More about rotavirus

This page provides links to PATH's work on rotavirus and information about the disease and related vaccines.

On the PATH website

• Delivering available rotavirus vaccines to developing countries.
• Investigating ways to improve the performance of currently available rotavirus vaccines.
• Developing new, live attenuated vaccines against rotavirus.
• Evaluating alternative non-replicating rotavirus vaccine candidates.

Rotavirus disease

• Rotavirus is the most common cause of severe diarrheal disease in children worldwide and is responsible for the deaths of more than 450,000 children each year, 85 percent of whom live in developing countries.
• Rotavirus accounts for 37 percent of global child deaths attributable to diarrhea and 5 percent of all deaths in children younger than age five.
• Rotavirus is found in all countries. Regardless of hygiene practices or access to clean water, nearly every child in the world will be infected with rotavirus before age five.
• In young children, rotavirus disease is characterized by diarrhea, vomiting, fever, and severe dehydration. In fatal cases, death is caused by severe dehydration due to rotavirus infection.
• Rotavirus disease cannot be treated with antibiotics or other drugs. Rehydration therapy is an important part of treating dehydration due to diarrheal diseases, including rotavirus. Vaccination offers the best hope for preventing severe rotavirus illness, particularly in settings where access to medical care is limited.

Rotavirus vaccines

• There are two currently licensed vaccines against rotavirus: Merck’s RotaTeq® and GlaxoSmithKline’s Rotarix®. Studies of these vaccines have demonstrated their safety and efficacy among children in every region of the world. Safety and efficacy trials in Africa and Asia found that the vaccines dramatically reduced severe disease among infants in developing countries, where the majority of rotavirus deaths occur. Results from these trials are essential to national governments as they make informed decisions about introducing rotavirus vaccines into the public sector.
• In 2009, the World Health Organization recommended that rotavirus vaccines be included in every country’s immunization program.
• Where they have been introduced, rotavirus vaccines are making a major impact—slashing hospitalizations due to rotavirus, while also reducing hospitalizations for diarrhea of any cause. Rotavirus is less prevalent among unvaccinated children, as well, suggesting herd immunity as an indirect result of rotavirus vaccine introduction.
• While current manufacturers play an important role in meeting the global demand for the existing vaccines, additional vaccine options and manufacturers are critical to ensuring a sustainable, affordable supply. Several manufacturers are developing rotavirus vaccines, including many from developing countries.
• Rotavirus vaccines are an important part of an integrated prevention and treatment strategy to control diarrheal disease. Other elements of this strategy include low-osmolarity oral rehydration solution; zinc supplementation, exclusive breastfeeding, proper nutrition, and safe water.

Related diseases

Diarrheal disease is the second leading cause of death in children in developing countries and the most common cause of childhood deaths in Africa. In addition to rotavirus, there are many pathogens that contribute to morbidity and mortality from diarrheal disease, including Shigella and enterotoxigenic Escherichia coli (ETEC), the leading bacterial causes. Learn more about Shigella and ETEC.

References

• Armah GE, Sow SO, Breiman RF, et al. Efficacy of Pentavalent Rotavirus Vaccine Against Severe Rotavirus Gastroenteritis in Infants in Developing Countries in Sub-Saharan Africa: A Randomised, Double-Blind, Placebo-Controlled Trial.
• Black RE, Cousens S, Johnson HL, et al. Global, Regional, and National Causes of Child Mortality in 2008: A Systematic Analysis.
• Madhi SA, Cunliffe NA, Steele D, et al. Effect of Human Rotavirus Vaccine on Severe Diarrhea in African Infants.
• Parashar UD, Gibson C, Bresee J, Glass R. Rotavirus and Severe Childhood Diarrhea.
• Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI. Global Illness and Deaths Caused by Rotavirus Disease in Children.
• Patel MM, Parashar US, eds. Real World Impact of Rotavirus Vaccination.
• Ruiz-Palacios G, Pérez-Schael I, Velázquez F, et al. Safety and Efficacy of an Attenuated Vaccine Against Severe Rotavirus Gastroenteritis.
• Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD. 2008 Estimate of Worldwide Rotavirus-Associated Mortality in Children Younger than 5 Years Before the Introduction of Universal Rotavirus Vaccination Programmes: A Systematic Review and Meta-analysis.
• Vesikari T, Matson D, Dennehy P, et al. Safety and Efficacy of a Pentavalent Human-Bovine (WC3) Reassortant Rotavirus Vaccine.
• World Health Organization. Rotavirus Vaccines: An Update - WHO Position Paper.
• World Health Organization. Rotavirus Vaccines—WHO Position Paper.
• Zaman K, Dang DA, Victor JC, et al. Efficacy of Pentavalent Rotavirus Vaccine Against Severe Rotavirus Gastroenteritis in Infants in Developing Countries in Asia: A Randomised, Double-Blind, Placebo-Controlled Trial.

Page last updated: February 2012.