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Vaccine Lauded In Rotavirus Decline

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By SHERRI ACKERMAN

The Tampa Tribune

Published: May 31, 2008

TAMPA - South Tampa mom Amber Peck can still remember when her infant son contracted rotavirus.

The highly contagious gastrointestinal virus is characterized by diarrhea and vomiting that occasionally leads to dehydration so severe, infants must be hospitalized. That didn't happen to Gavin, 21/2 years old now and only 4 months at the time, but he suffered for days before the bout passed.

"It was heartbreaking to watch," Peck said. "Gavin was such a trooper. He would throw up and then smile at me to let me know he was OK."

When son No. 2 came along this year, Peck didn't think twice about giving him RotaTeq, a relatively new vaccine that has shown early success in easing symptoms.

Locally, that success has been measured in a dramatic decline in the number of infants testing positive for the virus.

About 260 children tested positive for rotavirus at All Children's Hospital in St. Petersburg in 2007 from January through April - peak season for the virus. This year, there were only five, said pediatrician Juan Dumois, chairman of the hospital's infection control committee.

To ensure the finding wasn't a fluke, Dumois researched the previous three years and found that 250 to 450 children had tested positive each year.

His colleague, Daniel J. Plasencia, a fellow of the American Academy of Pediatricians and the pediatric medical director for St. Joseph's Children's Hospital in Tampa, found similar outcomes.

"There is no doubt," he said. Fewer children are being hospitalized with rotavirus at St. Joseph's and other hospitals nationwide, and it's "due to the rotavirus vaccine."

Rotavirus, which can spread to the brain and even cause death, typically is transmitted by contact with feces from an infected person. Children age 3 and younger are especially susceptible because their immune systems aren't that strong. Adults also can contract the illness, though it's usually a milder form.

The vaccine won't necessarily prevent rotavirus, but it can lessen the severity of symptoms, doctors say.

The national Centers for Disease Control and Prevention in Atlanta cautions that because the vaccine, manufactured by Merck, is still so new - it has only been licensed since February 2006 - there is not enough data yet to measure the medicine's success rate.

"The indicators are good," said Marc Widdowson, an epidemiologist with the CDC. "But it's too early to say if it may be effective."

Another vaccine to treat rotavirus symptoms, Rotarix, is made by GlaxoSmithKline. Both vaccine developers conducted the largest clinical trials in history, involving 60,000 infants each.

The research helped quell concerns about side effects, which plagued the first rotavirus vaccine, RotaShield, after it was linked in the late 1990s to rare cases of intussusception, a condition that causes the intestine to telescope into itself.

Side effects with the new vaccines appear to be minimal, Widdowson said, and include fussiness, irritability, coughing, a runny nose, fever, loss of appetite and vomiting.

Most children will recover from rotavirus just fine at home, but the CDC reports that at least 55,000 American children are hospitalized every year because of the virus, and about 50 to 60 die. Worldwide, rotavirus is a leading cause of death in children.

The CDC, The American Academy of Pediatrics and the American Academy of Family Physicians recommend that parents have their infants immunized against rotavirus. So do many Tampa Bay area pediatricians.

"We love the vaccine," said longtime Tampa pediatrician Earl Smith, though he cautions that it's not a sure-fire preventive for rotavirus. "We have had kids who had three vaccines come down with it."

Smith has even had a case of intussusception in a child who was vaccinated, though he is unsure whether the condition was related.

"We keep our ears perked," he said.

The oral vaccine RotaTeq, which contains five weakened strains of rotavirus, is a liquid given to infants at 2 months, 4 months and 6 months to help build immunity against the virus.

Most health plans and Medicaid cover the vaccine as part of a child's regular vaccination schedule. But it is not required for school or day care enrollment, said Susan Smith, a spokeswoman for the Florida Department of Health.

Despite some concerns, many parents who lived through never-ending diarrhea, vomiting and dangerously high fevers with their older children are anxious to spare younger children.

"We did not want to go through that again," Peck said.

Reporter Sherri Ackerman can be reached at (813) 259-7144 or

sackerman@tampatrib.com.

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