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Strides made in treating rotavirus

Faith Gachobe @wangechigachobe

Rachel Mwaniki woke up one day in the middle of the night to find her daughter in a bad state. Her two-year-old baby had a stomach upset and had begun passing loose stool.

It quickly progressed to full-blown diarrhoea in less than three hours. Rachel rushed her daughter to hospital as soon as she could hoping that her daughter hadn’t contracted anything serious.

Unknown to Rachel, her daughter had been infected with rotavirus. The two were discharged with sachets of oral rehydration salts (ORS) and asked to maintain high standards of hygiene to prevent her daughter from contracting the virus again.

Rotavirus is transmitted by the fecal-oral route, via contact with contaminated hands, surfaces and objects and possibly by the respiratory route. Viral diarrhoea is highly contagious. Rota is a mild to severe disease characterised by nausea, vomiting, watery diarrhoea and low-grade fever.

Once a child is infected by the virus, there is an incubation period of about two days before symptoms appear. The period of illness is acute. Symptoms often start with vomiting followed by four to eight days of profuse diarrhoea.

Dehydration is more common in rotavirus infection than in most of those caused by bacterial, and is the most common cause of death related to rotavirus infection among children. Rotavirus is the most common cause of diarrhoeal disease among infants and young children below the age of five.

Nearly every child in the world is infected with rotavirus at least once by the age of five, yet it is vaccine-preventable. However, data on rotavirus vaccine effectiveness in sub-Saharan Africa is limited.

Kenya introduced a vaccine in July 2014. The problem with this particular infection is that it is still relatively new in Kenya and research about the virus is still ongoing. In light of this, Kenya Medical Research Institute (KEMRI) in conjunction with Nagasaki University Institute of Tropical Medicine (NUITM), held the first Africa-Asia symposium at Sopa Lodge in Naivasha last week.

The theme of the symposium was accelerating Rotavirus Research. The aim of the symposium was to help people understand the role played by rotavirus vaccines in minimising childhood rotavirus diarrhoea as well as prevailing issues in administration of available vaccines.

According to a presentation by Dr Ernest Ad Wandera of NUITM, following the introduction of Rotavirus vaccine in Kenya in 2014, the proportion of children below five hospitalised for rotavirus, declined by 30 per cent in the first year and 64 per cent in the second year.

In the research carried out by Kemri and NUITM, the burden of rotavirus associated diarrhea morbidity and mortality in Africa is high with more than 50 per cent of this burden recorded in only three African countries.

So far, only two vaccines, the Rotarix and Rotateq, have been certified for inclusion in the expanded programme for immunisation of developing countries. Both logistical and financial support is provided by Global Alliance for Vaccines and Immunisation (GAVI).

Dr Sammy Khagayi further explained: Diagnosis of infection with rotavirus normally follows diagnosis of gastroenteritis (inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection and causing vomiting and diarrhoea) as the cause of severe diarrhoea.

Most children admitted to hospital with gastroenteritis are tested for rotavirus. A Specific diagnosis of infection with rotavirus is made by finding the virus in the child’s stool.’

If a child has been infected, the doctor is keen of treating the symptoms such as dehydration. Your doctor will administer ORS during which the child is given a lot of water with special salts and minerals.

If untreated, children can die from the resulting severe dehydration. In conclusion, the research showed that rotavirus vaccine has resulted in a notable decline in hospital admissions, especially for children in the rural setting.

Kemri future plans are to expand coverage on second dose of rotavirus so as to maximise the impact of the vaccine. Rotavirus vaccine is administered orally in two doses.

The first given to six weeks and the other at 10 weeks after a child is born. Between the period 2012 and 2017, 92 developing countries across the word introduced rotavirus vaccine. A vaccine against the virus is the best chance a child has of not contracting rotavirus.

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