Beware the ‘Silent Killer’

by Reggie Rullan
(Manila, Philippines)

Thursday, 19 July 2012 00:00 Published in Daily Tribune Life Style

The silent killer, unbeknownst to many, is a rotavirus infection that wraps its deadliness around children when left unchecked.

The common onset of loose or watery stools among children is dismissed by many parents and caregivers as part of childhood where children usually touch the floor or ground as they play and put dirty objects in their mouths. Some may think this kind of diarrhea is merely viral and will pass after a few days. The usual immediate and sole resort is to keep the child clean and hydrated.

The rotavirus infection, however, causes a severe form of diarrhea, which has been identified as the leading cause of death among children with diarrhea. As of January 2012, the 13th Asian Conference on Diarrheal Disease and Nutrition (ASCODD) released data that the rotavirus infection is responsible for over 600,000 childhood deaths per year globally. To put it more closely, every minute, one child dies due to rotavirus-related gastroenteritis (RVGE).

In Brazil, its national program reduced the mortality rate of children less than one year of age due to rotavirus by 48 percent. These results were presented in the 6th World Congress of the World Society for Pediatric Infectious Diseases (WSPID) in 2009. The main cause for the significant reduction of deaths was idenitifed as the initiative of the Brazilian government to nationalize vaccination against the rotavirus infection.

Gastroenteritis (GE)-related hospitalization in Brazil in children under five years of age was reduced by 31 percent after the implementation of the rotavirus vaccination, a testament to its effectiveness in reducing the incidents of the disease.

The Philippines follows its lead this year and at the helm of the initiative is the Department of Health Secretary Enrique T. Ona, who launched the public-private partnership and global collaboration to ensure that children all over the Philippines have access to the rotavirus vaccination.

In the Philippines, the recorded number of deaths per year due to rotavirus infection is 3,500. For all types of diarrhea, the total number of deaths per year is 89,000. While the oral rehydration therapy (ORT) helped scale down diarrhea as the number one cause to the seventh cause of death, it cannot be ignored that to date diarrhea is still in the top ten cause of disease related mortality.

As there is no cure for RVGE, the treatment option is to properly and effectively manage the symptoms of the disease. Thus, the effectiveness of vaccination in the incidence of severe RVGE becomes important in the fight against mortality rates among children due to this disease.

According to a booklet released by the Rotavirus Organization for Training and Advocacy in the Philippines, a child can easily get infected by contaminants in food, drinks and objects touched by the child. The rotavirus infection is highly contagious and even a small dose of infection can cause severe diabetes. The rotavirus infection has even been found in the secretions from the respiratory track of children, thus, raising the possibility that the infection may be transmitted through the air.

Worse, the infection when on the surface of a human body survives for hours on end and when on the surface of solid objects, survives for several days, making the incidence of contamination higher. The rotavirus infection has even been found to survive in a child’s stool for 21 days.

The ASCODD held recently in Tagaytay had representatives from the Philippines, Bangladesh, Singapore, Malaysia, Thailand and other countries and they focused in their mission to prevent and manage diarrhea, along with preventive nutrition interventions, in Southeast Asia and Asean countries.

“As it alarmingly causes a significant number of child deaths, as well as impacts child growth and development, RVGE must be urgently addressed by Asia-Pacific’s medical community. And taking off from the success of Brazil’s program, the Philippines, as announced by Sec. Ona, is pushing to be the first country to implement rotavirus vaccination all over the region to combat the scourge of the rotavirus,” says Dr. Lulu Bravo, conference chair of 13th Asian Conference on Diarrheal Disease and Nutrition.

Since the ASCODD’s launch in February 1981 in Dhaka, Bangladesh, it is being hosted every two years in an Asian country. Since then, eleven conferences were held in seven different Asian countries.

The vision of the 13th ASCODD Organizing Committee, which is composed of the Section of Infectious and Tropical Disease in Pediatrics (INTROP) and the Section of Gastroenterology and Nutrition, both from the Department of Pediatrics at the Philippine General Hospital, University of the Philippines Manila and the International Society of Tropical Pediatrics-Philippines (ISTP-Philippines), is to provide a platform for global collaboration and knowledge sharing to address the urgency of the incidence of deaths due to the rotavirus infection.

The ASCODD Secretariat is located in ICDDR, Dhaka, Bangladesh. Currently, the ASCODD international officials are Dr. N.K. Ganguly (president); Dr. Yati Soenarto (immediate past president); and Dr. K.M.S. Aziz (secretary general). Advisors for ASCODD XIII are Dr. Alejandro Cravioto (ICDDR, B), Prof. Yushifumi Takeda (Japan), Dr. B.K. Nair (NICED, India), Prof. Zulfiqar Bhutta (Pakistan), and Dr. Nils-Kare Barkeland (Bergen University, Norway).

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