Bishop R
Department of Gastroenterology, Royal Children's Hospital, Melbourne, Victoria, Australia.
Southeast Asian J Trop Med Public Health. 1988 Sep;19(3):429-35.
Rotavirus infection is one of the most important causes of morbidity in young children throughout the world. The high associated mortality in Southeast Asia (and elsewhere) warrants the development of a vaccine. It is probable that most of the life-threatening watery diarrhoea due to rotavirus infection occurs as a result of primary infection in children aged 6-18 months after protection due to maternal antibody has diminished. Thus rotavirus vaccines are targeted at young infants from birth to 3 months of age. At present three candidate rotavirus vaccines (RIT-4237, MMU-18007, WC3) have undergone trials in young children. A bovine rotavirus strain (RIT-4237), was shown to be safe, immunogenic and efficacious in prevention of severe rotavirus diarrhoea in young children in Finland. However it was found to be weakly immunogenic in infants in developing countries, and to have only low efficacy in prevention of disease. A simian rotavirus strain (RRV, MMU-18006) has proved to be highly immunogenic and its reactinogenicity to be diminished by pre-existing maternal antibody (in infants aged 1-4 months). It has high efficacy against clinically severe rotavirus infection. However protection is homotypic against human serotype 3 only so that eventually a multivalent vaccine incorporating reassortant rotavirus strains that protect against human serotypes 1, 2, 4 (and other newer serotypes) may be required. It is hoped that, once safe immunogenic and protective candidate rotavirus vaccines are identified, they can be administered in an acceptable form with no alteration to existing immunization schedules.
轮状病毒感染是全世界幼儿发病的最重要原因之一。东南亚（及其他地区）与之相关的高死亡率促使人们研发疫苗。由于轮状病毒感染导致的大多数危及生命的水样腹泻，可能是在6至18个月大的儿童中，因母体抗体提供的保护减弱后发生初次感染所致。因此，轮状病毒疫苗的目标人群是从出生到3个月大的婴儿。目前，三种候选轮状病毒疫苗（RIT-4237、MMU-18007、WC3）已在幼儿中进行了试验。一种牛轮状病毒株（RIT-4237）在芬兰的幼儿中显示出安全、具有免疫原性且能有效预防严重的轮状病毒腹泻。然而，在发展中国家的婴儿中发现它的免疫原性较弱，预防疾病的效果也很低。一种猿猴轮状病毒株（RRV，MMU-18006）已被证明具有高度免疫原性，并且其反应原性会被母体预先存在的抗体（在1至4个月大的婴儿中）所减弱。它对临床上严重的轮状病毒感染具有高效的预防作用。然而，其保护作用仅针对人类3型血清型，因此最终可能需要一种包含重组轮状病毒株的多价疫苗，以预防人类1、2、4型血清型（以及其他新血清型）。人们希望，一旦确定了安全、具有免疫原性且有保护作用的候选轮状病毒疫苗，它们能够以可接受的形式给药，且不改变现有的免疫接种计划。
