how it is transmitted, the stages of infection, diagnosis, treatment including antiretroviral therapy, prevention of mother-to-child transmission, and the nursing care of children with HIV/AIDS. The nursing care involves supporting the emotional needs of the child and family, maintaining nutrition, treating infections early, ensuring immunization when appropriate, and providing a good quality of life.
WEBINAR - Zyvac tcv master class september 2018Gaurav Gupta
WEBINAR - Zyvac tcv master class september 2018. All indian webinar on the new Indian typhoid conjugate vaccination,
Broadcast throughout India with more than 500 pediatricians from across the country registering for viewing and asking questions
This document provides a summary of a presentation on prospects for developing a Group B Streptococcus (GBS) vaccine for pregnant women globally. It notes that GBS is a leading cause of neonatal infections and discusses the limitations of the current prevention strategy using intrapartum antibiotics. Developing a maternal GBS vaccine could have a higher impact by preventing more outcomes and providing more equitable coverage. Ongoing work includes further vaccine development and clinical trials, establishing a global disease burden, developing standardized assays to assess vaccine protection, and guidance for vaccine policy and implementation. The goal is to develop a safe and effective maternal GBS vaccine to reduce infant mortality from this disease worldwide.
This document discusses HIV and TB co-infection. It notes that HIV increases the risk of developing active TB due to immunosuppression. Diagnosing TB is more difficult in HIV patients as sputum smears can be negative and symptoms are atypical. WHO recommends treating TB first before beginning antiretroviral therapy for co-infected patients, and directly observed treatment to ensure adherence. Clinical trials are exploring optimal antiretroviral regimens for co-infected patients.
Current status of Malaria vaccine (Nov 2016)Pranav Sopory
This document summarizes information about the current status of malaria vaccines. It discusses the burden of malaria worldwide and in India. It describes the life cycle of Plasmodium parasites and the different types of malaria. The key targets for malaria vaccines including pre-erythrocytic, blood stage, and transmission blocking vaccines are outlined. The currently available RTS,S vaccine is described including results from phase 3 trials showing moderate efficacy that wanes over time. Challenges in developing effective malaria vaccines are discussed such as applying traditional vaccine approaches, limitations of animal models, and waning vaccine efficacy. New malaria vaccine projects in India including JAIVAC-1 and JAIVAC-2 are briefly introduced.
Rotavirus vaccines: recent developments and future considerations discusses two new rotavirus vaccines that have been shown to be safe and effective in protecting young children against severe rotavirus gastroenteritis. While both vaccines are now marketed worldwide, there is still room for improvement. The review addresses recent advances in rotavirus research that could help improve existing vaccines or develop new ones, with a focus on the immune response induced by the current vaccines and mechanisms of protection.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
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ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
2. Outline of Presentation
Introduction
Epidemiology and Disease Burden
The Rotavirus
Clinical Presentation
Prevention and Control
Vaccination
Surveillance
WHO Recommendations
Conclusion
3. Introduction
Rotavirus (RV) is the commonest cause of severe
diarrhoeal disease in infants and young children
globally
527 000 children die each year
Children under 5 most vulnerable
Majority in low-income countries (85%)
Country-specific data show 80-90 children die every
day in Nigeria from the disease, 50-60 deaths occur
daily in Cameroon, and 10-12 in South Africa
Estimated cost to healthcare system: USD 264 to 318
million per year
Estimated societal costs: USD 890 to 1 billion per year
4. Epidemiology and Disease Burden
Causes of Death in Children Under 5
Worldwide, 2008
15% Diarrhoea
Pneumonia
37%
19% Other infections
Non communicable diseases
7% 22%
Neonatal causes
15% = 1.3 million deaths annually !
Black RE, Lancet 2010; 375:1969-1987
7. Transmission
Primary mode of transmission is feacal to oral
Highly communicable and transmissible
Close person-to-person contact and environmental
surfaces are common vectors of transmission
Incubation period is 1 – 3 days
8. Transmission
Large quantities of virus are shed in stool from just prior
to onset of symptoms until about 10 days after onset
Amount of virus shed in stool:
10-100 billion virions/gram of stool !
Amount of ingested virus required to cause infection:
As few as 10 infective virions !
Amount of stool that needs to be ingested to potentially
result in infection:
≈ 0.000001mg !
9. The Rotavirus
First recognized in 1973, rotavirus belongs
to the viral family Reoviridae
Its wheel-like shape under an electron
microscope earned it the name of “rota”
virus
The rotavirus genome consists of 11
double-stranded RNA segments, each
encoding one viral protein
A triple-layered capsule surrounds the
RNA
Scientists have described seven rotavirus
groups (A to G)
Only groups A, B, and C infect humans
Group A, which has multiple
strains, causes the majority of childhood
infections
Vaccine candidates are designed to protect
against Group A rotaviruses
10. The Rotavirus
The G-type and P-type define the serotype
They are critical to vaccine development
because they are the vaccine targets for
stimulating a protective immune response
SEROTYPES
Source : WWW.ROTAPICTURES/BU/EDU
G1P[8] is the most common serotype worldwide and accounts for over two
thirds of rotavirus infections worldwide
Infections with G1, G2, G3, G4, and G9 together comprise almost 95% of
rotavirus serotypes observed
Because the 2 gene segments that encode these proteins can segregate
independently, a typing system consisting of both G and P types is used. i.e.
G1P[8], G2P[4], G3P[8], G4P[8], G9P[8], and G9P[6]
13. Clinical Presentation
Pathogenesis
The virus causes diarrhoea by three principle mechanisms:
infection of villus epithelial cells causes cell
destruction, decreased absorption of salt and water, and
decreased disaccharidase activity, increasing the osmotic
load in the gut lumen
stimulation of the enteric nervous system, leading to
increased fluid secretion
direct enterotoxin effects of nonstructural protein 4
(NSP4), the first viral enterotoxin to be described
The osmotic load in the gut and increased fluid secretion lead
to diarrhoea and, if unchecked and without fluid
replacement, can ultimately lead to dehydration and acidosis
14. Clinical Presentation
Complications
• The major complication is the dehydration, which can lead to
acidosis and eventually to circulatory collapse.
Also been associated with
aseptic meningitis, necrotizing enterocolitis, acute
myositis, hepatic abscess, pneumonia, Kawasaki
disease, SIDS and Crohn's disease
Rotavirus induced gastroenteritis in children with
immunodeficiency may cause persistent infection lasting
weeks or months
Self-limited illness in immunocompetant
15. Clinical Presentation
Diagnosis
Mostly clinical
Rapid antigen detection by ELISA of rotavirus in stool
specimens.
Isolates may be further characterized by reverse-
transcriptase polymerase chain reaction
16. Clinical Presentation
In infants, natural rotavirus infection confers protection against subsequent
infection
By the age of 2 years, nearly every child in a cohort of children in Mexico
had experienced at least one rotavirus infection
These children had greater protection against severe diarrhoea with
subsequent infections
Two natural infections were required for 100% protection against
moderate-to-severe diarrhoea
The first exposure to rotavirus also protected 87% (95% CI, 54%, 96%) of
children from having severe disease from the second infection
The protection rates observed with one natural infection are similar to
those observed with vaccine-induced protection
Vaccination protects 84% to 98% of children against severe outcomes of a
second rotavirus infection
Thus, the vaccines are mimicking the protection rates of one natural
infection
Source: Velazquez, FRet al. N Engl J Med. 1996;335:1022-1028
17. Clinical Presentation
Probability of RV Infection by Age
Cumulative Probability of First and Subsequent Natural Rotavirus Infections during the
First Two Years of life (Source: Velazquez, FRet al. N Engl J Med. 1996;335:1022-1028.)
18. Treatment
Therapy for rotavirus-induced diarrhoea involves replacement of fluids and
electrolytes lost during infection.
Priorities
feeding (breast milk or diluted formula in infants and lactose free
carbohydrate rich foods in older children) within 24 hours after onset of
illness
the use of oral rehydration therapy in children with mild or moderate
dehydration.
Fruit juices and soft drinks are not recommended due to their high glucose
content, low sodium content and high osmolarity.
Antibiotics, antisecretory drugs, antimotility drugs, absorbents and
antiemetics do not ameliorate acute infection, prevent reinfection or reduce
fluid losses during rotavirus induced gastroenteritis, and therefore do not
play a role in treatment.
Children with immunodeficiency disorders may be treated with rotavirus-
specific immunoglobolin preparation. Administer orally to decrease shedding
and ameliorate disease .
20. Infection Control
In the Home and Day-Care Facilities
Hand-washing areas
Food-preparation areas
Diaper-changing surfaces
Diaper disposal containers
Toys
In Hospital Areas and Clinics
Hand-washing areas
Medication-preparation areas
Equipment
Patient care areas
22. Rotavirus Vaccines
Two oral, live, attenuated rotavirus vaccines
Rotarix (GlaxoSmithKline Biologicals,Rixensart, Belgium)
RotaTeq (Merck & Co. Inc., West Point, PA, USA)
Available internationally
Both vaccines are considered safe and effective
WHO now recommends that infants worldwide be vaccinated
against Rotavirus
Vaccines differ in composition and dosing schedule
Rotarix (RV1) is a monovalent vaccine given in a 2-dose
schedule
Rotateq (RV5) is a pentavalent vaccine given in a 3-dose
schedule
23. Rotavirus Vaccines
RotaTeq Rotarix
Manufacturer Merk & Co. GSK
Genetic framework Bovine Rotavirus – WC3 Human Rotavirus-89-12
Composition 5 Human, Bovine reassortant Single Human rotavirus
Genotypes G1, 2, 3, 4 and [P8] G1 [P8]
Dosage Schedule 3 doses at 2, 4 and 6 months 2 doses at 2 and 4 months
Route oral oral
Presentation liquid Lysophilized-reconstituted
Efficacy against severe 85% 95%
disease
Virus shedding Up to 13 % 17 % - 27%
25. Vaccine Efficacy
Rotavirus Efficacy in Clinical Trials in Africa and Asia
Vaccine Region Country Efficacy
RV1 (Rotarix) Africa South Africa, 62% (44% - 73%)
Malawi
RV5 (RotaTeq) Asia Bangladesh, 51% (13% - 73%)
Vietnam
RV5 (RotaTeq) Africa Ghana, Kenya, 64% (40% - 79%)
Malawi
Madhi SA, et al. N Engl J Med 2010;362:289-298
Armah GE, et al. Lancet 2010;376:606-614
Zaman K, et al. Lancet 2010;376:615-623
26. Vaccine Efficacy
Factors to Consider in Rotavirus Efficacy
Efficacy of Rotavirus Vaccines by Mortality Stratum and Country
Mortality rate RV vaccine Countries were studies
defined by WHO efficacy estimates were performed
HIGH 50 – 64 % Ghana, Kenya, Malawi,
Mali
46 – 72 % Bangladesh, South Africa
INTERMEDIATE 72 – 85 % Vietnam, the Americas
LOW 85 – 100 % The Americas, Western
Pacific and Europe
Adapted from WHO. Wkly Epidemiol Rec 2009;84:533-40
27. Rotavirus Surveillance in South Africa
Diarrhoea sentineal surveillance programme implemented in April 2009 by
the NICD
Five hospitals in four provinces (Gauteng, North-West, Kwazulu Natal and
Mpumalanga)
The aim of the programme is to evaluate the prevalence of rotavirus in
diarrhoea cases and to monitor the effect of the introduction of the Rotarix
vaccine into the EPI
The rotavirus vaccine was introduced in August 2009
Children < 5 years admitted (slept overnight in hospital) to one of the
sentinel hospitals for acute diarrhoea (3 loose stools in 24 hour period and
onset within 7 days) are eligible for enrolment in the surveillance
Stool specimens are collected and tested at the NICD/NHLS and at the
Diarrhoeal Pathogens Research Unit, MEDUNSA, using the Rotavirus ELISA
kit
28. Rotavirus Surveillance in South Africa
In the first year, coverage was less than 50%; data from early
2010 indicated uptake of 50-75%
Rotavirus in South Africa is a very seasonal disease, usually
peaking in May, with a second smaller peak a few months later
In summer months there is little rotavirus but quite a bit of
other diarrheal disease
Data collected from the sentinel sites through June 2010
showed a major decline in RV-positive stool samples in the 2010
rotavirus season, the first following the vaccine’s introduction
In vaccinated children, rotavirus was detected in 11% of stool
samples during the surveillance period, while in the unvaccinated
children the rate was 20%
29. Rotavirus Surveillance in South Africa
Cumulative number of specimens tested rotavirus positive and total number of
samples collected by hospital - Reporting period: 04/01/2010 to 30/12/2010.
Hospital Rotavirus Positive Total Samples
Chris Hani Baragwanath 128 541
Edendale 16 84
George Mukhari 46 232
Mapulaneng 10 67
Matikwane 41 218
Total 241 1142
Rotavirus also has a distinct seasonality with peaks in the winter months in
temperate climates
serotype G1 accounts for approximately 50% of infections in South Africa.
Other serotypes causing infection in South Africa include G2, G8, G9 and G12
Data courtesy of NICD Epidemiologic Report; ROTA Surveillance, 2011.
30. Rotavirus Surveillance in Africa
25-40% of African children hospitalized with
diarrheal illness are infected with rotavirus
By 18 months of age, 83% of children will have
contracted the virus
G1 is most prevalent strain in Africa, estimated
50% of cases, followed by G3 at 30%
G2 strain occurs in “waves” every 3 to 4 years
G4 and G8 strains occur in sporadic isolation
G9 is emerging in countries across the
continent
Mixed serotypes are increasingly common
Of the P genotypes, P6 is the most
common, accounting for 50-60% of
cases, followed by P8 (35-40% of cases).
An unusual VP4 serotype has also been
detected
African Rotavirus Surveillance Network (AFRSN) – www.afro.who.int/en
32. Other Effects of Rotavirus Vaccination
Health Impact
decrease in all-cause diarrhoea
Herd Immunity
protection extends to the unvaccinated
Age specific incidence of disease
change in age of exposure
Season specific incidence of disease
shift in onset of epidemics. Helps guide surveillance systems
Long-term interaction of rotavirus vaccination and strain
ecology
Strains may changes post-vaccination
34. Rotavirus in HIV-infected Infants
HIV infected children with RV diarrhoea have similar short-
term clinical course and outcome.
HIV infected children 4.7 fold more likely to have
ongoing, prolonged asymptomatic shedding of RV four weeks
post-diarrhoeal illness.
RV IgG and IgA seroconversion post wild type RV illness similar
between HIV-infected and -uninfected children
RV infection does not affect blood HIV viral load or CD4cell
counts
RV vaccine not associated with progression of immune-
deficiency in HIV infected children.
Cunliffe NA et al. The Lancet; 2001; 358: 550-555 ; Jere C et al. AIDS 2001; 15: 1439-42
35. Rotavirus Vaccine Safety
Intussuseption
Currently NO data supports hypothesis of increased risk of
intussuseption with RV vaccines
Rotavirus vaccines are safe
• Reviewed safety data from phase III efficacy studies of Rotarix
and RotaTeq, as well as postmarketing safety data from
Australia, Latin America and the United States
• Previous association with the now withdrawn
vaccine, RotaShield
36. Rotavirus Vaccine Safety
Contraindications
Severe Combined Immunodeficiency Syndrome
History of:
severe allergic reaction to a prior dose of RV
Severe allergic reaction to latex
Intussuseption
Some congenital GI malformations e.g. Meckel diverticulum
Vaccine-vaccine interactions
RV vaccines have been found not to interfere significantly with
the immunogenicity or safety of other childhood vaccines
However, OPV appears to have an inhibitory effect on the
immune response to the first dose of RV vaccine
37. WHO - EPI Recommendations
RV vaccine should be included in all national immunization
programmes
In countries where diarrhoeal deaths account for ≥10% of mortality
among children aged <5 years, the introduction of the vaccine is
strongly recommended
WHO recommends that the first dose of either RotaTeq or Rotarix be
administered at age 6–15 weeks
The maximum age for administering the last dose of either vaccine
should be 32 weeks.
It is recommended that 2 doses of Rotarix be administered with the
first and second doses of DTP rather than with the second and third
doses
This ensures maximum immunization coverage and reduces the potential for
late administration beyond the approved age window
This schedule will be reviewed as new data become available
6 and 14 weeks in RSA EPI schedule
38. Conclusions
Rotavirus vaccines are not the solution to controlling this
disease
Disease Control involves an integrated approach
Zinc treatment
Improved oral rehydration solution (ORS)
Exclusive breastfeeding
Improved nutrition
Community education
Safe water, adequate sanitation and hygiene
These can complement the impact of vaccines and together
have a huge impact in reducing the burden of diarrhoea – one
of the largest killer of young children.
39. References
• WHO Weekly Epidemiological Record 2008; 83 (47), 27 November 2008
• Global networks for surveillance of rotavirus gastroenteritis, 2001-2008. Wkly Epidemiol Rec 2008;83:421-428.
• Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI. Global illness and deaths caused by rotavirus disease in children. Emerg Infect
Dis 2003;9:565-72.
• Chin, J. (Ed.). (2000). Control of Communicable Disease Manual. Wash. DC: American Public Health Association.
• American Academy of Pediatrics. (1997). Rotavirus. In Red book: Report of the committee on infectious diseases. (24th ed., pp.454 - 456). Elk
Grove Village, IL:Author.
• Velazquez F, Matson DO, Calya JJ, et al. Rotavirus infections in infants as protection against subsequent infections. N Engl J Med.
1996;335:1022-1028.
• Offit, P. A. & Clark, M. F. (2000). In G. L. Mandell, J. E. Bennett, & R. Dolin (Eds)., Principles and practice of infectious diseases. (5th
ed., pp.1696 -1703). Philadelphia, PA: Churchill Livingstone
• Estes M. Rotaviruses and their replication. In: Howley PM, ed. Fields Virology. 3rd ed. Vol. 2. Philadelphia, PA: Lippincott-Raven; 1996:1625-
55.
• Estes MK, Cohen J. Rotavirus gene structure and function. Microbiological Reviews 1989;53:410-49.
• Glass RI, Bhan MK, Ray P, et al. Development of candidate rotavirus vaccines derived from neonatal strains in India. J Infect Dis
2005;192(Suppl):S30-S5.
• Ward RL, Bernstein DI. Lack of correlation between serum rotavirus antibody titers and protection following vaccination with reassortant RRV
vaccines. Vaccine 1995;13:1226-32.
• Green KY, Taniguchi K, Mackow ER, Kapikian AZ. Homotypic and heterotypic epitope-specific antibody respones in adult and infant rotavirus
vaccinees: implications for vaccine development. J Infect Dis 1990;161:667-79.
• Madhi S, Cunliffe NA, Steele D, Witte D, Kirsten M, et al. N Engl J Med 2010: 362: 289-98
• Vesikari T, Matson DO, Dennehy P, et al. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J
Med 2006;354:23-33.
• CDC. Withdrawal of rotavirus vaccine recommendation. MMWR 1999;48:1007.
• Peter G, Myers MG. Intussusception, rotavirus, and oral vaccines: summary of a workshop. Pediatrics 2002;54:110.
• WHO. Report of the Global Advisory Committee on Vaccine Safety, December 1-2, 2005. Wkly Epidemiol Rec 2006;2:13-20.
• African Rotavirus Surveillance Network (AFRSN) – www.afro.who.int/en
• Rotavirus (ROTA) Surveillance: Rotavirus Report, National Institutes of Communicable Diseases, 2 March 2011.
• WHO Weekly Epidemiological Record. No. 51-52, 2009, 84, 533-540.
• Diarrhoea: why children are still dying and what can be done. Geneva, UNICEF and World Health Organization, 2009 (available from:
http://www.who.int/child_adolescent_health/documents/9789241598415/en/index.html; accessed November 2009).
• CDC, unpublished data, 2006.
Rotavirus strains are serotyped according to the neutralization of one of the two proteins present in the outer capsid: VP7, a glycoprotein, is neutralized in G types, and VP4, a protease-cleaved hemagglutinin, is neutralized in P types. G types 1, 2, 3, and 4 are responsible for most infections in children.Rotavirus was given its name when scientists observed its wheel-like appearance; it was named after rota, the Latin word for wheel. The inner hub of the rotavirus (yellow on the slide) is usually referred to as the G-type, and the spokes coming off of the inner hub (red on the slide) are usually referred to as the P-type. The G-type and P-type define the serotype of the virus and are critical to vaccine development because they are the vaccine targets for stimulating a protective immune response.
Two surface rotavirus proteins, VP7 (a glycoprotein—G protein) and VP4 (a protease-cleaved protein—P protein), inducehomotypic and heterotypic neutralizing antibody responses that are suspected to partly provide protective immunity after naturalinfection and vaccination
Before symptoms of rotavirus infection appear, feacal shedding occurs. Fever and vomiting precede diarrhoea, and hospitalization for dehydration usually occurs between days 2 and 6 after infectionFever and vomiting are usually the first symptoms, followed quickly by diarrhoea. Oftentimes the vomiting is a rate-limiting factor in attempts to provide oral rehydration. When hospitalization for dehydration does occur, it is usually 2 to 6 days into the illness, and intravenous fluid therapy is necessary.
The diarrhoea is usually non-bloody, profuse, and lasts for up to 3-8 days. Compared with children with non-rotavirus-related diarrhoea, rotavirus-infected children experience more vomiting and have a greater number of diarrhoea episodes per day, which explains why dehydration is so common with this illness.[13] Dehydration is commonly isotonic. Diarrhoea is watery without blood or mucous. Although coryza and cough may precede GI symptoms, replication of rotavirus in the upper respiratory tract is not important in the spread of the virus (4). Neurologic symptoms may occur in severe cases as a result of electrolyte imbalance or direct viral infection of the central nervous system (1).
Cause of diseaseRotavirus replicates in certain cells that line the inside of the small intestine. This replication decreases the ability of the intestine to absorb salts and water. Rotavirus has never been detected consistently in the blood or in other sites far from the intestine.
Cause of diseaseRotavirus replicates in certain cells that line the inside of the small intestine. This replication decreases the ability of the intestine to absorb salts and water. Rotavirus has never been detected consistently in the blood or in other sites far from the intestine.
In a cohort of Mexican children, nearly every child had a rotavirus infection by the age of 2 years. Rotavirus vaccination mimics the protection rates of one natural infection.The failure of a primary natural rotavirus infection to protect completely against subsequent infection may indicate the need for multiple vaccinations or for the administration of a polyvalent vaccine that can elicit full protection against all prevalent serotypes.It is encouraging that the degree of protection conferred by asymptomatic infection was similar to that afforded by symptomatic infection. The occurrence of two rotavirus infections, whether symptomatic or asymptomatic, resulted in complete protection against moderate-to-severe illness. This finding implies that an attenuated vaccine that caused asymptomatic infection could induce protective immunity. That two natural infections were required for complete protection against moderate-to-severe illness implies that more doses of an attenuated vaccine will be required to achieve efficacy similar to that from exposure to a wild-type strain adapted to the human intestine.
In a cohort of Mexican children, nearly every child had a rotavirus infection by the age of 2 years. Rotavirus vaccination mimics the protection rates of one natural infection.The failure of a primary natural rotavirus infection to protect completely against subsequent infection may indicate the need for multiple vaccinations or for the administration of a polyvalent vaccine that can elicit full protection against all prevalent serotypes.It is encouraging that the degree of protection conferred by asymptomatic infection was similar to that afforded by symptomatic infection. The occurrence of two rotavirus infections, whether symptomatic or asymptomatic, resulted in complete protection against moderate-to-severe illness. This finding implies that an attenuated vaccine that caused asymptomatic infection could induce protective immunity. That two natural infections were required for complete protection against moderate-to-severe illness implies that more doses of an attenuated vaccine will be required to achieve efficacy similar to that from exposure to a wild-type strain adapted to the human intestine.
Deaths also result from treatment. Hypotonic solution given in a large volume can create cerebral oedema. It is important to remember that the range of sodium excretion of rotavirus diarrhoea is around 30 to 60 mL equivalents per liter. Rehydration with fluid less than one-third normal saline causes total body sodium loss. The brain cannot correct fluid imbalance as quickly by moving solute as it can by moving water; patients who have been given too much free water may develop brain oedema and die.
Where is RV found ? Parents cannot prevent their children from getting a rotavirus infection. The primary mode of rotavirus transmission is fecal to oral. Rotavirus is highly communicable and transmissible. Close person-to-person contact and environmental surfaces are common vectors of transmission. It is impossible to keep contaminated fingers and objects from going into children's mouths. Even if a child is not cared for in a daycare setting, he or she is likely to have contact with other children or objects that other children have touched. Rotavirus is an extremely hardy pathogen. The incubation period is 1-3 days and large quantities of virus are shed in stool from just prior to onset of symptoms until about 10 days after onset. Rotavirus is highly transmissible. Under experimental conditions, almost 50% of rotavirus remains viable on contaminated hands for 60 minutes
Where is RV found ? Parents cannot prevent their children from getting a rotavirus infection. The primary mode of rotavirus transmission is fecal to oral. Rotavirus is highly communicable and transmissible. Close person-to-person contact and environmental surfaces are common vectors of transmission. It is impossible to keep contaminated fingers and objects from going into children's mouths. Even if a child is not cared for in a daycare setting, he or she is likely to have contact with other children or objects that other children have touched. Rotavirus is an extremely hardy pathogen. The incubation period is 1-3 days and large quantities of virus are shed in stool from just prior to onset of symptoms until about 10 days after onset. Rotavirus is highly transmissible. Under experimental conditions, almost 50% of rotavirus remains viable on contaminated hands for 60 minutes
RV1, the live-attenuated human rotavirus vaccine, was approved by the FDA in 2008 and contains one strain of live-attenuated human rotavirus, a G1 P[8] strain. RV1 shares neutralizing identity with G1, G3, G4, and G9 through the P[8] VP4 protein. RV1 does not share neutralizing identity with G2 P[4] strains, and a major concern with the RV1 strain is efficacy against G2 P[4] strains. RV5 The RV5 vaccine contains five reassortant viruses developed from human and bovine parent rotavirus strains and shares neutralizing identity with G1, G2, G3, G4, and P[8], the same P serotype as many of the G9 strains observed in the US. Phase 3 trials included more than 70,000 infants in 11 countries.2 The vaccine demonstrated 74% overall efficacy and 98% efficacy for severe rotavirus disease. In a cohort of infants for which data from clinic and ED visits were collected, there was an 86% reduction in the need for a physician visit for diarrhea and a 96% reduction in hospitalization.2 RV5 was effective against all the G serotypes tested
Defination of attenuated vaccine, monovalent, pentavalent
Do the rapid immunoassays detect vaccine-strain virus?Yes, the threshold for detection is on the order of 105 or 106 for the enzyme immunoassay. There is a low rate of shedding with the RV5 vaccine, while the rate of shedding is higher for the RV1 vaccine. Shedding is higher for the monovalent vaccine in part because it is better adapted to the host for replication.
Defination of attenuated vaccine, monovalent, pentavalent
After 1 year of follow up, the efficacy of Rotarix in preventing severe rotavirus gastroenteritis was 61.2% (95% CI, 44–73%) in the combined study populations,76.9% (95% CI, 56–88%) in South Africa and 49.5% (95% CI, 19–68%) in Malawi Despite its lower efficacy in Malawi, the number of episodes of severe gastroenteritis prevented by vaccination was higher (3.9/100 vaccinees) than in South Africa (2.5/100 vaccinees) because of the higher incidence of severe rotavirus gastroenteritis in young infants in Malawi.
Rotavirus vaccination is effective and is now affecting epidemiology. Most severe infections occur during the first year of life, and it appears as though vaccination is affecting exposure, which means that a person’s age of first exposure might be delayed. A change in the age distribution of severe infection is likely to be seen. The concern when measles vaccination was introduced was that if all children were immunized, the epidemiology of the disease would shift and older children and adults, when infected, would experience more severe disease since they lack previous natural exposure. In fact, there was a temporary shift toward older individuals getting infected, but the overall absolute number of cases declined drastically, and as you know, endemic measles transmission was eliminated in the U.S. in 2000 (despite recent outbreaks related to importations and pockets of undervaccination).
-25 countries based in Harare
SLIDE SHOWS REDUCTION OF rv CASES AFTER INTRODUCTION rv VACCINE IN THE usa
Routine immunization occurs in real-world conditions different from ideal clinical trial settings. Thus, monitoring postlicensure impact on rotavirus disease is crucial for ensuring that appropriate gains in terms of expected vaccination benefits are attained. Changes in the epidemiology of rotavirus disease might occur in the postlicensure era, such as shifts in average age at infection, seasonality of disease, and serotype distribution after vaccination or appearance of unusual genetic variants ensuring that protection is conferred through the first and second years of life when most severe disease and mortality from rotavirus occur will be crucial for the success of a rotavirus vaccination program. Finally, assessing whether vaccination has an affect on rotavirus transmission in the community, thus providing benefits to unvaccinated groups, is important. Monitoring impact with focus on these public health considerations will not only allow assessment of the effectiveness of rotavirus vaccines in routine use, but also generate the necessary evidence to inform public health policy decision-making and continued investment in rotavirus vaccines.
Herd immunity is when a vaccine protects even subjects not vaccinatedThis study confirms on a national scale that the 2008 rotavirus season among children aged <5 years was dramatically reduced compared to pre-RV5 seasons. … Based on the observed decrease during the 2008 season, we estimated that ~55,000 acute gastroenteritis hospitalizations were prevented during the 2008 rotavirus season in the United States. A decrease of this magnitude would translate into the elimination of 1 in every 20 hospitalizations among US children aged <5 years.Interestingly, the reduction in gastroenteritis wasn’t only in vaccinated children:In 2008, acute gastroenteritis hospitalization rates decreased for all children aged <5 years, including those who were either too young or too old to be eligible for RV5 vaccination. …These findings … raise the possibility that vaccination of a proportion of the population could be conferring indirect benefits (ie, herd immunity) to nonvaccinated individuals through reduced viral transmission in the community
Cunliffe NA et al. The Lancet; 2001; 358: 550-555Jere C et al. AIDS 2001; 15: 1439-42.
In December 2008, GACVS reviewed safety data from phase III efficacy studies of Rotarix and RotaTeq, as wellas postmarketing safety data from Australia, Latin America and the United States. GACVS concluded thatthese vaccines are safe and that a risk of intussusception of the order associated with the previously marketed,but now withdrawn, tetravalent reassortant rotavirus vaccine (RotaShield, Wyeth Lederle, Philadelphia,PA, USA) can be ruled out with confidence. In June 2009, GACVS stated that no data directly support a hypothesisthat administration of rotavirus vaccine even outside of the age range 6–15 weeks for the first doseand 32 weeks for the second dose is associated with an increased risk of intussusception..
In various settings, rotavirus vaccines have been found not to interfere significantly with the immunogenicityor safety of OPV or other childhood vaccines. OPV, however, appears to have an inhibitory effect on the immuneresponse to the first dose of rotavirus vaccine, although this interference does not persist after administrationof subsequent doses.