Rotavirus

Rotavirus is the most common cause of severe diarrheal diseases in infants and young children worldwide, causing about one-fourth of all deaths among children from diarrheal diseases. It is generally accepted in the medical community that rotavirus infects practically every child throughout the world by the age of five.  Globally, rotavirus accounts for an estimated 125 million cases of diarrhea each year and represents 30-40% of the hospitalizations for diarrhea in children less than five years of age. 

In the United States, there are approximately 3.5 million rotavirus cases each year. There are an estimated 20 to 40 childhood deaths annually in the United States associated with rotavirus diarrhea and the resulting dehydration.

In developing countries, where medical care is limited and malnutrition is prevalent, rotavirus infection is far more deadly, causing an estimated 600,000 deaths in children each year (over 1,600 children die each day).

Rotavirus is highly infectious and is spread by the oral-fecal route. The infective dose in a child can be very small. Contaminated food or water can also be a source of infection. Infants and young children who become infected with the virus suffer vomiting, fever and watery diarrhea.

Most cases are mild, but in severe cases, these symptoms will cause life-threatening dehydration if left untreated. One-third of parents whose children are infected with rotavirus become ill. Because infection is so common, most children will develop immunity to the virus within their first two to four years of life. Throughout life, asymptomatic or minimally symptomatic reinfection can occur. The elderly and others with decreased immunity may be susceptible to severe effects of the disease.

Rotavirus appears to infect all children in the world in the first few years of life, whether they are rich or poor, or live in temperate or tropical areas.  The global nature of this infection and the fact that the fecal-oral route spreads rotaviruses implies that improvements in water quality, food hygiene, or sanitation are unlikely to significantly alter the incidence of the disease.  To date, no interventions have proven to be effective in preventing the spread of rotavirus infection.

There are no appropriate drug treatments for rotaviral infections.  Palliative measures such as oral rehydration therapy helps to save the lives of infected children who lose a large amount of fluid and electrolytes (i.e., salts) but such therapy does not prevent new infections.

Readily available oral rehydration therapy is one of the principal reasons for the low mortality from rotavirus in the United States. For children who are not severely dehydrated, oral rehydration solution is the treatment of choice whereas for children who are severely dehydrated and are unable to drink, intravenous therapy can be lifesaving. Antibiotics are not required, provide no benefits, and are contraindicated. A prophylactic oral vaccine like the RotaShield^® rotavirus vaccine that prevents rotavirus infection will satisfy a critical medical need.