THE REPUBLIC OF UGANDA MINISTRY OF HEALTH Introduction Rotavirus Factsheet What you need to know about Rotavirus Rotavirus infection is the leading cause of diarrhoea in children under 5 years of age worldwide. It is responsible for over 600,000 deaths annually and approximately 40% of hospitalizations due to diarrhoea worldwide. WHO s Strategic Advisory Group of Experts (SAGE), has emphasized the importance of providing Rotavirus vaccination in the context of a comprehensive diarrhoeal disease control strategy. The strategy also emphasizes improvement of water quality, hygiene, and sanitation; provision of oral rehydration solution and zinc supplements; and overall improved case management In 2018, the Rotavirus vaccine will be introduced into the UNEPI Immunisation schedule. This vaccine will protect children against the most common strains of Rotavirus, which is the commonest cause of diarrhoea among children and results in a significant number of children being admitted to hospitals each year. In Uganda, surveillance for Rotavirus infection was initiated in June 2006 at one sentinel site based at Mulago National Referral Hospital in Kampala. The surveillance records showed that: Rotavirus infections is a major burden ranked among the first 10 killer diseases in under five-year-old: in Uganda and occurs throughout the year In Uganda Rotavirus infections were detected all year round, which shows that Rotavirus infection was a regular factor in the high disease burden among the study population An estimated 10,637 children <5 years of age die in Uganda each year due to Rotavirus diarrhoea Diarrhoea is among the top ten causes of morbidity in Uganda Rotavirus accounts for almost 40% of diarrhoeal cases Based on the available evidence, Rotavirus vaccine will have a significant impact on reducing diarrhoea in children in Uganda and will result in a significant number of lives being saved and medical costs averted. PREVENT DIARRHOEA AND SAVE LIVES Immunise your child against Rotavirus
Rotavirus Factsheet Justification for routine immunization against Rotavirus Evidence shows that Rotavirus vaccine will have a significant impact on reducing diarrhoea in children in Uganda and will result in a significant number of lives being saved and medical costs averted. What is Rotavirus? Rotavirus is a highly infectious virus that causes severe diarrhoea and vomiting mostly in children under 5 years of age. Diarrhoea and vomiting can lead to serious dehydration (loss of body fluid) which can be especially harmful for young children. If dehydration is not treated, it can lead to death. How Rotavirus is spread Individuals suffering from Rotavirus diarrhoea often shed large amounts of the virus in the stool. The Rotavirus that is passed into the environment through faeces, is spread primarily by the fecal-oral route directly from person-to-person or indirectly via contaminated food and drinks. It spreads easily from person to person through touching hands and/or objects contaminated with Rotavirus and putting soiled hands into the mouth or consuming contaminated food or drinks. The disease commonly spreads in families, hospitals and childcare centres. Rotavirus can live on contaminated hands for hours and surfaces/objects for several days. It is very difficult to stop the spread of Rotavirus just by hand washing or disinfecting surfaces. Children can spread Rotavirus both before and after they become sick with diarrhoea Signs & symptoms of Rotavirus Rotavirus signs and symptoms include the following: Diarrhoea Vomiting Fever Stomach pain Additional symptoms include: Loss of appetite Dehydration (loss of body fluid) Diarrhoea and vomiting can last for 3 to 8 days. Children may stop eating and drinking while they are sick. Since infection occurs early in life, the majority of older children who survived and adults develop some immunity against Rotavirus disease. Humans are the only known reservoir of the Rotavirus that lead to clinical manifestation of the disease. Population at risk of Rotavirus Nearly every child is at risk of infection, regardless of location, hygiene practices, or access to safe drinking water or sanitation. Children aged six (6) months to two (2) years are most vulnerable to infection, along with premature infants, the elderly, and those with weakened immune systems. While older children and adults can get Rotavirus infections, these usually have no symptoms (asymptomatic) or are mild. 2
Prevention of Rotavirus Rotavirus Factsheet Immunisation with the Rotavirus vaccine is the best way to protect children from Rotavirus and the dehydrating diarrhoea that it can cause. This however should be done alongside improving water quality, hygiene and sanitation to stop bacteria and parasites that cause other forms of diarrhoea. Our hands constantly touch dirt as we work or interact with other people. We need to wash hands with soap and clean water regularly to prevent all forms of diarrhoea. Wash your hands with soap and clean water at the following critical times: After using the toilet or pit latrine Before preparing, serving, eating and after eating food After cleaning the baby s faeces or changing the baby s diaper/ nappy After handling blood, raw meat or uncooked eggs After sneezing, coughing or blowing your nose After handling surfaces that many people touch such as doorknobs After touching/ cleaning animals, animal waste or garbage After touching/ counting money After shaking hands Administration of the Rotavirus vaccine The Rotavirus vaccine is administered orally, i.e. through the mouth Rotavirus vaccine will be given in two doses: 1st dose at 6 weeks (1 ½ months) while the 2nd dose is at 10 weeks (2 ½ months) Safety of the Rotavirus vaccine It is approved by the Ministry of Health, WHO and UNICEF It is SAFE, EFFECTIVE and FREE Millions of children globally have been given the vaccine safely Possible side effects of the Rotavirus vaccine With a vaccine, like any medicine, there is a chance of side effects but they are rare and usually mild. These may include: Irritability Mild temporary diarrhoea Vomiting Abdominal pain Flatulence Skin inflammation Fever Loss of appetite Most children who get the Rotavirus vaccine do not experience any side effects and the benefits of the Rotavirus vaccine to prevent hospitalization and death far outweigh the potential side effects. 3
Rotavirus Factsheet Roles and responsibilities of key stakeholders Political leaders Sensitise communities on the benefits of immunisation Advocate for resources to strengthen routine immunisation Monitor immunization activities Religious leaders Sensitise congregations and the communities on the benefits of immunisation Cultural/Traditional leaders Sensitise communities on the benefits of immunisation Civil society organisations Sensitise the communities on the benefits of immunisation Advocate for resources to strengthen routine immunisation Monitor immunisation services Service clubs Sensitise the communities on the benefits of immunisation Mobilise resources to strengthen routine immunisation Provide resource persons and equipment Empower communities to demand for immunisation services Strengthen existing social structures to mobilise communities for immunisation Development partners Provide technical and financial support for immunisation activities Media Sensitise the communities on the benefits of immunisation Disseminate timely and accurate immunisation information to the public Monitor and report on immunisation services Professional bodies Organise in service training on immunisation Support the immunisation program by providing scientific evidence Security (Army, Police, Prisons) Mobilise their communities Provide resource persons and equipment Support the DHTs to follow up defaulters and resistant groups for immunisation 4
Rotavirus Factsheet Line Ministries Ministry of Health Ministry of Local Government & Ministry of Gender Labour & Social Development Allocate resources from local revenue for immunisation Ensure utilization of the existing local structures (local councils, parish chiefs, sub county chiefs, CDOs, health assistants, DEO) to strengthen mobilisation and advocacy for routine immunisation Key Messages 1. Rotavirus is highly contagious and cannot be treated with antibiotics or other drugs 2. Rotavirus infection is the leading cause of diarrhoea in children under 5 years 3. An estimated 10,637 children under 5 years of age die in Uganda each year due to Rotavirus diarrhoea 4. Immunisation with the Rotavirus vaccine is the best way to protect your children from Rotavirus and the deadly dehydrating diarrhoea that it can cause 5. The Rotavirus vaccine is administered orally, i.e. through the mouth, in two doses at 6 weeks (1 ½ months) of age and 10 weeks (2 ½ months) of age 6. Prevention of dehydration by providing timely Oral Rehydration Solution (ORS) and Zinc saves lives. 7. Immunisation against Rotavirus should be done alongside improving water quality, hygiene and sanitation to stop bacteria and parasites that cause other forms of diarrhoea. 8. All faeces, including those of babies and young children, should be disposed of in a latrine. Make sure that all family members use a latrine to dispose of faeces. Where there is no latrine, faeces should be buried 9. All family members, including children, need to wash their hands thoroughly with soap and clean water after using the toilet or pit latrine, before preparing, serving, eating and after eating food, after cleaning the baby s faeces or changing the baby s diaper/ nappy 10. Every child has a right to immunisation 5
Remember: Rotavirus vaccine is now available in Uganda Take your child at 6 weeks and 10 weeks of age for immunisation against Rotavirus at the nearest health facility If your child should get diarrhoea, give him/her ORS with Zinc SUMMARY OF KEY FINDINGS Rotavirus infection is the leading cause of diarrhoea in children under 5 years of age worldwide Rotavirus infections is a major burden ranked among the first 10 killer diseases in under five-year-old in Uganda Rotavirus infections were detected all year round An estimated 10,637 children under 5 years of age die in Uganda each year due to Rotavirus diarrhoea Diarrhoea is among the top ten causes of morbidity in Uganda Rotavirus accounts for almost 40% of diarrhoeal cases PREVENT DIARRHOEA AND SAVE LIVES Immunise your child against Rotavirus