Viral Gastroenteritis in Ghana
BACKGROUND & SIGNIFICANCE
Diarrhea is the passage of loose or liquid stools at a rate that is more frequent thannormal—typically 3 or more times per day.
The loss of vital fluids and electrolytes throughdiarrhea can cause severe dehydration, leading to death if left unmanaged. The WorldHealth Organization (WHO) ranks diarrheal diseases as the 5
leading cause of mortalityworldwide, with an estimated 2.5 million deaths each year.
Over half of these deaths(1.3-1.8 million) occur in children younger than 5 years old, making diarrhea the 2
leading killer of children globally.
Of these 1.3 million deaths, 80% are under 2 years old.While there are many causes of diarrhea, it is often a symptom of an infection in thegastrointestinal tract.
A variety of pathogens—ranging from bacteria to viruses toprotozoa to helminths—can cause acute gastroenteritis, a medical condition characterizedby inflammation of the gastrointestinal tract.
This inflammation results in diarrhea,vomiting, abdominal pain, and often fever. Most pathogens that cause diarrhea aretransmitted from person to person through the fecal-oral route by vehicles such as waterand food. In many developing nations, poor sanitation facilities and practices promote thespread of diarrheal diseases.
Moreover, access and use of rehydration therapy is limited inthese countries.
Unsurprisingly, of the 1.3 million deaths among children caused bydiarrhea each year, about 800,000 occur in Africa.
Rotavirus: Profile of a Leading International Killer
The leading causes of severe acute gastroenteritis are viral. Globally, rotavirus aloneaccounts for about 40% of all cases of diarrheal diseases in children under age 5 that leadto hospital admission.
Overall, rotavirus infection is responsible for over 2 millionhospitalizations and an estimated 527,000 deaths worldwide each year.
Out of thesedeaths, nearly 240,000 are believed to occur in sub-Saharan Africa.
The rotavirus diseaseburden and mortality limit the economic development of resource-limited countries; it would thus be beneficial for developing nations like Ghana to reduce rotavirus infectionsthrough vaccination. However, many challenges stand in the way of doing so.Rotaviruses comprise a genus within the family
(reviewed in ) that consists of icosahedral RNA viruses.
The rotavirus virion is a 100 nm non-envelopedparticle that is made up of 3 protein layers surrounding the genome (Figure 1A-B).
Theinnermost is made up of the core shell protein VP2, with the RNA polymerase VP1 and theRNA capping enzyme VP3 attached to the interior side.
Contained inside of this core isthe genome, which consists of 11 segments of double-stranded RNA (dsRNA). Theintermediate layer is solely made up of VP6. The outer layer consists mostly of the VP7glycoprotein but also contains spikes of the VP4 attachment protein. In the gastrointestinaltract of the infected host, trypsin-like proteases cleave VP4 to yield VP5* and VP8*.