Diarrheal illness is a leading cause of death across the United States and internationally. Control and prevention of viral gastroenteritis is essential to save lives. This report is a review of an article by Stephan S. Monroe of the Centers for Disease Control and Prevention which has been published in the journal Emerging Infectious Diseases, “Control and Prevention of Viral Gastroenteritis.”
Diarrheal illness is 1 of the top 5 causes of death in low-income and middle-income countries, particularly for children less than 5 years of age. The introduction of universal childhood vaccination against rotaviruses has significantly reduced the incidence and severity of diarrheal illness in upper-income and lower-income settings. Norovirus is the leading cause of sporadic cases and outbreaks of diarrheal illness in adults and is associated with nearly 21 million episodes of diarrhea annually in the United States, of which 5.5 million are food borne.
Ever since the initial detection of Norwalk virus and rotavirus by electron microscopy in stool samples of patients with gastroenteritis, there has been an increase in the recognition of the role of enteric viruses as a major cause of diarrhea-associated illness and death in young children and adults. Standard improvements in water and sanitation which reduce the incidence of enterically transmitted bacteria are unfortunately not equally effective for reducing the incidence of enterically transmitted viruses.
Therefore, other public health approaches have been pursued in order to control and prevent viral gastroenteritis.
Rotavirus is the leading cause of diarrhea-associated illness and death in children less than 5 years old. Safe and effective vaccines against rotavirus illness are fortunately now available in many countries. The introduction of universal childhood vaccination against rotaviruses significantly reduces the incidence and severity of illness in upper-and lower-income settings. Therefore, the World Health Organization has recommended that rotavirus vaccines be included in all national immunization programs.
Norovirus is now recognized as the leading cause of sporadic cases of diarrhea in adults. Norovirus is responsible
for about 21 million episodes of diarrhea annually in the United States, with 5.5 million being foodborne. There have thus far been no effective vaccines developed for norovirus. Therefore outbreak detection and control are the primary public health efforts used to control and prevent norovirus. Due to the fact that a large percent of norovirus illness results from food borne exposures, a great deal of effort has been aimed at development of methods for detecting and eliminating virus contamination from food items, particularly shellfish and fresh produce.
Several other viruses, including astrovirus, sapovirus, and Aichi virus are also responsible for diarrheal illness in children and adults and manners to control these viruses are being investigated. Therefore, although there is optimism for universal vaccination to help prevent illness and death from severe rotavirus diarrhea and for the reduction of norovirus illness by rapid outbreak detection and source identification, there remain many challenges for the control and prevention of viral gastroenteritis.
Mandel News Service