Natasha Halasa, MD, MPH, Vanderbilt University Medical Center, discusses the most pressing diarrheal illness challenges and successful strategies physicians can use to reduce this burden in patients.
Natasha Halasa, MD, MPH, of Vanderbilt University Medical Center (VUMC), lists the most pressing diarrheal illness challenges and successful treatment methods to reduce the disease burden in patients.
Halasa is a professor of pediatrics at VUMC, Division of Pediatric Infectious Diseases. Her research focuses on determining the burden of diarrheal and respiratory illnesses in pediatric and specialized populations and how to reduce them. Currently, Halasa is the principal investigator (PI) of the Vanderbilt site of the New Vaccine Surveillance Network, which was established in 1999 by the CDC to predict the impact of potential new vaccines.
What do you see as the most pressing challenges in diarrheal illnesses today, particularly concerning pediatric and specialized populations?
As a part of the New Vaccine Surveillance Network, we do acute gastroenteritis surveillance, and this is at 7 sites across the United States. For kids that come in with vomiting within a 24-hour period, or 3 loose stools in a 24-hour period, we approach them and we collect their stool. We actually test them for pathogens that cause acute gastroenteritis. And what we've seen after the rotavirus vaccine is that norovirus is the most common cause of why kids are being hospitalized, seen in the ED [emergency department] and the outpatient setting.
There are still some cases of rotavirus, and if they get it, they're actually a little more severe compared to the other viruses and pathogens, but the burden compared to before the rotavirus vaccine existed is much lower.
Could you share some successful strategies or interventions you found to help reduce the burden of diarrheal illnesses?
The rotavirus vaccine has definitely been the most effective way of reducing the burden, specifically to rotavirus. Something that has actually been very simple to reduce the severity of acute gastroenteritis—not necessarily getting it, but once you get it, to reduce the severity—is oral rehydration therapy and, here in the United States, IV [intravenous] therapy.
Bringing individuals in for hydration has reduced at least the severity of illness, and it's been effective. There's vaccines in the pipeline for norovirus, so hopefully those will come and be approved soon to help reduce the burden of illness due to norovirus.