and GlaxoSmithKline. Several other indigenously manufactured rotavirus vaccines are in development in India, some of which are in late stages of clinical testing. With an effective, indigenously produced rotavirus vaccine on the near-term horizon, India, which singularly accounts for almost one fifth of the world’s burden of rotavirus deaths in children [2], is poised to have a new tool in the arsenal of interventions to reduced morbidity and mortality from childhood diarrhea. To help assess

the public health value of the vaccine, understanding the current rotavirus disease burden and epidemiology, circulating strains, and economic burden of rotavirus in India is important. This supplement contains papers summarizing the most up-to-date data on these issues. In addition, the supplement addresses areas relevant for post-introduction monitoring of rotavirus vaccine, including potential safety concerns associated with Dabrafenib order other rotavirus vaccines such as intussusception, a condition in which one portion of the bowel telescopes into another causing a blockage. Finally, this supplement contains papers looking at the performance of rotavirus vaccines, both the indigenous and internationally available vaccines, in India and explores strategies to improve vaccine

performance. This BI 2536 manufacturer collection of papers will help provide a complete picture of rotavirus disease in India and the potential for a rotavirus vaccination program, and also set the platform to assess the impact of vaccines post-introduction. Rotavirus persists as a major cause of severe acute diarrhea in Indian children. By 5 years of age, an estimated 1 out of every 344 Indian children will die

from rotavirus diarrhea, 1 in every 23–46 children will be hospitalized for rotavirus diarrhea, and 1 in every 6 to 12 children will have an outpatient visit due to rotavirus diarrhea [3]. This translates into 78,500 deaths, 872,000 hospitalizations, over 3.2 million outpatient visits and 11.37 million diarrhea episodes due to rotavirus in children <5 years of age each year in India [3]. Most previous disease burden estimates have provided figures for mortality and hospitalizations alone, and hence the availability of these updated estimates, which include outpatient visits next and diarrheal episodes managed at home, will provide a tool to better assess the health and economic burden of disease that might be alleviated by rotavirus vaccination. Rotavirus causes a significant proportion of the severe health burden due to diarrhea. Sentinel hospital-based surveillance, often conducted as part of the Indian Rotavirus Surveillance Network, found the proportion of diarrheal hospitalizations among children <5 years of age associated with rotavirus ranging from 26% in Vellore, 35% in Pune, 38–40% in Delhi, 50% Trichy, and 53% in Kolkata [4], [5], [6], [7] and [8] (Fig. 1).