Muncie Times, Muncie, Delaware County, 20 November 1997 — Page 18

The Muncie Times, November 20,1997 • Page 18 Oral vaccine protects Venezuela infants from 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 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 a 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 Disease (LID), part of the National Institute of Allergy and Infectious Disease (NIAID); Irene Perez-Schael, M.D., chief of the Laboratory of Enteric disease at the Istituto de

Biomedicina, Universidad Central de Venezuela in Caracas; and their coworkers. Results were 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,” said 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,” Perez-Schael said. Children in developing countries more often develop severe and fatal illness. Symptoms develop quickly and, in addition to diar-

rhea, including 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 available or utilized in many parts of the developing world, said Kapikian. Also, Kapikian said, “Ratoaviruses are very egalitarian viruses. Practically every child in the developed and developing world will be infected with rotavirus in the first few years of life, regardless of hygienic conditions.” Kapikian has devoted a major part of his career to working on rotavirus since its discovery almost 25 years ago by Australian investigators. He and his colleagues in NIAID’s LID developed and patented the vaccine.

which, with assistance from many outside collaborators, has been tested on nearly 18,000 people in the United States and abroad. “The development of the quadrivalent rotavirus vaccine evaluated in the study... represents the culmination of a long and highly creative process of research and development at the National Institutes of Health,” said Gerald T. Keusch, M.D., and Richard A. Cash, M.D., M.P.H., both affiliated with the Harvard Institute for International Development, in a companion editorial in the Journal. “To be there from the beginning has been a great privilege,” Kapikian said. “But what’s most exciting and gratifying to me as a physician is to see that most babies can be protected from a severe disease with a product that has been developed in our laboratory.” Imhe United States, rota-

virus causes more than 3 million cases of childhood diarrhea during the cooler months of each year, leading to an estimated 500,000 doctor visits, 55,000 to 100,000 hospitalizations and 20 to 100 deaths. Rotavirus illness costs the U.S. health care system and estimated $400 million in direct costs annually, rising to $1.4 billion when indirect costs, including lost work time for parents, are included. The potential benefits of a licensed vaccine in developed countries such as the United States are noted by Keusch and Cash. “Studies in the United States indicate that the rhesus rotavirusbased quadrivalent vaccine is safe and can prevent nearly half of all rotavirus infections, 80 percent of severe episodes, and virtually all cases of dehydrating rotavirus illness.” The candidate vaccine is see VACCINE on page 26

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