CDC em 30-06-09

The World Health Organization (WHO) has recommended that health authorities in all nations routinely vaccinate young children against rotavirus, which causes 2 million hospitalizations and 500,000 deaths from severe diarrhoeal dehydration every year. Rotavirus vaccines are already recommended for use in the Americas and Europe. But more than 85% of deaths caused by rotavirus occur in developing countries in Asia and Africa, says the WHO. The recommendation was made by the WHO's Strategic Advisory Group of Experts, which reviewed a clinical trial of GlaxoSmithKline's Rotarix vaccine in South Africa and Malawi that cut the occurrence of severe diarrhoeal episodes. RotaTeq, a rotavirus vaccine developed by Merck, is being tested in clinical trials in Japan, India, Mali, Ghana, Kenya, Bangladesh and Vietnam.

The World Health Organization says a vaccine which can prevent a diarrhoea and vomiting virus should be given to all children as a routine vaccination. Rotavirus causes more than 500,000 diarrheal deaths and two million hospitalisations a year among children. Over 85% of deaths occur in developing countries in Africa and Asia.

Researchers at Griffith University's Institute for Glycomics in collaboration with colleagues at the University of Melbourne have moved a step closer to identifying a broad spectrum treatment for the dreaded 'viral tummy bug' or rotavirus. These highly-infectious viruses are the leading cause of severe diarrhoea in young children, responsible for thousands of hospitalisations in the developed world, and hundreds of thousands of deaths each year in developing countries. Institute Executive Director Professor Mark von Itzstein said research findings published in the world-leading Chemical Biology journal Nature Chemical Biology this week demanded a total rethink of how these viruses work. "Rotaviruses are thought to infect the bodies by sticking to certain types of sugars called sialic acids on the surface of our stomach cells. They then enter cells and reproduce rapidly, causing illness," he said. "Rotavirus vaccines are still in their infancy, as problems emerged with the first vaccine that was trialled a number of years ago. While other vaccines are now in clinical use, new directions are required in the development of potential drugs to prevent or treat this deadly virus." He said that to better understand how carbohydrates are involved in rotavirus infection, researchers had focussed on treating mammalian cells with a protein called sialidase which cuts these surface sugars so the virus cannot attach.

Background. In developing countries rotavirus is the leading cause of severe diarrhoea and diarrhoeal deaths in children under 5. Vaccination could greatly alleviate that burden, but in Mexico as in most low- and middle-income countries the decision to add rotavirus vaccine to the national immunisation program will depend heavily on its cost-effectiveness and affordability. The objective of this study was to assess the cost-effectiveness of including the pentavalent rotavirus vaccine in Mexico's national immunisation program. Methods. A cost-effectiveness model was developed from the perspective of the health system, modelling the vaccination of a hypothetical birth cohort of 2 million children monitored from birth through 60 months of age. It compares the cost and disease burden of rotavirus in an unvaccinated cohort of children with one vaccinated as recommended at 2, 4, and 6 months. Results. Including the pentavalent vaccine in the national immunisation program could prevent 71,464 medical visits (59%), 5,040 hospital admissions (66%), and 612 deaths from rotavirus gastroenteritis (70%). At US$10 per dose and a cost of administration of US$13.70 per 3-dose regimen, vaccination would cost US$122,058 per death prevented, US$4,383 per discounted life-year saved, at a total net cost of US$74.7 million dollars to the health care system. Key variables influencing the results were, in order of importance, case fatality, vaccine price, vaccine efficacy, serotype prevalence, and annual loss of efficacy. The results are also very sensitive to the discount rate assumed when calculated per life-year saved. Conclusion. At prices below US $15 per dose, the cost per life-year saved is estimated to be lower than one GNP per capita and hence highly cost effective by the WHO Commission on Macroeconomics and Health criteria. The cost-effectiveness estimates are highly dependent upon the mortality in the absence of the vaccine, which suggests that the vaccine is likely to be significantly more cost-effective among poorer populations and among those with less access to prompt medical care – such that poverty reduction programs would be expected to reduce the future cost-effectiveness of the vaccine.

WASHINGTON, Oct 25 (Reuters) - An oral vaccine for diarrhea reduced hospitalizations of children with rotavirus by more than 70 percent in some parts of the United States, saved money and protected unvaccinated children, researchers reported on Saturday. One study by vaccine maker Merck and Co.(MRK.N: Quote, Profile, Research, Stock Buzz) showed the vaccine eliminated emergency room visits for the strains of rotavirus targeted by the vaccine last year, while others showed clear benefits of the vaccine, which prevents the most common cause of severe diarrhea.

Merck & Co.'s vaccine against rotavirus, which causes vomiting and diarrhea in thousands of children annually, worked so well it may have cut the spread to non-immunized children in the U.S., researchers said. Merck's Rotateq reduced the number of new cases of rotavirus by at least two-thirds in its second year of use, according to research by the U.S. Centers for Disease Control and Prevention and Quest Diagnostics Inc. Children are urged to get the three-shot series of Rotateq immunizations at 2, 4 and 6 months of age. The vaccine, which was approved in 2006, appeared to interrupt the spread of the disease in older children who couldn't have been immunized, said Jay Lieberman, medical director of infectious diseases for the Focus Diagnostics unit at Madison, New Jersey-based Quest.