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Oral Vaccine Protects Infants From Severe Rotavirus Diarrhea

An oral vaccine against rotavirus -- the most important cause of life-threatening diarrhea in children under age 2 -- reduced severe diarrheal illness by 88 percent in a study of more than 2,000 infants in Venezuela. This is the largest and most successful trial to date of a rotavirus vaccine among children in a developing country.

Worldwide, rotavirus diarrhea affects 130 million infants and children each year, some 18 million of whom have moderate to severe disease, resulting in 873,000 deaths.

The study was conducted by Albert Z. Kapikian, M.D., head of the Epidemiology Section of the Laboratory of Infectious Diseases (LID), part of the National Institute of Allergy and Infectious Diseases (NIAID); Irene Perez-Schael, M.D., chief of the Laboratory of Enteric Disease at the Instituto de Biomedicina, Universidad Central de Venezuela in Caracas; and their co-workers. Results are reported Oct. 23 in The New England Journal of Medicine.

"This is the first study designed to determine if the vaccine prevents severe illness in a developing country where rotavirus circulates year-round rather than seasonally," explains Anthony S. Fauci, M.D., NIAID director. "In this setting, the vaccine proved to be very efficacious."

Although rotavirus infection is nearly universal, "The outcome and consequences of rotavirus illness in developed countries are very different from those in developing countries," Dr. Perez-Schael says. Children in developing countries more often develop severe and fatal illness.

Symptoms develop quickly and, in addition to diarrhea, include vomiting, fever and dehydration. In severe cases, a child can experience 10 to 20 episodes of diarrhea and 10 to 15 vomiting episodes per day. Dehydration can be reversed through oral rehydration therapy or, if more serious, through hospitalization and intravenous fluids. Although effective, these therapies are not readily a
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Contact: Laurie K. Doepel
ldoepel@nih.gov
301-402-1663
NIH/National Institute of Allergy and Infectious Diseases
22-Oct-1997


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