Rotavirus vaccine: current status and future prospects.
Rotavirus is the most important cause of severe gastroenteritis in infants and children worldwide. Efforts to develop a vaccine have concentrated on live oral vaccines, especially with attenuated animal viruses. Because studies with rhesus monkey rotavirus and bovine rotavirus RIT 4237 or WC3 were inconsistent, reassortant rhesus and bovine vaccines have been developed that include the gene encoding the neutralising protein, VP7, of several human strains. These efforts culminated in the licensure of a tetravalent rhesus rotavirus vaccine, in 1998. Subsequent reports linking vaccination to intussusception, however, led to withdrawal of this vaccine. Trials, nevertheless, continue with an oral bovine reassortant vaccine and an attenuated human strain, 89-12. Other strategies in preclinical development include the use of virus-like particles, DNA vaccines and subunit vaccines given by mucosal and nonmucosal routes.
Division of Infectious Diseases, Children's Hospital Medical Center, Cincinnati, Ohio, USA. dib@chmcc.org
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