A landmark study published in 'The Lancet' pinpoints rotavirus as the major cause of diarrhoeal disease among Indian children. The findings can guide prevention, treatment and research on diarrhoeal diseases which globally claim the lives of 800,000 children every year. Dr NK Arora, executive director, The Inclen Trust, joined IBNLive readers for an interaction on how to prevent diarrhoea and what causes it.
Q. Intestinal worms could also be a reason for the problem. Is there a deworming campaign around? Asked by: sundar1950in
A. There have been fragmented efforts to take community wide deworming campaigns but there is no national program to address this issue yet. Only rarely do intestinal worms cause acute diarrhea. They are associated with vague abdominal discomfort and occasionally increased frequency but not much water loss.
Q. Will government introduce ROTAVAC, the new vaccine for diarrhea from India, into the national immunisation program? Asked by: Dr. Mayank Jindal
A. ROTAVAC is probably one of the first indigenously developed and produced vaccine. It is effective but there are some regulatory requirements before it can be introduced into the market. The government will have to take a call when that stages reaches.
Q. What are the side effects of the rotavirus vaccine? Asked by: Navolina Mukherjee
A. It is a safe vaccine. however, after the vaccine is introduced into the market, post marketing surveillance for adverse events is necessary as it is for any other new vaccine. The rota vaccine manufactured by some of the multi- national companies increase the risk of intussusception minimally. The same complication will have to be monitored when ROTAVAC is used for wider public consumption.
Q. Will the onset of rotavirus infection be sudden or gradual? Asked by: sundar1950in
A. The diarrhea due to rotavirus infection is sudden and often associated with vomiting as well. The stools are watery and do not contain blood.
Q. The vaccine in question will only take care of certain strains of the virus. What is the success rate of the vaccine in such a case? Asked by: Dr. Sharma
A. According to GEMS study as well several other studies from across the country, one-third to one-half of all hospitalized children with severe diarrhea have rotavirus infection. In this manner rotavirus infection in India contributes to maximum number of diarrheal deaths amongst children under five years of age. Therefore, vaccine for children will be able to prevent this severe form of diarrhea which kills.
Q. Do we really need an expensive vaccine for diarrhea? Asked by: Rajita Jaiswal
A. The rotavirus vaccine is indigenously developed and produced. The scientific community and the government is given to understand that the vaccine will be available for INR 50 or less per dose, if introduced in the national program. It is estimated that the deaths 40,000-50,000 child deaths and 6,00,000 hospital admissions due to severe diarrhea can be prevented if the vaccine is used in the national program and all eligible children get the vaccine.
Q. The rotatorus vaccine requires ant special storage conditions? If so how will it get available in rural areas? Asked by: sundar1950in
A. The polio eradication program has demonstrated that the cold chain system available in the country is robust to carry vaccines that require special storage condition even to the remotest area. India of the 21st century should not feel these challenges as barriers.
Q. Olden days Granny used to give children regular doses of castor oil to purge out the bad elements in the system.Is that of any value? Asked by: sundar1950in
A. These are some of the socio-cultural practices which are harmful and potentially fatal. Small children can get rapidly dehydrated due to diarrhea that develops after castor oil. Very simple home remedy comprised of sugar, salt and lemon juice (shikanji) is life saving and rehydrates children with diarrhea.
Q. Diarrhoea is a symptom or Disease? Asked by: sundar1950in
A. This is an excellent question! Diarrhea is a symptom which occurs due to ingestion of contaminated food and water. Various types of virus and bacteria enter into the gut in this manner and cause loose watery motion.
Q. Where was the Lancet study done in India? Asked by: Chetan Malhotra
A. Kolkata.
Q. I am a doctor. My question is are there vaccines available for other pathogens like Cryptosporidium, Shigella, and Enterotoxigenic E. Coli (specifically ST-ETEC) which are main contributors of Diarrhoea, as the Lancet study suggests? Asked by: Shikha Agarwal
A. Currently there are scientific studies going on to develop vaccines for Shigella, and Enterotoxigenic E. Coli but it will take several years before clinical trials can begin. Meanwhile, for all of us the most important strategy is to maintain personal and environmental hygiene and ensure clean drinking water.
Q. Is rotavirus vaccination needed for elders? Asked by: Sobha soman
A. No.
Q. We don't see diarrhea as life-threatening. Yet it is surprising so many children die in India due to diarrhea. Isn't ORS enough to control diarrhea? Asked by: Sangeetha subramanium
A. Diarrhea is life threatening, particularly in children under 2 years. In these young children, dehydration and electrolyte loses occur rapidly and can kill a child even after 4 to 6 large watery stools. Therefore, with the first vomiting and/or lose stool, ORS must be started for every individual particularly children. ORS is for management of diarrhea, it does not prevent diarrhea.
Q. I gave my son rotavirus vaccine for diarrhea. Is there anything else I need to do? Asked by: Sharmila sengupta
A. Rotavirus vaccine will prevent only one-third of diarrheal episodes that your son is likely to get. So do not forget to follow basic principles for prevention of diarrhea given below: 1. Handwashing before feeding, after defecation, after urination 2. Clean drinking water. 3. Obsession for personal and environmental hygiene.
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