Prevention and treatment of viral diarrhea in pediatrics

Abstract

Diarrhea is the second largest cause of mortality worldwide in children from the perinatal period to the age of 5 years. Rotavirus has been the most commonly identified viral cause of diarrhea in children. Norovirus is now recognized as the second most common viral pathogen. Adenovirus, astrovirus and sapovirus are the other major viral causes of pediatric gastroenteritis. Strategies for prevention include basic hygiene, optimization of nutrition and, ultimately, vaccination. Two new vaccines have recently been licensed for the prevention of rotavirus, the monovalent human rotavirus vaccine (Rotarix™) and the pentavalent bovine–human reassortant vaccine (RotaTeq^®). These vaccines have already dramatically decreased the morbidity associated with rotavirus in countries where they are widely used. Efforts to develop a norovirus vaccine face substantial hurdles. Treatment of the viral pathogens is primarily limited to symptomatic measures.

Keywords::

• adenovirus
• astrovirus
• diarrhea
• gastroenteritis
• human rotavirus vaccine
• norovirus
• pentavalent rotavirus vaccine
• rotavirus

Acknowledgements

The author is indebted to Stanford T Shulman for his careful review of an early draft of this manuscript.

Financial & competing interests disclosure

Evan J Anderson has previously served on the speaker’s bureau for Merck. He has consulted for both Merck and GSK and has received research support from Merck, Clearview, MedImmune and Meridian Bioscience, Inc. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.