Vaccine to prevent diarrhoea
A vaccine to prevent rotavirus associated diarrhoea has been launched recently in Bangladesh
Throughout the world, rotaviruses are the single most causative agents of severe diarrhoea in infants and young children. As a result of the associated mortality and morbidity, rotaviral gastroenteritis represents a major public health burden. Within the first five years of life, virtually every children becomes infected with this diarrhoeal pathogen, irrespective of race or socio-economic status.
Globally, it is estimated that rotaviruses are responsible for more than 111 million cases of infantile gastroenteritis leading to approximately 600,000 deaths per year. 82 percent of these deaths occur in the developing countries like ours. Children of developing nations die more frequently, because of poorer access to treatment and a greater prevalence of malnutrition.
ICDDR,B estimated that between 5,756 and 13,430 children died each year in Bangladesh between 2001 and 2004 from severe rotavirus gastroenteritis.
The similar incidence of rotavirus in both developed and developing countries suggests that the disease will not be controlled by merely improving water quality, sanitation of hygiene.
Administration of oral rehydration therapy (ORT) and Zinc in the treatment of severe rotavirus gastroenteritis have helped to decrease the number of severe and fatal infections, the mortalty rate remains unacceptably high, particularly in our part of the world.
These findings, together with the high level of morbidity and associated costs emphasise the dire need for the introduction of a new and effective public health intervention like vaccine, which is strategic to prevent rotavirus-attributable disease.
Understanding the natural history of rotavirus-attributable disease, its pathogenesis, immunologic response of human body to the pathogen have helped to develop a live-attenuated vaccine against the virus. The use of an attenuated rotavirus strain as a vaccine is designed to provide broad protection, mimicking natural infection without causing the disease.
It is anticipated that this vaccine will have a substantial impact in reducing rotavirus-related mortality and morbidity, and their associated costs.
The global clinical development programme has proven that RotarixTM protects against the most common circulating strains (G1 and non-G1 rotavirus strains) including the globally emerging G9 strain.
GlaxoSmithKline, which is pioneer in vaccine manufacturing in the world has recently launched their novel vaccine against rotavirus, RotarixTM, a live-attenuated based on human rotavirus strain in Bangladesh. It has been investigated in an extensive, and still ongoing, worldwide clinical development programme including Bangladesh.
Earlier it has been approved in over 63 countries in the world.
RotarixTM is a lypholised oral vaccine and is administered in two doses within the first six months of life. The first oral dose can be administered from as early as six weeks of age with a minimum interval of four weeks prior to the second oral dose. The vaccination course must be completed by 24 weeks.
It can be co-administered with all infant vaccines within the routine infant vaccination schedules.
Although some protection is already conferred after the first dose, as expected from the experience of natural infection, effective protection is achieved after two doses.
A vaccination course of only two doses (compared with a three-dose schedule required for another vaccine in development) provides protection earlier in life, enhances compliance and reduces physician visits and costs.
The vaccine is likely to be available in the local market from the very beginning of next year. Sources of GlaxoSmithKline Bangladsh Ltd. informed that the price would be at an affordable range of the common people of the country.
Many countries in the world have included a vaccine against rotavirus in their routine childhood immunisation programme.
Data from Asia Pacific support rationale for a rotavirus vaccine to be made available through government's paediatric immunisation programmes. Both the World Health Organisation (WHO) and Global Alliance for Vaccines and Immunisation (GAVI) have declared rotavirus vaccination a public health priority.
Whereas, Bangladesh is a GAVI eligible country, it should thing about the introduction of these sort of vaccine in the Expanded Programme on Immunisation (EPI).
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