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By the age of three years most children in the world have been infected with rotavirus. In the developed world many cases need nothing more than attentive treatment and rest at home but in about 5-10% of cases children become so dehydrated due to gastro-enteritis they may need hospital care. The picture is more grim in developing countries where three-quarters of infants have had their first clinically serious rotavirus infection by their first birthday. Worldwide rotavirus accounts for an estimated two-fifths of all severe diarrhoea cases and causes up to a third of the 1.9 million deaths a year among under-fives due to diarrhoea. Ninety percent of these deaths occur in the developing countries where access to lifesaving treatment is limited and where a vaccine would offer the best hope for preventing countless deaths. Finding a safe and effective rotavirus vaccine has been a priority for the World Health Organization (WHO) in the 1990s. But the search got off to a false start. In mid-1998Wyeths RotaShield was licensed for sale in the United States of America (USA) and rapidly introduced into routine childhood vaccination programmes. Within nine months cases of vaccine-related intussusception a serious condition that causes bowel obstruction were reported among some one million children who had been vaccinated. The manufacturer voluntarily withdrew the vaccine and the US Advisory Committee for Immunization Practices withdrew its recommendation for its use. (excerpt)

New vaccines to boost child care in developing countries