KPLU Local News
(2010-01-30)
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Dr. Eileen Klein, at Seattle Children's Emergency Department, where she is co-director of research.
Keith Seinfeld photo.
Graph illustrating what happens when the vaccine is introduced (e.g. in Mexico). (Click to enlarge) (NEJM 2010)
(Read the story below, listen above.)
Just about every parent has seen how easily a baby can get dehydrated because of simple diarrhea. It's one of the main reasons babies end up in the emergency room. Those visits are starting to decline because of a new vaccine against the pathogen, rotavirus. And, now, the Bill & Melinda Gates Foundation wants to make this success a centerpiece of its newly declared "Decade of Vaccines."
"Rota" refers to its shape, which is round like a wheel. There's a good chance you had it when you were young. It's responsible for nearly half the cases of severe diarrhea among the babies of the world. Traditionally, it's been a leading reason American babies end up in the hospital.
At Seattle Children's Hospital, emergency department research director Eileen Klein sees plenty of babies with rotavirus. Parents don't know the name of the virus, just that their baby is really sick.
Parents at wit's end
"'When they come in, the parents are usually at wit's end," says Klein, "because the kids are having diarrhea every half-hour, every hour. Usually the stools are greenish and watery. And they're exhausted because they've been changing diapers all night long."
And, the babies may be vomiting, too. "The parents are really worried about, "How can I keep fluids in my kid?'" says Klein.
So, the first job is to get the baby re-hydrated. They start with teaspoon-size servings of fluids, full of electrolytes, such as Pedialyte or Gatorade. If the baby keeps vomiting, then they'll need to put fluids straight into the bloodstream, using an I-V line.
Every year, especially during winter, there are babies at Children's Hospital getting I-V's because they're dehydrated from rotavirus. But the numbers have been declining, steeply. At Children's, hospitalizations are down more than 70%. That's because of a relatively new vaccine. It's become routine for babies born in the U.S. since 2007.
Success here is raising hopes around the world. Rotavirus kills about half a million children, globally, every year, and about 90% of those deaths are in Africa and Asia. Preventing the illness could make a huge difference.
In Africa, vaccine prevents deadly dilemma
"If you're a mother who has a two-hour walk to a clinic, who can't get any transportation, and you have six other children, and your baby starts to have diarrhea, that's a real decision for you," says Kathy Neuzil of the Rotavirus Vaccine Program, based at PATH in Seattle. She coordinates testing of rotavirus vaccines in developing countries.
"Do you leave the other children? Do you not cook dinner that night, and walk the two hours to the health clinic?" she asks. It's a life-and-death decision, because the mother may not realize without re-hydrating, the baby won't survive.
PATH focuses on finding ways to get vaccines adopted in poor countries, where there's no easy access to medical care. It's a Seattle-based non-profit, largely funded by the Gates Foundation.
Adopting a new rotavirus vaccine has plenty of extra challenges in developing countries. The vaccine must be kept cold at all times, no matter how hot the climate is. Babies need to get the vaccine in multiple doses, starting in the first couple months of life. And, some vaccines just don't work as well where people are malnourished and fighting other diseases.
The good news is, despite those obstacles, a series of tests in Africa (and Mexico) shows it works well enough to prevent at least 60% of the severe cases of rotavirus -- meaning it could save 300,000 lives every year globally. Neuzil is part of a team that published those results in the current issue of the New England Journal of Medicine. And, unlike an earlier rotavirus vaccine that caused problems in the 1990's, the new ones appear to have no serious side effects.
The next step is to pay for the vaccine. Bill Gates' announcement last Friday, that his foundation is committing $10 billion dollars this decade toward vaccines, should get the ball rolling.
For More Information:
CDC | Rotavirus Home Page
PATH's Rotavirus Information Page
Rotavirus Vaccine Program's Website
Seattle Children's Rotavirus Overview
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