Diarrhea is a Serious and Deadly Disease

Dr. Anna Ong-Lim eplaining about rotavirus

Busy moms with a multitude of daily tasks and mounting bills to worry about may overlook a child’s cold, cough, or diarrhea problem as common malady that will eventually go away with an over-the-counter syrup or tablet without much thought or concern. Perhaps luck was on their side in previous years when these conditions indeed were cured after a few days.  But that should not be a reason to be complacent anymore.Certain “simple” conditions in recent years have mutated with the various environmental changes and have become difficult to treat.  Due to pollution in the air we breathe, in the water we drink, in the soil that feeds our vegetation and livestock, our children’s fragile immune system have become vulnerable to infections and diseases. One example is the “sore eyes” which takes longer to treat nowadays, appears totally bloodshot red, and very contagious. And then there’s diarrhea in small children, if taken lightly and allowed to last longer than three days will certainly lead to death. There are more examples out there but let us focus on diarrhea for now.Rotavirus-Infection-Symptoms

Recent studies by WHO and UNICEF have shown that diarrhea is the second leading killer of children below 5 years in the Philippines and worldwide.  In the Philippines, more than 13 Filipino children die from diarrhea everyday.  This accounts for at least 12% of deaths among children under 5 in the country.   And the most common cause of vomiting and diarrhea in children worldwide is Rotavirus.

In developing countries, rota viral diarrhea and vomiting kills a child every minute, each day 4,000 children die of diarrhea.  The burden is greatest in developing countries of Asia and Africa where access to clean water, sanitation, and urgent medical may be limited.

rotavirus magnified

Those who escape death may not be so lucky as well. Because diarrhea affects nutrient absorption, it leads to lasting impact on the growth and development of a child.  Growth shortfalls of up to 8.2 cm by age 7 years have been attributed to early childhood diarrhea, with profound effects on fitness, cognition and schooling observed among children who experience repeated bouts.  In  fact, it has been calculated that children who regularly suffer from it in the first 2 years of life can lead to a loss of 10 IQ points and 12 months of schooling by age 9 years (from Guerrant dl et al. Am J Trop Med Hyg 1999).

In recent months, Secretary Enrique Ona of the Department of Health has announced to media its intention to include Rotavirus Vaccination as part of the Expanded Program for Immunization (EPI) in 2012.  This is aligned to P-Noy Administration’s direction and goal of Universal Health Care and moves the Philippines forward to achieving Millennium Development Goal (Reduce Child mortality) by 2015.

The Philippines will become the very first Asian Country to implement Rotavirus Vaccination in the EPI.  Some of the countries that have Rotavirus Vaccine in the EPI include Australia, Austria, Brazil, Belgium, Ecuador, El Salvador, Finland, Germany, Mexico, Peru, South Africa, Bolivia, and Honduras.

Rotavirus infection

So how can we prevent diarrhea?  Sadly, Rotavirus is highly contagious and stable in the environment which means it can survive on the hands for hours and on solid surfaces for days. It can be infective in stools for a week. Improvements in water and sanitation do not significantly reduce rotavirus diarrhea contamination. This explains why in developed countries like Australia, USA, Spain, and UK, rotavirus still contributes around 50% of the diarrhea cases with rotavirus vaccination having been successful in reducing the burden by as much as 75.6% as well as reducing the need for hospitalization.  Rotavirus infectio

Dr. Ong-Lim is a Pediatric-infectious diseas specialist in PGH, RotaPhil. and Phil. Foundation for Vaccination

n, which often causes vomiting, renders oral rehydration therapy far less effective. Prevention simply boils down to consuming clean drinking water often and 2-3 doses of vaccination before the baby reaches 8 months.

World Health Organization’s Strategic Advisory Group of Experts (SAGE) recommends that rotavirus vaccines be included in all national immunization programs, particularly in countries where diarrhea deaths account for more than 10% of deaths in children younger than 5 years.

Every year about 3 million deaths are prevented 750,000 children are saved from disability due to vaccines.  With the exception of clean drinking water, vaccines are the most effective intervention in reducing and preventing the return of infectious diseases.

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