Bill & Melinda Gates Foundation

Double Dose of Diarrhea News

May 14, 2013

In global health, we are often working to tackle big problems – like ending preventable child deaths –with limited data.  This lack of data makes you anxious that you’re not targeting the right children or the right infections, or that maybe your tool doesn’t work for preventing the disease.  So, this week’s news is full of reassuring and important information for children around the world. 

In just one week, we’ve learned that the leading causes of childhood diarrheal disease include a vaccine preventable target – rotavirus - and that a new rotavirus vaccine, developed by Indian scientists works better than expected and will be made available to children in poor countries for a price of just $1.00 per dose.

In a landmark study of the infections that cause serious diarrhea in developing countries (known as the GEMS study), researchers from 7 different developing countries and the University of Maryland collaborated to study the germs that were responsible for the most illness.  The findings were both reassuring and surprising.  The findings reconfirmed rotavirus as the leading cause of serious diarrheal illnesses in these young children and showed that two bacteria, Shigella and ETEC, were also common.  Perhaps the biggest surprise in this study though was that a protozoan parasite with a long name – Cryptosporidium – showed up as one of the 4 most important causes of disease.  The first three germs – rotavirus, shigella, and ETEC – have long been the focus of our efforts to develop vaccines but cryptosporidium has not so this provides both reassurance that many of our vaccine development efforts are aimed at important causes of child illness but also tells us to set ourselves to adding a fourth, new one as well.

The GEMS study also surprised us by showing that children who had serious diarrheal disease were 8.5 times more likely than children who did not suffer from this disease to die in the 60 days following their illness. Knowing that these children are at increased risk of death highlights the importance of preventing diarrhea episodes and allows health workers to identify and target these high risk children in ways that might prevent their later deaths.

The news from India on the development of a new rotavirus vaccine that is safe, effective, and priced to be affordable to poor countries is a major advance for global health.  It is estimated that if every child in India got the vaccine it could prevent up to 100,000 child deaths.  In a study that included over 6,000 Indian infants, the study reduced the risk of serious rotavirus diarrheal disease by 56%.  This is slightly higher than the percent reductions seen previously in similar settings with other rotavirus vaccines.

One important characteristic that links the two research studies is that they were conducted with exceptionally rigorous methods in challenging environments.  By using precise and standardized methods, the research teams in these countries have given us a set of data we can trust. And for those of us who sometimes have to lead global health efforts on limited data, it sure is reassuring to know that we’re aiming for the right targets and using effective tools.

 To learn more about diarrheal disease and how you can get involved to help children around the world, visit www.defeatdd.org. 

 

 
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