35 Years after Discovery, the World is on the Verge of Stopping Deadly Rotavirus
07/30/2009
Dr. Ruth Bishop, who led the team that identified rotavirus on eradicating the disease.
Throughout my career as a microbiologist, I have worked alongside clinicians responsible for the treatment of children with severe diarrhea. The lightning quick onset of vomiting, diarrhea and dehydration in young children causes alarmed parents to rush their toddlers into the hospital. At first, many parents think it is just a "stomach bug," but this deceptively friendly name masks an illness that has confounded doctors for centuries and taken countless lives worldwide. The disease was often referred to as "pseudo cholera infantum" but the cause remained unknown.
In 1973, using electron microscopy, a "new" virus causing this illness was discovered in a child admitted to the Royal Children's Hospital in Melbourne, Australia. Within a year of that discovery, the virus finally had a name - rotavirus - and the global health community was beginning to understand that the best way to protect children from this often deadly disease was to prevent them from getting it in the first place. It has taken more than three decades to develop safe and effective vaccines since my colleagues and I first saw this virus. The prospect for global introduction of rotavirus vaccines is finally within reach.
So what obstacles have been overcome?
The same vaccines don't always work with every population. Like many past and present global health epidemics - polio and cholera come to mind - extensive clinical trials in industrialized and impoverished settings alike are necessary to find the most effective and safe vaccines. This takes time and a long-term commitment that is difficult to maintain against other competing global health priorities.
But the success of rotavirus vaccines in nations where they have already been licensed for use has propelled development forward. In the U.S., routine rotavirus vaccination has led to a reduction in rotavirus-related hospitalizations and emergency room visits by as much as 80 percent. In Australia, vaccine uptake among infants of between 70 and 80 percent is helping to reduce rotavirus hospitalizations across the country.
Rotavirus is still afflicting children on a global scale. In fact, by the age of three, every child is likely to be infected by rotavirus. Whether they survive or die is largely dependent on where they live. In developing countries, it's more likely to kill. Each year more than 500,000 children die from diarrhea and resulting dehydration caused by rotavirus; a vast majority of these deaths are in poor countries where access to treatment is minimal.
With clinical trials recently completed in Africa and Asia, we are on the verge of stopping this killer everywhere. Just last month, the World Health Organization recommended in favor of universal introduction of rotavirus vaccination. GAVI funding means that worldwide prevention is now within our reach.
Getting to this moment in history has been the life work of many microbiologists and clinicians worldwide. Now it's up to individual governments to take advantage of the availability and funding that could prevent thousands of needless deaths every year. I write this with great hope that the time for rotavirus vaccine has finally arrived. The moment cannot arrive soon enough.
Dr. Ruth F. Bishop, who led a team that discovered rotavirus, is a senior principal research fellow at the Murdoch Children's Research Institute at the Royal Children's Hospital Melbourne and a professorial fellow at the Department of Pediatrics at the University of Melbourne.
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