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A Vaccine Hero’s Journey to Prevent Rotavirus

May 18, 2011

Imagine an African mother whose baby is near death, and the closest health clinic is ten kilometers away. Her only means of transport is walking, or the back of a donkey, or, if she’s very lucky, bike. She’s carrying a small baby who is malnourished and has been struck by deadly diarrhea. She has the hard choice of leaving the other children alone or staying home and praying that the child recovers.

She’s literally looking at her child dying in her palms.

When I started my work as a researcher of diarrheal diseases 25 years ago, it was believed that all diarrhea was caused by bacteria. I had an electron microscope, and I used it to demonstrate that, in fact, a virus was behind many severe cases of diarrhea in Africa. It has been my life’s work to demonstrate the importance of rotavirus because here in Ghana, as in other African countries, the burden of diarrheal disease is so great. Yet there could be a simple answer—a vaccine.

It was very exciting when I shared the rotavirus results with other doctors. We realized we needed to generate an African database, so we trained doctors and researchers around the continent to detect rotavirus. We found that in Africa, 20 to 30 percent of severe diarrhea and 40 percent of diarrhea causing hospitalization was due to rotavirus.

More than 200,000 African children die each year from the disease.

In Ghana, we found that over 50 percent of children admitted to hospitals with severe diarrhea during the “rotavirus season” (the dry months of October to February) were infected with the virus. Of course, in rural areas many children never make it to the hospital at all. Our studies also showed that almost every Ghanaian child will experience at least two episodes of rotavirus before his or her second birthday. The first is the most severe. It’s the one that sends the child to the hospital or kills him.

A number of interventions for diarrhea are promoted, the most common being hand-washing. These will reduce the number of bacteria, but have little effect on rotavirus. The only effective intervention is vaccination.

Thankfully, vaccines have now been created for rotavirus. However, they have not yet been rolled out in Africa. In part, this is because many countries had to make the very hard choice of introducing the pneumococcal vaccine first, due to limited financing. In addition, we needed to show convincing evidence that rotavirus vaccines would be effective in the African setting.

In conjunction with research sites in Mali and Kenya, and with sponsorship from the international global health organization PATH, and their Rotavirus Vaccine Project, I spent the past four years conducting a clinical trial that evaluated the effectiveness and safety of the Rotateq® vaccine in infants.

We now have the results. Infants who received the vaccine at 6, 10, and 14 weeks old had a 64-percent reduced incidence of severe diarrhea in the first, most dangerous year of their lives.

Our work in Ghana, Kenya, and Mali clearly shows that the vaccines work. We know that if they are introduced on the continent, they will have a huge impact in reducing the suffering of children and their parents.

It has been a joy for me raising awareness of this vaccine-preventable disease. It will be the icing on the cake for me when the vaccine is given to children all across Africa.

 
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