By Eulalee Thompson, Staff Reporter
THE ROTAVIRUS IS a serious challenger. In its bouts of the 'running belly' disease - gastroenteritis - it swings hard punches, especially on vulnerable children under five.
The World Health Organisation (WHO) indicates that in the first five years of life, four out of five children in the United States will develop rotavirus diarrhoea, one in seven will require a clinic or emergency room visit, one in 78 will require hospitalisation and one in 200,000 will die from rotavirus diarrhoea.
Rotavirus diarrhoea also nibbles at medical resources, costing U.S. health authorities $264 million in direct medical costs and more than $1 billion in total costs to that society.
An epidemiologic study (Lopman et al), reviewing a five year (1995 to 2000) viral gastroenteritis surveillance period in European countries indicates for example, that in England, Wales, Spain and the Netherlands most reported outbreaks occurred in hospitals and residential homes while in Denmark most outbreaks occurred in food outlets. Though the study points out that some countries may be skewed to report outbreak spreads in one setting over another.
Bring this 'challenger virus' home to Jamaica and local epidemiologists also indicates that it is also an annual source of havoc. Last year, based on the Health Ministry's statistics, more than 22,000 children, most of them under five years old, were hit by the virus; the year before that, 2001, just over 18,000 children were affected with the virus and nearly 26,000 in 2000. Rotavirus has also pulled a smart one on the epidemiologists this year, showing up uncharacteristically in the warm, summer months instead of its usual show in the cooler, winter month. This is now puzzling health officials working alongside officers from the U.S. Centre for Disease Control (CDC).
"We are working with certain hypotheses...for example any event that may have occurred which is different such as climatic or environmental changes, temperature changes over time, rainfall, humidity. We are looking in communities, looking at environmental issues, flooding issues," said Dr. Deanna Ashley, director, Health Promotion and Protection.
On the surface, local epidemiologists can't identify any new variables that would trigger the outbreak this year but they were on the alert last year when there was widespread flooding and damage to property and livestock. The outbreak didn't happen then and they didn't expect a rotavirus outbreak in the warm summer months. .
"So what we are doing now is getting all the data to look at trends. We want to see whether there is any change in patterns, type of virus...there are several things, viruses mutate and so we are doing our epidemiological investigation, real detective work but because of the germ, it is hard to pin down," Dr. Ashley said.
It's because this germ is so difficult to pin down, that the current international trial on a gastroenteritis vaccine takes on greater significance. Jamaica is taking part in this trial and University of the West Indies' Professor Celia Christie, principal investigator indicates that up to Monday, 910 Jamaican babies were enrolled in the vaccine trial. The main side effect, which the trial investigators are expecting from this prospective vaccine, is blocked or choked bowels in babies, but Professor Christie said that so far, this side effect is not showing up in local babies.
Adding this candidate vaccine to the battery of vaccines now given to babies a few weeks after birth, would certainly knock the lights out of rotavirus.
