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Rotavirus Vaccine Available

For the first time, vaccine for rotavirus - the most common cause of severe diarrhoea among children worldwide - will be available for infants at Health Services Authority facilities on all three islands from 12 March 2009, Director of Primary Health Services Dr. Kiran Kumar announced.

Around the world, rotavirus causes more than 600,000 child deaths each year. In Cayman, the Public Health Care Department annually registers between 300 to 400 cases of gastroenteritis among children under five years. From these cases, about 20 - 25% of children are hospitalized.

Minister for Health and Human Services, the Hon Anthony Eden, OBE, JP, applauded the move, saying: "I am proud of the success of our immunization programme. My ministry is committed to ensuring that every child has access to age appropriate vaccines, and government fully supports the continual upgrading of our immunization schedule."

Health Services Authority paediatrician Dr. Marilyn McIntyre also welcomed the introduction of the rotavirus vaccine: "Vaccinations will reduce the number of hospitalizations due to rotavirus infections significantly, and will spare many children and their families undue suffering."

The Public Health Care Department will be using RotaTeq, an oral vaccine that is administered to infants in three doses. The first dose is given at six weeks, followed by second at four months, and the third at six months, Dr. McIntyre explained.

A rotavirus infection can cause severe vomiting and diarrhoea, accompanied by fever and abdominal pain that can last up to eight days. These symptoms, in turn, can lead to life-threatening dehydration.

Public Health officials cited studies that show the vaccination to have reduced hospitalizations caused by gastroenteritis by 96% after the third dose.

The vaccine will be offered at the George Town Public Health Clinic and all Grand Cayman district health centres. It will also be available at Faith Hospital on Cayman Brac and the Little Cayman Clinic.

For more information, contact your doctor, your district health centre (Bodden Town - 947-2299; East End - 947-7449; North Side - 947-9525; West Bay - 949-3439) or the Public Health Department at 244-2648.

Sidebar: Rotavirus Fact Sheet

What is rotavirus?

  • Globally, rotavirus is the most common cause of severe gastroenteritis in early childhood. Almost all children have been infected by the time they reach five years of age.

  • In developing countries, rotavirus is responsible for more than half a million deaths per year.

  • In developed countries, death from rotavirus is rare but hospitalizations are common, especially in children younger than 2 years of age.

  • It is not possible to test all gastroenteritis cases in the Cayman Islands for rotavirus, as stool samples have to be submitted and sent overseas. However, it is confirmed that rotavirus is in the Cayman Islands.
  • In 2008, Cayman had 343 reported cases of gastroenteritis among children younger than five years of age, with 75 admissions to the pediatric ward. Locally, there have been no deaths caused by gastroenteritis, for at least the past three decades.

What are the symptoms?

Symptoms include:

  • diarrhoea;
  • vomiting;
  • fever; and
  • abdominal (tummy) pain.

In some cases severe dehydration and death can occur. Symptoms usually appear between 1 and 3 days after being exposed to the virus. Rotavirus infections occur more commonly in winter.

How is it spread?

Rotavirus is highly infectious, and is spread by the vomit or faeces of an infected person through:

  • person-to-person contact (for example, touching someone who has been sick and has the virus on their hands);
  • contaminated objects;
  • contaminated food or drink; and
  • coughing and sneezing.

Who is at risk?

Young children are at greater risk of the disease, although older people can sometimes be infected. Subsequent infections are generally milder than the first infection.

How is it prevented?

  • Vaccination - Two different oral (by mouth) rotavirus vaccines are now available. Cayman will use RotaTeq. RotaTeq is given to infants in three doses. The first dose is given at 6 weeks, followed by the second dose at 4 months, and the third dose at 6 months.
  • Studies have shown RotaTeq vaccine to be between 63% and 74% effective in preventing gastroenteritis of any severity, and 88% to 100% effective in preventing severe gastroenteritis. Hospitalizations were reduced by 96% through the first two years of offering the vaccine, after the third dose.

Good Hygiene

  • Wash your hands for 10 seconds, using soap and hot water, and drying with a clean towel. You should always wash your hands after going to the toilet; before preparing or handling food; before eating food; and after caring for someone with rotavirus.
  • Using hot water and detergent, thoroughly clean the surfaces of objects (including toys), as well as clothing that have been exposed to vomit and/or faeces. Allow objects to dry after they have been cleaned.
  • Children who have experienced diarrhoea should not return to childcare until 24 hours after symptoms have ended.
  • Anyone with diarrhoea should not swim, wade or paddle in pools for at least two weeks after complete recovery.

How is Rotavirus Gastroenteritis treated?

  • Drink plenty of clear fluids to prevent dehydration.
  • Avoid undiluted fruit juice and soft drinks, because they may increase dehydration and diarrhea.
  • Do not give medicines to prevent vomiting and diarrhea, especially to children, except when prescribed by a doctor.
  • Some children may require hospitalization for intravenous fluids.

Advice to Parents/Guardians

As with all medicines and vaccines, the rotavirus vaccine has side effects. The most common side effects reported within one week of any dose are:

  • Fever:17% to 20 %
  • Vomiting: 4% to 8%
  • Diarrhoea: 6% to 10%
  • Irritability: 4% to 7%

Overall, the most frequently reported serious side effects associated with RotaTeq include:

  • bronchiolitis (0.6%);
  • gastroenteritis (diarrhoea & vomiting) (0.2%)
  • pneumonia (0.2%)
  • fever (0.1%)
  • urinary tract infections (0.1%)
  • seizures, which also are called fits (less than 1%).

A condition called intussusception (a type of bowel obstruction) was problematic with the first rotavirus vaccine (Rota Shield) a few years ago. With RotaTeq, studies have shown no increased risk of developing intussusception after having the vaccine, although there have been reported cases.

Therefore, call your child's doctor or seek medical attention right away if your child has vomiting, diarrhoea, severe stomach (tummy) pain, blood in the stool, or change in bowel movements. These may be signs of intussusception. Seek assistance for these symptoms even it was several weeks since the last vaccine dose.

Source: Public Health Clinic, Health Services Authority.

For further information contact: Cornelia Oliver