gastroenteritis%20-%20viral
GASTROENTERITIS - VIRAL
Acute gastroenteritis is a diarrheal disease of rapid onset.
Viruses are one of the common causes of gastroenteritis.
Rotavirus, enteric adenovirus serotypes 40 & 41, astrovirus and calicivirus (eg "Norwalk-like" virus) are the established viral agents causing gastroenteritis.
Rotavirus is the most common pathogen causing diarrhea in patients 3-24 months old.
Patients <3 months old are protected by maternal rotavirus antibodies that are passed transplacentally and possibly by breastfeeding.
Transmission is through fecal-oral route.
Incubation period may vary from 1-10 days depending on the causative agent.

Prevention

  • Prevention of most cases of viral gastroenteritis depends on the use of safe & effective vaccines
  • Currently, 2 vaccines are available to prevent severe diarrhea caused by rotavirus infection
    • Several studies support that early vaccination simulate initial natural infection, thus preventing subsequent severe cases of rotavirus gastroenteritis
Human Rotavirus Vaccine
  • Contains live attenuated human rotavirus strain
  • Prevents gastroenteritis caused by serotypes G1, G2, G3, G4 & G9
  • Based on clinical studies on the efficacy during the 1st year of life, it showed that the vaccine has a protective efficacy of 87.1% against any rotavirus gastroenteritis, 95.8% against severe cases & 100% against hospitalization due to rotavirus gastroenteritis
  • Can be simultaneously administered with the following vaccines without affecting the immune response of the administered vaccines: Hepatitis B vaccine, inactivated polio vaccine (IPV), Haemophilus b conjugate vaccine (Hib), pneumococcal conjugate vaccine (PCV), diphtheria & tetanus antigens in diphtheria-tetanus-acellular pertussis vaccine
  • Concomitant administration with oral polio vaccine may slightly reduce the immune response to rotavirus vaccine, however the clinical protection of rotavirus vaccine against severe gastroenteritis would not be affected
    • It is advised that 2 weeks should lapse between administration of the 2 vaccines
Pentavalent Rotavirus Vaccine
  • Contains live reassortant rotaviruses developed from human & bovine hosts
  • Prevents gastroenteritis caused by serotypes G1, G2, G3 & G4
    • Efficacy in preventing any grade of gastroenteritis severity reached 72.5-74% based on 2 studies done from the time of completion of 3-dose regimen through the 1st rotavirus season after the vaccination
    • The 2 trials also showed that the vaccine has clinical efficacy of 98-100% in preventing severe cases
    • There’s a 95.8 % reduction in hospitalizations for severe gastroenteritis during the 1st 2 years following the final dose
  • May be simultaneously administered with the following vaccines without affecting the immune response of the administered vaccines:
    • Hepatitis B vaccine (recombinant)
    • IPV, Hib, PCV
    • Diphtheria & tetanus antigens in diphtheria-tetanus-acellular pertussis vaccine
      • Immunogenicity data are insufficient to confirm the lack of interference of immune response between rotavirus & acellular pertussis vaccines; validation of pertussis assays is still under study
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
19 Jun 2019
The choice between nonvitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonists (VKAs) for stroke prevention appears to be complex and largely heterogenous across different, countries, a new study has found.
2 days ago
Monotherapy with tenofovir disoproxil fumarate increases virologic response for up to 240 weeks in pretreated patients with hepatitis B virus infection (HBV) who are resistant to entecavir and/or adefovir, a new study has found.
Elvira Manzano, 2 days ago
Long-term treatment with the interleukin-5 receptor alpha-directed cytolytic monoclonal antibody benralizumab led to long-term control of asthma, improvement in pulmonary function, and was safe in patients with severe eosinophilic asthma in the 2-year integrated analysis of the SIROCCO, CALIMA, and ZONDA pivotal studies plus the BORA extension study reported at ATS 2019.
Pearl Toh, 3 days ago
Emerging evidence is showing that the two major new classes of antidiabetic drugs — SGLT2* inhibitors and GLP-1** receptor agonists (RAs) — not only confer cardiovascular (CV) benefits to patients with type 2 diabetes (T2D), they also delay the loss of kidney function among these patients, potentially providing nephrologists with an additional tool in their armamentarium for managing patients with chronic kidney disease (CKD) in the future.