The thought of a murderous virus often conjures images of patients suffering from Ebola virus in Africa, SARS in Asia or hantavirus in the U.S. Yet those evildoers have taken far fewer lives than rotavirus, whose name is virtually unknown. This virus infects nearly all children in their first few years of life. It causes vomiting followed by diarrhea. The diarrhea is often so severe that, if left untreated, it can lead to shock from dehydration and then death. Worldwide, rotavirus kills an estimated 610,000 children every year, accounting for about 5 percent of all deaths among those younger than five years. In the U.S., few children perish from the virus, but as many as 70,000 require hospitalization for it annually, and several million suffer quietly at home.

Scientists, though, are now about to break the grip of this devastating disease. In January--some three decades after investigators first identified the pathogen--researchers reported that two rotavirus vaccines had proved successful in massive clinical trials. The process of developing rotavirus vaccines has been more difficult and complicated than anyone imagined, full of setbacks and surprises. But today both the World Health Organization and the Global Alliance for Vaccines and Immunization consider rotavirus vaccine a top priority, and the final battle to get immunizations to the young children who so desperately need them has begun.

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