The danger of rotavirus infection is greatly exaggerated

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

We are encouraged to vaccinate children against rotavirus. Officials' arguments cause mistrust, which is associated with a number of either accidental or deliberate errors in figures and facts

On April 3, a press conference was held in Moscow at the International Multimedia Press Center of the Rossiya Segodnya MIA, dedicated to the free vaccination of Moscow children under the age of 8 months against rotavirus infection.

Of course, medical officials must inform the residents of the city that they have the opportunity to vaccinate young children against another infection. As always, however, when it comes to vaccinations, the information given to parents is inaccurate.

Representatives of official medicine are surprised by the anti-vaccine sentiments of a number of citizens, but why be surprised if their arguments give rise to mistrust, which, in turn, is caused by a number of either accidental or deliberate errors in figures and facts. We will deal with them step by step, as we study the topic.

What is Rotavirus?

Rotavirus infection is often called in everyday life "intestinal flu": the onset of the disease, as a rule, is acute, the symptoms of gastroenterological disorder can be combined with signs of a respiratory illness. Rotavirus is quite active during the cold season, although outbreaks of this infection occur in summer.

Rotavirus infection is characterized by vomiting, a sharp rise in temperature, and diarrhea. On the second - third day of the disease, a characteristic stool may appear: gray-yellow and clay-like. In the acute period, there is no appetite, there is a breakdown.

The disease is considered childhood, adults get sick with it much less often, although this happens to them too. The disease is transmitted mainly through dirty hands.

Doctors, as a rule, prescribe the intake of sorbents (activated carbon, smecta, attapulgite) to combat the consequences of intoxication. In the course of treatment, it is necessary to follow a strict diet: with rotavirus, lactase deficiency often develops, therefore, it is necessary to exclude dairy products until complete recovery.

“According to WHO statistics, about 30% of child deaths in the world at the age of 1–5 years are associated with rotavirus,” the RIA Novosti website says in an invitation to a press conference.

“According to the WHO, more than 500 thousand children die from RVI all over the world every year,” Nikolai Briko, chief freelance epidemiologist of the Russian Ministry of Health, cites this figure in his speech.

In poor countries in Asia and Africa, dehydration can be a serious problem and, in the absence of clean drinking water and timely medical care, can lead to patient death.

The authors refer to statistics from the World Health Organization, which are very easy to verify because WHO documents are in the public domain. This document says that according to data for 2013, approximately 3.4% of child deaths are caused by rotavirus. At the same time, in absolute terms, the number of deaths from this infection was 215,000 in 2016, not 500,000.

As you can see, the officials responsible for informing greatly exaggerated the real scale of the danger.

The geography of mortality from the disease is also important. Nearly half of all deaths from this infection among children under 5 years of age occur in four countries: India, Pakistan, Nigeria and the Democratic Republic of the Congo.

Angola is the leader in the number of deaths from rotavirus (again among children under 5 years old) per 100,000 population with an indicator of 241, and in 70 countries of the world not a single child died from this infection in 2013.

The much smaller scale of the problem, however, does not make rotavirus an enjoyable experience for children and parents. Death from it in our country with a predominantly enlightened population that understands the need for medical care for a small child with diarrhea, vomiting and high fever is rather rare, and, nevertheless, it is better to try to avoid this disease.

Prevention is important. But this raises two questions. What is included in prevention - is it just vaccination? And the second question: what needs to be considered when deciding whether to immunize a child against rotavirus?

Let's start with the second one.

Vaccine

WHO recommends vaccination against rotavirus worldwide. At the same time, she strongly recommends it for those countries where at least 10% of all deaths of children under 5 years old are due to diarrhea of various origins.

In the United States and Japan, rotavirus immunization is included in national immunization schedules, in Europe it is different. Countries such as Great Britain, Germany, Austria, Belgium, Finland, some Eastern European countries have introduced this vaccine into the calendar, but in France, Denmark, the Netherlands, Sweden, Spain and most of Eastern Europe, it is not on the calendar.

Two rotavirus vaccines have been patented: Rotarix (GSK) and RotTek (Merck).

The RotaTek vaccine is used in Russia, so we will tell you about it in detail.

The vaccine contains five recombinant viruses derived from human and bovine rotavirus strains. It is oral, that is, it is introduced through the mouth in the form of drops.

The first dose of the vaccine is administered at a period of 6 to 12 weeks of life, and the last, third - no later than 32 weeks, because from this age the risk of intussusception in children increases (what this is, we will tell you a little later). The minimum interval between doses is 4 weeks.

The effectiveness of the vaccine in the prevention of rotavirus gastroenteritis of any severity is estimated at 71, 3–74, 0%, in the prevention of a serious illness - 98, 0–100%.

Clinical trials of the vaccine were carried out by the manufacturer for 2 seasons, during which immunity was maintained. How long it lasts beyond this period is unknown.

What is the safety profile of rotavirus vaccination?

“… The vaccine is absolutely safe, Oleg Filippov, the chief physician of the Center for Medical Prevention of the Moscow Healthcare Department, assured,” is another strange statement from the lips of a medical worker. One can speak of a good safety profile of a drug, but no drug can be “absolutely safe”.

Potential negative side effects of the vaccine have been reported by both the manufacturer and the World Health Organization. These include diarrhea, vomiting, irritability, otitis media, nasopharyngitis, and bronchospasm. They are not common, but they need to be kept in mind and monitored after vaccination.

This is a type of obstruction, the cause of which is the introduction of one part of the intestine into the lumen of another, in other words, the intestine folds like a telescope. This condition requires immediate medical intervention, mostly conservative, but in some cases, surgical.

The WHO statement on the benefits and risks of vaccination against rotavirus refers to an increased risk of intussusception (which occurs in children under one year of age and for other reasons), mainly in the first 7 days after vaccination. The experience of France is cited as an example: there the risk of this complication remained within the same limits as in the rest of the world, however, two infant deaths from intussusception are linked by the health authorities of this country to vaccination.

WHO experts note, however, that the benefits of immunization against rotavirus infection far outweigh the risks.

What else you need to know if you have decided to vaccinate your child against rotavirus

The RotaTek vaccine is contraindicated if the child has demonstrated hypersensitivity to it after the previous dose. Do not vaccinate those children who have a history of intussusception.

There is insufficient data on the safety of the vaccine for other diseases associated with disorders of the immune system or with immunosuppressive therapy, as well as for children with a history of gastroenterological diseases, surgery in the abdominal region, in acute conditions (diarrhea, vomiting, fever).

In addition, it should be borne in mind that the vaccinated child is a virus carrier and, up to 15 days after vaccination, secretes rotavirus, so if he is in close contact with a person suffering from immunodeficiency, it is necessary to carefully weigh the family-wide balance of benefits and possible harm from vaccination.

"Prevention" is not equal to "vaccination"

For some reason, our medical officials do not hold conferences on this topic and do not write articles.

Meanwhile, there is medical literature on the important role of vitamin D in increasing the body's resistance to rotavirus. This is understandable: like the flu, rotavirus is a disease of the cold season, which means that there is also a seasonal factor in its epidemiology. Vitamin D may be such a factor for influenza, scientists suspect, levels of which decrease in the fall and winter, when the human body receives less sun (read more about this here). It is logical to assume the same for rotavirus.

This is supported by a number of medical studies.

In this work, Turkish scientists compared the levels of vitamin D in the blood of 67 healthy children and 70 suffering from rotavirus diarrhea, and found a significant difference: in sick babies, it averaged 14.6 ng / ml, in healthy babies - 29.06 ng / ml.

But in this Chinese study, vitamin D3 supplementation stopped rotavirus replication in pigs.

Rotavirus infection is receiving a lot of attention in India, where it remains a very serious problem. A number of studies conducted there also point to a link between the disease and vitamin D deficiency.

Keep in mind that vitamin D3 should be used as a dietary supplement (D2 is ineffective), and this will also prevent rickets and flu for the baby. The only contraindication for taking vitamin D is hypercalcemia, but in any case, you should first consult a pediatrician.