Dimapur, July 31 (EMN): The department of Health & Family Welfare is all set to introduce a new vaccine Rotavirus vaccine (RVV) as part of routine immunisation. It is scheduled to be launched on August 2 across Nagaland.
The government publicity agency, the department of Information and Public Relations (IPR), issued updates on Wednesday to the media informing about the development.
Global burden of Rotavirus diarrhoea
According to the World Health Organisation’s 2013 report, “Rotavirus is responsible for more than 2,15,000 deaths each year in children younger than five years of age and 3.4% of all under-five deaths worldwide.”
Rotavirus is also responsible for millions of hospitalizations and clinic visits each year. It affects children around the world in both rich and poor countries.
India bears the highest burden accounting for 22% of worldwide Rotavirus deaths, the IPR stated. In India, the Indian Rotavirus Strain Surveillance Network (IRSSN) has reported that Rotavirus accounts for 40% of hospitalizations due to diarrhoea in children. Rotavirus is responsible for nearly 32.7 lakh outpatient visits 8.72 lakh hospitalizations, and 78,000 deaths annually in India, the IPR stated.
Further, approximately 50% of Rotavirus-associated deaths occurred in the first year of life and about 75% occur in the first two years of life. The burden of Rotavirus diarrhoea and associated death varies by region, age and sex in India.
Rotavirus is estimated to cause 37% of the total diarrhoeal deaths and 40% of the total diarrhoea-related hospitalizations in children under five years of age worldwide.
So far, Rotavirus vaccine has been successfully introduced in eleven states of the country namely Himachal Pradesh, Odisha, Haryana, Andhra Pradesh, Tripura, Rajasthan, Madhya Pradesh, Assam, Tamil Nadu, Jharkhand and Uttar Pradesh, in a phased manner from 2016.
Nagaland’s preparedness on RVV
• Nagaland has completed required training at all levels that is, state, districts and blocks.
• Received 27,000 doses of RVV from the government of India distributed to all the cold chain points in accordance with the target.
• Printed banners, leaflets are distributed to all the districts.
About Rotavirus
The IPR listed also a number of aspects about the Rotavirus.
• Rotavirus is the most common organism that causes diarrhoea in children which may lead to hospitalisation and death.
The clinical features of Rotavirus diarrhoea may vary from transient loose stools to severe diarrhoea with vomiting. If not treated adequately, it may result in dehydration, electrolyte imbalance, shock and death.
• Rotavirus accounts for 40% of hospitalisation due to diarrhoea amongst children in India. It is responsible for nearly 32.7 lakh outpatient visits, 8.72 lakh hospitalisations and 78000 deaths annually in India of which 59,000 occur in the first two years of life.
• Approximately 50% of Rotavirus-associated deaths occur in the first year of life and about 75% occur in the first two years of life.
• Rotavirus transmission occurs primarily by the faeco-oral route directly from person to person, or indirectly via contaminated fomites and the virus can live for hours on hands and even longer on hard surfaces.
• Rotavirus infection and diarrhoea can occur throughout the year, most commonly seen in winter season.
• Rotavirus diarrhoea cannot be clinically distinguished from diarrhoea due to other causes. Rotavirus diarrhoea can be diagnosed in stool specimen, using laboratory tests.
• There is no specific treatment for Rotavirus diarrhoea. The treatment of Rotavirus diarrhoea is similar to other acute diarrhoeas, using ORS for correcting fluid and electrolyte imbalance and zinc for 14 days. Severe dehydration may require hospitalization for treatment with intravenous (IV) fluids.
• Rotavirus vaccine is the only specific prevention against Rotavirus diarrhoea. The vaccine is effective in reducing the hospitalisations and deaths due to diarrhoea in children. General measures to prevent diarrhoea like good hygiene, frequent hand washing, safe water and safe food consumption, exclusive breastfeeding and vitamin A supplementation reduces the risk of Rotavirus infection, but are not enough to control the spread of the disease.
• The dose of this liquid Rotavirus vaccine currently being supplied under UIP is 5 drops (0.5 ml) given orally. Rotavirus vaccine will be administered to all infants.
• The infant can be breastfed before or after vaccination.
• If the infant has minor illnesses like mild fever, upper respiratory infection etc. Rotavirus vaccine can be given. If the infant is well enough to have the other routine vaccinations, then Rotavirus vaccine can also be given.
There’s no reason to postpone the vaccination unless the infant is seriously ill, having high grade fever, severe diarrhoea or vomiting.
• The upper age limit for giving the first dose of Rotavirus vaccine is one year of age. If the child has received first dose of Rotavirus vaccine by one year of age, subsequent 2nd and 3rd dose of the vaccine should be given at an interval of 4 weeks between two doses to complete the course.
• Rotavirus vaccine will be provided free of cost through routine immunisation sessions under UIP. It will be provided at all government health facilities including hospitals, medical colleges, urban dispensaries, PHCs, CHCs, sub centers and outreach session sites.
• Rotavirus vaccine is a safe vaccine. However, mild and transient symptoms including vomiting, diarrhoea, cough, runny nose, fever, irritability and rash may be associated with Rotavirus vaccination.
A rare adverse event known as intussusception (one part of bowel folding/telescoping into another) has been reported after Rotavirus vaccine.
As per the World Health Organisation’s position paper (2013), “In some but not all settings, post-marketing surveillance of both currently available Rotavirus vaccines has detected a small increased risk of intussusception (about 1–2/100 000 infants vaccinated) shortly after the first dose”. Parents are requested to inform the nearest health centre as it is easily treatable.
