For one of the leading global causes of childhood diarrhoeal disease, an oral vaccine of a new generation, has produced promising results, providing a new shot in the arm for millions of children forced to contend with the deadly combination of disease and contaminated food and drink. The ETVAX vaccine is to prevent infection from enterotoxigenic Escherichia coli, or ETEC. This bacterium accounts for many moderate-severe diarrhea in young children in low- and middle-income countries and is one of the leading causes of traveler’s diarrhea.
Clinical trial results from Phase IIb trials in The Gambia, show that the vaccine might greatly lessen disease from ETEC. Diarrheal disease remains an important world health problem, Mostly in the under-five age group. Severe diarrhea can cause rapid dehydration and hospitalization, and in the very young can be fatal.
Repeated episodes of diarrhea during childhood may also result in adverse effects on growth and development. To address the disease burden, scientists have been looking for new, more effective vaccines to protect against infection. May be helpful to have an oral vaccination.
ETVAX is an oral dose and may be useful in the setting of a mass immunization program to reach children quickly in a community. For example given the difficulty of establishing and maintaining a comprehensive national vaccination program, the oral dose may be an advantage over injections. The recent trial was done in The Gambia with young children and tested whether a vaccine was useful in reducing moderate-to-severe diarrheal illnesses.
The authors reported promising protection against the ETEC-positive diarrhea and also a decrease in the moderate-to-severe diarrhea from all causes meaning that overall the potential benefits of a public health impact could go beyond that of diarrhea caused directly by ETEC. These results are Mostly relevant, as infections of ETEC are prevalent in areas that have limited access to potable water, sanitation and health care.
The bacteria can be spread via contaminated food and water, and pose a recurring problem to families and public-health services.
The vaccine has not yet been introduced as a routine vaccination for children. Positive results from the Phase IIb trials have led to the approval for a Phase III trial of a larger population.The European Medicines Agency has determined that ETVAX is ready to undergo this essential testing phase, to further assess its efficacy and safety using a broader population.
The case for more effective prevention is perhaps even more compelling, given that current preventative measures for childhood diarrhea do nothing to remove the risk of infectionimproved sanitation, access to clean water, nutrition and prompt treatment will always be necessary, and vaccination could provide an additional safeguard. Another question investigators want to know is, if blocking repeat ETEC infections might have benefits beyond the individual episodes of diarrhea.
High rates of childhood diarrheal disease have implications for nutrition and development; so prevention might have lasting effects.
ETVAX is just one element of an international drive to develop vaccines for the world’s poorest children. Still, testing new vaccines can be difficult as their efficacy may not be consistent across different populations, climates and strains of bacteria. Very large clinical trials are So required before public health officials can make recommendations on the vaccine’s use.
