What is rotavirus?
Rotavirus is the leading cause of severe diarrhea and dehydration in children, in both developing and developed countries, with seasonal variation depending on latitude and climate. Specifically, rotavirus is responsible for nearly half of all cases of severe diarrhea requiring hospitalization.

What are the symptoms?
Signs and symptoms of rotavirus infection may include:
Fever
abdominal pain
Vomit
Watery diarrhea

Diarrhea can range from mild, moderate to severe and can last up to nine days.

Who gets rotavirus?
Rotavirus is highly infectious and contagious. It is Affects children around the world beyond their ethnicity, culture, social class or socioeconomic status. Mostly against rotavirus gastroenteritis among 4 to 36 months of age, this age group making up the risk group most exposed and vulnerable to disease.

How is rotavirus?
The primary mode of transmission is fecal -oral. Since the virus is stable in the environment, transmission can occur through ingestion of contaminated food or water, and contact with contaminated surfaces (such as a diaper, a toy or a pillow.) Infection can occur even in places where there are adequate levels of hygiene,

Where does the rotavirus?
The incidence is similar in developing countries and developed countries. Infection can occur even in places where there are adequate levels of hygiene, which suggests that differences in the environment (water, hygiene and sanitation) do not affect incidence.

When a child gets rotavirus?
Because it is so contagious and difficult to control over 95 % of children worldwide will become infected between 3 and 5 years of age. The highest rates of infection occur in children between 4 and 36 months of age who also have the highest risk of severe illness requiring hospitalization.

What is the severity of rotavirus infection?
The rotavirus can result in severe complications rapidly since those virus infections can cause significant loss of body fluids. If rotavirus disease is not immediately and properly managed it can lead to serious consequences such as dehydration, which can lead to hypovolemia (decrease of the normal amount of blood), circulatory collapse and even death. The risk of serious complications and death from rotavirus infection is higher in children than in adults.

What is the potential impact of rotavirus?
Each year, rotavirus causes approximately 440,000 deaths of children around the world. Most of these deaths occur in developing countries, while mortality from rotavirus infection is rare in developed countries. Rotavirus is the main cause of diarrhea requiring hospitalization and it is estimated that rotavirus causes one third of all diarrhea in children. In Latin America, it is estimated that rotavirus diarrhea is responsible for more than 15,000 deaths and 75,000 hospitalizations per year.

What to cope with a rotavirus infection?
Be alert to signs of dehydration: irritability, loss of appetite and dry mouth.
Managing the child infected fluids frequently to replace fluid loss from vomiting and diarrhea. When a child has severe diarrhea in phase is common for vomiting and diarrhea episodes occur with a frequency of up to 20 days. It is likely to be severe dehydration quickly hospitalized to receive intravenous fluids. Children with rotavirus usually receive supportive treatments that manage the symptoms and complications of the disease. Dehydration is usually treated through oral rehydration therapy.

Rotavirus treatment
What is rotavirus vaccine from MSD ?
This is a pentavalent oral vaccine to prevent rotavirus gastroenteritis in infants and children caused by serotypes G1, G2, G3, G4 and G serotypes that contain P1 ( as the G9 ).
As protection against natural rotavirus infection is largely specific to each serotype in Merck’s rotavirus vaccine have been selected human rotavirus serotypes G1, G2, G3, G4 and P1 because these strains caused about 90 % Of rotavirus disease in 1996-1999 in the United States and more than 88 % of them throughout the world between 1973 and 2003.

How is?
The vaccination schedule of Merck’s rotavirus vaccine consists of three oral liquid doses. The first dose should be administered at six to twelve weeks of age and subsequent doses should be administered at intervals of at least four weeks.

What studies were conducted with the vaccine?
The vaccine has been extensively evaluated in large study REST ( Rotavirus Efficacy and Safety Trial – Trial of the Efficacy and Safety Rotavirus), which included 70.301 children aged 6-12 weeks old, was released on January 5 2006 by the prestigious scientific journal New England Journal of Medicine. Study was a placebo-controlled, double-blind, randomized, conducted in 2001-2004 in 11 countries (Germany, Belgium, Costa Rica, United States [ including Puerto Rico ], Finland, Guatemala, Italy, Jamaica, Mexico, Sweden and Taiwan).

In REST the dose of Merck’s rotavirus vaccine consisted of three oral doses, delivered at intervals of four to ten weeks, the first dose administered at age six to twelve weeks.

What is the effectiveness of the vaccine?
In REST, which included 70.301 children, Merck’s rotavirus vaccine was shown to be very effective:

In a cohort of efficacy ( n = 5.673 )
74 % effective in preventing all cases of rotavirus gastroenteritis
98% effective in preventing severe cases of rotavirus gastroenteritis

In a cohort of health resource use (n = 57.134 )
96 % reduction in hospitalizations
94 % reduction in emergency visits
95 % reduction in hospitalizations / ER visits
87 % reduction in lost work days
86 % reduction in lost work days

What is the safety and tolerability profile of the vaccine?
In clinical studies has been generally well tolerated. The safety profile of this vaccine has been extensively tested in the large study REST ( Rotavirus Efficacy and Safety Trial – Trial of the Efficacy and Safety Rotavirus). REST is a comparative study with placebo and included 70.301 children.

The study was carried out active surveillance to identify potential cases of intussusception ( abnormal introduction of a portion of the intestine into another) of 7, 14 and 42 after each dose, and then every six weeks during the year following the first dose.
The Merck’s rotavirus vaccine did not increase the risk of intussusception compared to placebo. There were no confirmed cases of intussusception during the period of 42 days after the first dose and no accumulation of cases among vaccinated at any time after either dose. After follow up one year, reported four cases of intussusception in children who had received placebo during the study.