Canadian Association of Emergency Physicians strongly supports NACI recommendation on rotavirus vaccination - Rotavirus a heavy burden on emergency department resources



    OTTAWA, Jan. 21 /CNW Telbec/ - The Canadian Association of Emergency
Physicians (CAEP) applauds the National Advisory Committee on Immunization
(NACI) for acknowledging in its recommendation published today that
"...individual infants and their families are likely to benefit from
immunization with (the pentavalent rotavirus vaccine). The vaccine has been
approved for use in infants 6 to 32 weeks of age and should be offered to
infants whose parents/guardians wish to reduce the risk of rotavirus."(1)
    Gastroenteritis caused by rotavirus is a very common childhood disease
that infects 95 per cent of children at least once by the time they are five
years old.(2) In its recommendation, NACI also noted that the implementation
of a universal rotavirus immunization program of all Canadian infants could be
expected to prevent as many as 56,000 cases of rotavirus gastroenteritis,
33,000 physician visits, 15,000 emergency department visits and from 1,000 to
5,000 hospitalizations annually.(3)
    In August 2006, Health Canada approved an oral vaccine that contains the
five rotavirus strains responsible for approximately 95 per cent of rotavirus
disease in Canada. In clinical trials, the vaccine prevented 94 per cent of
rotavirus-related emergency department visits.(4)
    "Rotavirus does not discriminate. It affects all socioeconomic groups and
can wreak havoc in childcare facilities, schools, doctor's offices and
hospital emergency departments. Not only is it a common cause of stressful and
costly emergency department visits, but its highly contagious nature makes it
a common cause of hospital-acquired illness for patients and their siblings
visiting the emergency department for any reason. The NACI recommendation is a
positive step that may encourage parents to have their children vaccinated and
protect them against this potentially serious disease, while also helping
prevent its rampant spread and reducing the burden on emergency departments,"
said Dr. Vincent Grant, Chair, Paediatric Section at CAEP.

    Highly contagious and unpredictable disease that can lead to serious
    complications

    Rotavirus is highly contagious and relatively resistant to most soaps and
disinfectants.(5) Symptoms can be mild to severe and generally last for three
to nine days with up to 20 episodes of vomiting and/or diarrhea in a 24 hour
period.(6,7) Severe diarrhea and vomiting caused by rotavirus can lead to
rapid and dangerous depletion of body fluids, which can be
life-threatening.(8) Rotavirus is a common reason for the need for intravenous
insertion and rehydration in the emergency department.
    Rotavirus infection is seasonal from November to June. During the peak
months of April and May, up to 78 per cent of children hospitalized for
gastroenteritis in Canada are rotavirus-positive.(9,10)
    "In our continuous effort to improve the delivery of emergency healthcare
in Canada, we want to create awareness about rotavirus infection and its
burden on emergency department resources; not to mention the burden on the
families of the sick children," said Dr. Anna Karwowska, Past Chair,
Paediatric Section at CAEP. "The rotavirus vaccine would be a welcome addition
to childhood vaccines offered through public health programs, since it would
not only provide relief to Canadian families, but also greatly reduce the
number of stressful and costly emergency department visits," concluded
Dr. Karwowska.

    About CAEP

    The Canadian Association of Emergency Physicians (CAEP) is a national
organization that keeps Canadian emergency physicians informed of developments
in the clinical practice of emergency medicine and addresses political and
societal changes which affect the delivery of emergency healthcare. In
cooperation with other specialties and committees, CAEP plays a vital role in
the development of national standards and clinical guidelines that members can
use to further enhance the delivery of emergency medical care in their own
institutions.

    ----------------------------
    
    (1)  Canadian Communicable Disease Report. January 2008, volume 34,
         page 26.
    (2)  Parashar UD et al. Emerg Infect Dis 1998;4(4): 561-70
    (3)  Canadian Communicable Disease Report. January 2008, volume 34,
         page 25.
    (4)  Vesikari T et al. Safety and Efficacy of a Pentavalent Human-Bovine
         (WC3) Reassortant Rotavirus Vaccine. N Engl J Med 2006;354;1:23-33.
    (5)  Offit P A, Clark, H F. In Mandell, Douglas & Bennett's Principles
         and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa:
         Churchill Livingston; 2000. Vol. 2; Chapter 139:1696-1702.
    (6)  Musher D M, Musher B L. Contagious acute gastrointestinal
         infections. N Engl J Med 2004;351:2417-27.
    (7)  Matson D O, In Principles and Practice of Pediatric Infectious
         Diseases. 2nd ed. Philadelphia, Pa: Elsevier Saunders; 2003.
         Chapter 232: section 1107.
    (8)  Centres for Disease Control and Prevention, accessed at
         http://www.cdc.gov/nip/diseases/rota/rotavirus.htm.
    (9)  Ford-Jones E L, Wang E, Petric M et al. Hospitalization for
         Community-Acquired, Rotavirus-Associated Diarrhea. Arch Pediatr
         Adolesc Med 2000;154:578-585.
    (10) Rivest P et al. Hospitalizations for gastroenteritis: the role of
         rotavirus, Vaccine 2004;22:2013-2017.
    




For further information:

For further information: or to speak with a medical expert: Valoree
McKay, CEO, CAEP, (613) 523-3343 ext. 15

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CANADIAN ASSOCIATION OF EMERGENCY PHYSICIANS

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