Vaccinations rotavirus

Infection risk In three infants, two with failure to thrive, who had dehydration and diarrhea within 1 month after their first or second rotavirus immunization and were subsequently found to have severe combined immunodeficiency, rotavirus was detected by means of reverse-transcriptase polymerase chain reaction in stool specimens the virus was confirmed by gene-sequence analysis as vaccine rotavirus [25 ]. These infections raise concerns regarding the safety of rotavirus vaccine in severely immunocompromised patients. 

Rotavirus. Rotavims causes infant diarrhea, a disease which has major socio-economic impact. In developing countries it is the major cause of death in infants worldwide, causing up to 870,000 deaths per year. In the United States, diarrhea is stiU a primary cause of physician visits and hospitalization, although the mortaUty rate is relatively low. Studies have estimated a substantial cost benefit for a vaccination program in the United States (67—69). Two membrane proteins (VP4 and VP7) of the vims have been identified as protective epitopes and most vaccine development programs are based on these two proteins as antigens. Both Hve attenuated vaccines and subunit vaccines are being developed (68). 

Pang, X. L., Joensuu, J., and Vesikari, T. (1999). Human calicivirus-associated sporadic gastroenteritis in Firmish children less than two years of age followed prospectively during a rotavirus vaccine trial. Pediatr. Infect. Dis. J. 18,420 26. 

Viruses are the most common cause of diarrheal illness in the world. A live, oral vaccine is licensed and recommended for use in infants for the prevention of rotavirus infection. 

The first rotavirus vaccine was a tetravalent rhesus rotavirus strain. It was licensed in the United States in 1998 and subsequently withdrawn from the market due to an association with intussusception. A pentavalent human-bovine reassortant rotavirus vaccine was approved by the FDA in February 2006. The exact mechanism by which the vaccine produces an immune response is unknown however, this live virus vaccine replicates in the small intestines and induces immunity. 

The rotavirus vaccine is a three-dose series that is orally administered. The first dose is given to infants between 6 and 12 weeks of age with subsequent doses administered 4 to 10 weeks apart. 

Nayak B, Panda AK, Ray P et al (2009) Formulation, characterization and evaluation of rotavirus encapsulated PLA and PLGA particles for oral vaccination. J Microencapsul 26 154-165... 

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Rotavirus — the most common cause of severe diarrhea in infanfs, with approximately 125 million cases worldwide per year and 600,000 deaths — vaccines have been linked with intussusceptions (a problem with the intestine in which one portion of the bowel slides into the next) at a rate of between 1 in 5000 and 1 in 11,000 infants. The only rotavirus vaccine approved in the United States, RotaShield (Wyeth-Ayerst), was withdrawn from market on October 22, 1999, about 1 year after licensure. 

Rotavirus Vaccine, Live, Oral, Pentavalent (RotaTeq)... 

Gallium Nitrate (Ganite) [Hormone] Uses t Ca of malignancy bladdCT CA Action -1- bone resorption of Ca Dose t Ca 200 mg/mVd X 5 d CA 350 mg/m cont inf X 5 d to 700 mg/m rapid IV inf q2wk in antineoplastic settings (pCT protocols) Caution [C, ] Do not give w/ live or rotavirus vaccine Contra SCr >2.5 mg/dL Disp Inj SE Renal insuff, -1- Ca, hypophosphatemia, -1- bicarb, <1% acute optic neuritis Interactions t Risks of nephrotox amphotCTicin B,... 

Uses Pancreatic islet cell tumors carcinoid tumors Action DNA-DNA (int -strand) cross-linking DNA, RNA, protein synth inhibitor Dose Per protocol -1- in renal failure Caution w/ renal failure [D, /-] Contra w/ rotavirus vaccine, PRG Disp Inj SE N/V/D, duodenal ulcers, depression, X BM rare nephrotox (proteinuria azotemia dose related), hypophosphatemia dose limiting hypo-/hypCTglycemia inj site Rxns Interactions t Risk of nephrotox W/... 

Rotavirus vaccines Live attenuated strains of rotavirus Active immunization against rotavirus (causes severe childhood diarrhoea)... 

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