While watching the Frontline video “The Vaccine War” I
was struck by some of the numbers which were offered by Dr. Margolis regarding
Rotavirus deaths in the United States and those worldwide. In order to correctly identify the
epidemiological significance of this disease in the United States I decided to
pursue information from the Centers for Disease Control and Prevention. In this blog post I will discuss the signs
and symptoms of Rotavirus, the statistical significance of its infection rate,
and how it relates to what we have discussed in class.
Rotavirus is a type of gastrointestinal irritation which
causes diarrhea and vomiting in young children and babies and “accounts for up
to fifty percent of hospitalizations for infants and young children for severe
dehydration resulting from diarrhea and vomiting (Wikipedia).” Further information provided from the Centers
for Disease Control and Prevention warns that although Rotavirus is not the
only cause of diarrhea which results in hospitalization it is the most
serious. Interestingly enough Wikipedia
states that by the time most children are five years old they will have been
exposed to Rotavirus at least once “and with each successive infection immunity
builds.”
What then are the statistics behind the infection and
death rates of the Rotavirus in the United States and worldwide? The Centers for Disease Control and Prevention
state that the Rotavirus is responsible for “400,000 doctor visits, 200,000
emergency room visits, and 55,000 to 75,000 hospitalizations yearly with 20-60
deaths.” So how does this stand in the
total of infant deaths in the United States?
According to the New York Times 28,000 infants die every year in the
United States before reaching the age of one.
If we take the average number of deaths by Rotavirus and divide it by
the total number of infant deaths in the United States the percentage is
0.14. The percentage is so small that in
reports of infant mortality for the United States, Rotavirus was not even
mentioned (Wikipedia). So how does the
United States’ infection and death rate compare to other countries?
The World Health Organization reports that an estimated
527,000 children die each year as a result of exposure to the Rotavirus and 85%
of these deaths are occurring in Africa and Asia. If we assume that the number of deaths is roughly
equal in each country then there are approximately 223,975 deaths in each
country each year. According to Ined, an
international demographic website, Africa accounts for 47% of infant deaths
every year which of the 6.2 million is 2,852,000 deaths annually. This high number is accounted for by
birthrate and by a disproportionate number of developing areas compared to the
rest of the world. If we take the
223,975 deaths from Rotavirus and divide it by 2,852,000 total deaths we have a
percentage of 7.85% being attributed to Rotavirus symptoms. Statistically 7.85% of deaths being
preventable by a vaccine seem to be a significant number; however, because of the
difficulties resulting from “greater
prevalence of concurrent enteric infections, a greater prevalence of
malnutrition, [and] a greater prevalence of unusual rotavirus strains” efficacy
of vaccination programs on this continent face a grave barrier.
In class we
have repeatedly discussed the efficacy of research being used improperly in the
defense of a scientific claim. In the specific
case of the Rotavirus I believe that children should be vaccinated for the herd
immunity effect as mentioned in the Frontline segment “The Vaccine War”;
however, the fact that the death rate in the United States has never been
significant compared to other countries is important. If pediatricians in the U.S. are going to recommend
the vaccine for Rotavirus then I believe that they should properly attribute
the necessity to herd immunity and not to individual safety.
Although
vaccines are a troubling issue facing our country in the 21st century
we must as a country must pause in the face of scientific evidence and be
careful to continue to examine the efficacy and side effects of these
preventative measures. The above post
was intended to discuss the nature of Rotavirus, the statistical significance of
Rotavirus, and how this blog post relates to what we have discussed in class.
All Websites accessed on 3/25/2013
Thanks for this! In my own research of these diseases that are vaccinated for, I found the death rate rather low, but some diseases like polio, hepatitis and others, have lasting consequences and other diseases linked to them. No one really dies from Hep B, but they die from the liver failure and cirrhosis it can sometimes cause, and most likely will cause. And the argument that Hep B is a sexually transmitted disease and since its given to children it's irrelevant, because most Hep B cases are transferred by the mother when the child is being born and can be prevented from manifesting with the vaccine.
ReplyDeleteAJ,
ReplyDeleteI have some news about your numbers. It appears that statistics presented by the Rota Council Path bulletin: "Rotavirus Disease and Vaccines in Africa," are very similar to those you calculated, 232,000 deaths per year of children five years or younger to your 223,975 deaths (though I am unsure of your age group). Unfortunately there is likely some error in either values and thus some unaccounted for deaths. The bulletin also identifies that Rotavirus is the leading cause of Diarrhea based fatalities of children under five in Africa, which diarrhea accounts for 12% of the total deaths. I know that this is not good news, but it is good to see that the calculated values are backed up by other independent sources.
Source: http://rotacouncil.org/resources/Tab-7-Partner-Materials-document-2.pdf
Cool. Thanks so much Kevin. I always feel uncomfortable estimating. Its good to know (for the sake of this post at least) that there are some consistencies in this area.
ReplyDelete