Decades of research on childhood diarrhea has revealed its main cause and new ways to prevent its occurrence on a global scale.
Kern: Childhood diarrhea remains one of the major causes of death in the developing world. Dr. Roger Glass, director of NIH's Fogarty International Center reflects on how our understanding of childhood diarrhea has changed over the past several decades.
Glass: We've discovered the most important agent of diarrhea in children, rotavirus. Not only have we discovered it, but it has led to a number of vaccines that have come forward, a recognition of its importance globally, and the first efforts to eliminate and prevent this severe childhood infection through the use of a vaccine both in the United States and in the developing world.
Kern: Dr. Glass explains that infection with rotavirus can be serious if not properly treated.
Glass: Rotavirus is the most common cause of severe diarrhea in children worldwide. It affects every child in the first few years of life. Most kids get a diarrheal episode. And for some of those children, this episode can be severe and can be fatal if they're not properly treated. So it's a huge problem. It's a universal problem. All kids have it, rich or poor, black or white, Chinese or American or African. We all share the same common infection.
Kern: Since the discovery of rotavirus, highly effective vaccines have been generated.
Glass: In the United States, we rolled out rotavirus most recently in 2006, and over the past five years we've seen a tremendous reduction in hospitalizations of children for diarrhea especially in the winter, about a 50% reduction in diarrheal disease, 95% reduction in rotavirus, and this has led to a decrease in hospitalizations that we estimate to be about 5% of all children under five. That is a huge advance and a huge savings to the hospitals and to the public.
Kern: Introduction of the vaccine around the world is now the main focus.
Glass: Globally we see that there are around a half a million deaths from rotavirus among children in the developing world, mostly in low income countries. The first ever to reduce mortality, deaths, in a developing country was documented in Mexico where the vaccine was introduced, and three years later the Mexicans, together with CDC, were able to document about a 40% reduction in diarrheal deaths in Mexican children. We still have a half a million deaths from rotavirus in the world today and the real goal of these programs will be to see how much of this we can eliminate through the use of the vaccine in the years ahead.
Kern: Dr. Glass says the field has changed since he began studying childhood diarrhea.
Glass: When I began working on rotavirus and diarrheal diseases, it wasn't a sexy topic. It's really hard to picture a child with diarrheal disease. It's not like a child with polio where they have a physical ailment. A child with diarrheal disease is dehydrated, is vomiting, may be covered with poop. It's not a very pleasant sight. And there is not a lot of recognition of its importance. Over the years we've developed very simple ways to document the importance of rotavirus among hospitalized children, and using that documentation we're able to make a case for the use of the vaccine in the United States and throughout the world. So rotavirus vaccination has been embraced by the World Health Organization as a priority disease, by the Global Alliance for Vaccines and Immunization, and earliest by the Bill and Melinda Gates Foundation which saw this as one of the prime reasons that they began investing in vaccines for child survival.
Kern: NIH's Fogarty International Center is leading the way in rotavirus research.
Glass: Here at Fogarty, we invest in capacity building of scientists, young scientists in the developing world to be able to do their own research, to help them with methods, to help them make new discoveries and observations. We really feel that the frontiers of science are not only in the United States but are in all the corners of the world. We share common problems just like rotavirus which is a universal infection.
Kern: For more about the Fogarty International Center, visit www.fic.nih.gov. And to learn more about rotavirus and rotavirus vaccines, visit www.niaid.nih.gov. For NIH Radio, I'm Margot Kern. NIH...Turning discovery into health®.
About This Audio Report
Reporter: Margot Kern
Sound Bite: Roger Glass
Topic: childhood diarrhea, diarrhea, rotavirus, rotavirus vaccine, rotavirus research, fogarty international center, Roger Glass,
Institute(s): Fogarty International Center