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Rotavirus • Causes, Effects & Indian scenario

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Rotavirus Diagram
Rotavirus Diagram

Introduction

  • The name Rotavirus comes from the characteristic wheel-like appearance of the virus when viewed by electron microscope (the name rotavirus is derived from the Latin word Rota, meaning “wheel”).
  • Rotavirus causes diarrheal infection of the stomach and bowel (or ‘gut’ means the part of the alimentary canal between the stomach and the anus). It spreads when infected children do not maintain proper personal hygiene.
  • Rotavirus is the most common cause of severe diarrheal (gastroenteritis) disease in infants and young children globally.
  • Children under five years of age, especially those between 6 months and two years are most vulnerable to this disease.
  • The first rotavirus infection tends to be the most severe because the body builds up immunity (resistance) to the virus afterwards. This is why these types of infections are extremely rare in adults. It is estimated that every child will have at least one rotavirus infection before the age of five. Most infections occur among children aged between three months and three years old.
  • 36% of hospitalizations for diarrhea among children aged below 5 years are caused by rotavirus infection. Rotavirus affects populations in all socio-economic groups and is equally prevalent in industrialized and developing countries.
  • No specific treatment exists for rotavirus gastroenteritis, and repeat infections are common in children. Since 2006, vaccines are available for rotavirus infection. Prior to the availability of a vaccine, almost all children became infected with rotavirus by their third birthday. Repeat infections with different viral strains were possible. After several infections with different strains of the virus, children acquire immunity to rotavirus. Adults sometimes get infected, but the resulting illness is usually mild.

How does the Rotavirus spread?

  • Rotavirus spreads by contact or airborne route. Most cases of gastroenteritis (Inflammation of the stomach and intestines) in children are mild and usually pass within 3-5 days without the need for treatment.

Rotavirus Effects

  • Rotavirus is estimated to be responsible for approximately 5, 27,000 deaths each year, with more than 85% of these deaths occurring in low-income countries in Africa and Asia, and over two million are hospitalized each year with pronounced dehydration.
  • Young children, particularly those under two years of age, are at risk of dehydration. So it is very important that they drink plenty of fluids. In severe cases of gastroenteritis, where there has been significant fluid loss, hospital treatment may be required so that fluid can be replaced through drips.

Rotavirus problem in India

  • Rotavirus is responsible for approximately 5, 27,000 child deaths due to diarrhoea globally each year. It is particularly threatening in India where — according to a recent study — around 1,00,000 children die each year from severe diarrhoea and dehydration caused by rotavirus.
  • India accounts for 22 per cent of the estimated global deaths from diarrhoea-causing rotavirus.
  • While some studies in India have found no association between rotavirus infection and time of year, most have observed an increase in rotavirus-associated diarrhoea during the winter months, October to February, throughout the country. The observed proportion of rotavirus cases occurring in the cooler season has ranged from 59% to 72%.
  • In India, nationally representative data on the incidence of severe rota virus disease is lacking. However, studies have revealed that on an average 34% of all diarrheal hospitalizations are due to rotavirus infection and the proportion of severe rotavirus infection has not decreased in the last few years, similar to the global trend indicating that improved sanitation and use of antibiotics have not been effective on rota virus. The prevalence of Rotavirus in new born is high in India to the extent of 73%, but these infections are normally a- symptomatic and the likelihood of acquiring infection increases with the length of stay in the hospital.

Prevention from Rotavirus is the key

  • Once sanitation and drinking water supply in the country improves, the efficacy of the vaccine is bound to go up.
  • Use of Rotovac vaccine should be part of a comprehensive diarrheal disease control strategy including, among other interventions, improvements of hygiene and sanitation, administration of oral rehydration solution and overall improved case management.

Conclusion

  • Currently two-rotavirus vaccines are available in the international market, namely Rotarix and Rotateq. These vaccines are less effective against medically attended rotavirus diarrhoea in lower income settings. Reasons for this could be high prevalence of other intestinal infections, malnutrition, tuberculosis etc.
  • Improving the overall performance of the immunization system is critical to the success of any vaccine introduction.
  • ROTAVAC represents the successful research and development of a novel vaccine from the developing world with global standards. The clinical trial results indicate that the vaccine, if licensed, could save the lives of thousands of children each year in India.

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