Discovery of rotavirus: Implications for Child health

Abstract

For centuries, acute diarrhea has been a major worldwide cause of death in young children, and until 1973, no infectious agents could be identified in about 80% of patients admitted to hospital with severe dehydrating diarrhea. In 1973 Ruth Bishop, Geoffrey Davidson, Ian Holmes, and Brian Ruck identified abundant particles of a ‘new’ virus (rotavirus) in the cytoplasm of mature epithelial cells lining duodenal villi and in feces, from such children admitted to the Royal Children's Hospital, Melbourne. Rotaviruses have now been shown to cause 40–50% of severe acute diarrhea in young children worldwide in both developing and developed countries, and > 600 000 young children die annually from rotavirus disease, predominantly in South‐East Asia and sub‐Saharan Africa. Longitudinal surveillance studies following primary infection in young children have shown that rotavirus reinfections are common. However the immune response that develops after primary infection is protective against severe symptoms on reinfection. This observation became the basis for development of live oral rotavirus vaccines. Two safe and effective vaccines are now licensed in 100 countries and in use in 17 countries (including Australia). Rotarix (GSK) is a single attenuated human rotavirus, representative of the most common serotype identified worldwide (G1P[8]). RotaTeq (Merck) is a pentavalent mixture of naturally attenuated bovine/human rotavirus reassortants representing G1, G2, G3, G4, and P(8) serotypes. Preliminary surveillance of the numbers of children requiring hospitalization for severe diarrhea, in USA, Brazil, and Australia, after introduction of these vaccines, encourages the hope that rotavirus infection need no longer be a threat to young children worldwide.

Rotavirus

“…[38] In humans there is an association between the blood group secretor status and susceptibility to infection. Non-secretors seem resistant to infection by types P [4] and P [8], indicating that blood group antigens are the receptors for these genotypes. VP6 forms the bulk of the capsid.…”

“…[140] In 1973, Ruth Bishop and colleagues described related viruses found in children with gastroenteritis. [4] In 1974, Thomas Henry Flewett suggested the name rotavirus after observing that, when viewed through an electron microscope, a rotavirus particle looks like a wheel (rota in Latin) ( Figure 8); [141][142] the name was officially recognised by the International Committee on Taxonomy of Viruses four years later. [143] In 1976, related viruses were described in several other species of animals.…”

“…It infects and damages the cells that line the small intestine and causes gastroenteritis (which is often called "stomach flu" despite having no relation to influenza). Although rotavirus was discovered in 1973 by Ruth Bishop and her colleagues by electron micrograph images [4] and accounts for approximately one third of hospitalisations for severe diarrhoea in infants and children, [5] its importance has historically been underestimated within the public health community, particularly in developing countries. [6] In addition to its impact on human health, rotavirus also infects animals, and is a pathogen of livestock.…”

­­Adherence to rotavirus vaccination quality measures in a commercially insured population

“…2 Primary infections of rotavirus do not provide sufficient immunity to protect against re-infections; however, the immune response after primary cases of rotavirus generally leads to a milder illness. 3 Two rotavirus vaccines are currently approved by the Food and Drug Administration for use in the US: the pentavalent vaccine (RV5) (RotaTeq ® , Merck and Co., Inc.), which is a 3-dose series introduced in February 2006, and the monovalent vaccine (RV1) (Rotarix (CDC); and (3) Healthcare Effectiveness Data and Information Set (HEDIS) measures from the National Committee for Quality Assurance (NCQA), which is a quality measure for vaccinations used by greater than 90% of health plans (See Table 1 for dosing schedules). A recent study by Krishnarajah et al observed that 83.3% of RV1 patients and 76.4% of RV5 patients were compliant with ACIP recommendations for the vaccine series, but no evaluation of compliance with HEDIS standards was made.…”

Genotyping of Rotavirus by Using RT-PCR Methods

“…The dominant strains always changes yearly. This changing is due to accumulation of point mutations that lead to antigenic change or new strain emergence (Kirkwood, 2010 [8], and G9P [9] have been the most common causes of severe disease in children worldwide (Bishop, 2009).…”