<unk> es are highly contagious and cannot be treated with antibiotics or other drugs. Because improved sanitation does not decrease the prevalence of rotaviral disease, and the rate of hospitalisations remains high despite the use of oral rehydrating medicines, the primary public health intervention is vaccination. In 1998, a<unk>  vaccine was licensed for use in the United States. Clinical trials in the United States, Finland, and Venezuela had found it to be 80 to 100% effective at preventing severe diarrhoea caused by<unk>  A, and researchers had detected no statistically significant serious adverse effects. The manufacturer, however, withdrew it from the market in 1999, after it was discovered that the vaccine may have contributed to an increased risk for intussusception, a type of bowel obstruction, in one of every 12,000 vaccinated infants. The experience provoked intense debate about the relative risks and benefits of a<unk>  vaccine. In 2006, two new vaccines against infection were shown to be safe and effective in children, and in 2009, the WHO recommended that<unk>  vaccine be included in all national immunisation programmes. The incidence and severity of<unk>  infections has declined significantly in countries that have acted on this recommendation. A 2014 review of available clinical trial data from countries routinely using<unk>  vaccines in their national immunisation programs found that<unk>  vaccines have reduced<unk>  hospitalisations by 49–92 percent and all cause diarrhoea hospitalisations by 17–55 percent. In Mexico, which in 2006 was among the first countries in the world to introduce<unk>  vaccine, diarrhoeal disease death rates dropped during the 2009<unk>  season by more than 65 percent among children age two and under. In Nicaragua, which in 2006 became the first developing country to introduce a<unk>  vaccine, severe<unk>  infections were reduced by 40 percent and emergency room visits by a half. In the United States,<unk>  vaccination since 2006 has led to drops in<unk> -related hospitalisations by as much as 86 percent. The vaccines may also have prevented illness in non-vaccinated children by limiting the number of circulating infections. In developing countries in Africa and Asia, where the majority of<unk>  deaths occur, a large number of safety and efficacy trials as well as recent post-introduction impact and effectiveness studies of Rotarix and RotaTeq have found that vaccines dramatically reduced severe disease among infants. In September 2013, the vaccine was offered to all children in the UK, aged between two and three months, and it is expected to halve the cases of severe infection and reduce the number of children admitted to hospital because of the infection by 70 percent. In Europe, hospitalisation rates following infection by<unk> es have decreased by 65% to 84% following the introduction of the vaccine. Globally, vaccination has reduced hospital admissions and emergency department visits by a median of 67%.<unk>  vaccines are licensed in over 100 countries, and more than 80 countries have introduced routine<unk>  vaccination, almost half with the support of the GAVI vaccine alliance. To make<unk>  vaccines available, accessible, and affordable in all countries—particularly low- and middle-income countries in Africa and Asia where the majority of<unk>  deaths occur, PATH (formerly Program for Appropriate Technology in Health), the WHO, the U.S. Centers for Disease Control and Prevention, and GAVI have partnered with research institutions and governments to generate and disseminate evidence, lower prices, and accelerate introduction. The vaccine may prevent type 1 diabetes.
Rotavirus
Norovirus
Campylobacter jejuni
Yersinia enterocolitica
Salmonella
Giardia
Enterotoxigenic Escherichia coli
Shigella