Water treatment and sanitation can be instrumental in
controlling fecal-oral transmission.
Background on Vaccine Development:
Acute diarrhoea is responsible for
nearly 1.9 million deaths per year in children under age five. Rotavirus is
responsible for as much as one fourth of these casualties, almost all of which
occur in developing countries.
Status of vaccine development: RotaRix, a
vaccine developed by GlaxoSmithKline (GSK), showed an efficacy rate against
severe rotavirus diarrhoea of 87% in a clinical study of 1986 infants in
Venezuela, Brazil, and Mexico, and is now licensed in Mexico, the Dominican
Republic, and Kuwait, although currently used only in the private market. A
Phase III trial of over 60 000 infants was carried out in Latin America in
2003-2004, and efficacy results are expected soon. Phase III trials also are
under way in South Africa and Bangladesh.
RotaTeq, a vaccine developed by Merck, protected more
than 95% of recipients from severe rotavirus diarrhoea in a clinical trial of
1946 infants in Finland. A Phase III trial of more than 70 000 infants in the
United States and European countries has been carried out to investigate safety,
and a subset of that group was followed to determine efficacy. The results of
these studies are expected by mid 2005. Trials in Asia and Africa - where
different strains of the virus may predominate - are likely to start this year
but may not be completed for several years.
Rotavirus vaccines in earlier stages of development
include two vaccines sponsored by the United States National Institutes of
Health; a neonatal vaccine developed by an Indian-US consortium; and an
Australian neonatal vaccine.