Rotavirus in Africa: Shifting the Focus to Disease Prevention

Abstract

On 5 June 2009, the Strategic Advisory Group of Experts on Immunization of the World Health Organization (WHO) recommended that rotavirus vaccines be included in the immunization programs of all countries of the world [ 1]. This recommendation came 10 years after a previous rotavirus vaccine was withdrawn from the market in the United States because of concerns over its association with intussusception. During that decade, it is estimated that >2 million children have died from rotavirus disease on the African continent alone [ 2]. This historic policy decision should serve as a catalyst for efforts to ensure that the next decade heralds reductions in deaths due to diarrheal disease, the second leading cause of death among young children in Africa. The commitment and hard work of literally hundreds of individuals, organizations, and governments over many years contributed to this notable policy decision on rotavirus vaccines. The initial step forward was establishing the burden of rotavirus illness in Africa. The first surveillance studies in the continent, though geographically limited, established rotavirus as an important cause of severe rotavirus gastroenteritis among young African children [ 3– 6]. As rotavirus surveillance expanded, so did the realization that rotavirus infection was an important and ubiquitous disease throughout the continent. In 2008, the WHO reported that, as in the rest of the world, rotavirus was the most common cause of severe diarrheal disease hospitalizations in young children in Africa [ 7]. Although this surveillance was limited to 4 countries, the consistency of the results among those countries, and with results from other studies in Africa and throughout the world, was striking. This supplemental issue of the Journal of Infectious Diseases illustrates the continued expansion of our knowledge on rotavirus circulation, strain diversity, and disease patterns in Africa, with many …