Stop the Cycle

Diarrheal Disease Solutions


Vaccines are one of the most effective tools we have to protect children from contracting a diarrheal disease. Currently, vaccines have already been developed or are in development for a number of diarrheal diseases, including rotavirus, Enterotoxigenic Escherichia coli (ETEC), and Shigella.


Vaccines produce immunity to disease. Several vaccines that provide protection against diarrheal disease pathogens are available today.

“The best way to protect children from deadly disease is to prevent them from getting it in the first place.”

– Dr. Ruth F. Bishop, member of team that discovered rotavirus
in PATH’s Diarrheal Disease: Solutions to Defeat a Global Killer report

  • Problem: limited access to urgent care

    Diarrhea can be deadly, and children who suffer repeated infections can be left with lasting disabilities. Communities with poor infrastructure or that are particularly susceptible to natural disasters are at heightened risk for outbreaks of diarrheal diseases like cholera and the spread of rotavirus, ETEC, and Shigella.

  • Solution: protect children from infection in the first place

    Vaccines for rotavirus, the most common and deadly cause of severe diarrhea in young children, are available now and are making a significant impact in countries where they have been introduced. Vaccines against ETEC and Shigella, the leading causes of bacterial diarrhea, are in development.

    Vaccines are also available to prevent cholera, a diarrheal disease commonly associated with outbreaks and linked to unsafe water and sanitation-related challenges. And vaccines are under development for other diarrheal diseases like norovirus, paratyphoid, and non-typhoidal Salmonella. (Typhoid vaccines are available, but it should be noted that typhoid is not a diarrheal disease.)

  • Impact: infections prevented, lives saved

    Six pathogens (including rotavirus, ETEC, and Shigella), account for nearly 80 percent of diarrheal infections. Vaccinations against these pathogens could prevent hundreds of millions of deaths and prevent the kinds of repeated diarrheal episodes that keep far too many children from reaching their full potential.

World Immunization Week


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  • Problem: incredibly contagious

    Rotavirus is a highly contagious virus that can cause diarrhea. It is often accompanied by vomiting and fever. If left untreated, it can lead to severe dehydration and death. While nearly every child in the world is at risk regardless of where he or she lives, children in poverty disproportionately die from rotavirus due to lack of access to emergency care.

    Unlike the bacteria and parasites that cause other forms of diarrhea, rotavirus cannot be prevented by improvements in water, hygiene, and sanitation—vaccines provide the best protection against it.

  • Solution: prevent infections, save lives

    In the countries where they are in use, rotavirus vaccines are saving lives and protecting child health. To date, more than 90 countries have introduced rotavirus vaccines into their national immunization program. However, 67 percent of the world’s children—over 90 million infants—still do not have access to them. Uptake in Asia, in particular, remains slow. We must do more to reach these children.

  • Global guidance: rotavirus

    The World Health Organization (WHO) recommends that all countries introduce rotavirus vaccines into their national immunization programs.

    • There are currently two globally available vaccines against rotavirus.
    • India, Vietnam, and China each have nationally licensed vaccines.

    Countries can learn about available vaccines here: ROTA Council: Available Rotavirus Vaccine Products

    And learn about vaccine introduction here: ROTA Council: How to Introduce.

    Get more evidence on the impact of the rotavirus vaccine.

    For qualifying countries, Gavi, the Vaccine Alliance provides rotavirus vaccine introduction support.

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ETEC & Shigella

  • Problem: leading bacterial causes of diarrhea

    ETEC and Shigella are the leading bacterial causes of diarrhea among children under five years. Shigellosis and illness from ETEC usually follow the ingestion of contaminated food or water. Shigella can also be transferred by person-to-person contact. Compounding the problem, inappropriate use of antibiotics for diarrhea strengthens bacterial pathogens. Persistent infections, regardless of the pathogen responsible, lead to long-term consequences.

  • Solution: prevent infections, save lives

    Vaccines against ETEC and Shigella are currently under development. PATH is collaborating with private- and public-sector partners to advance safe, effective, and affordable vaccines against these pathogens.

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  • Problem: can become deadly within hours if left untreated

    Cholera is a rapidly-dehydrating diarrheal disease caused by infection of the intestine with the bacterium Vibrio cholera. It is closely linked with poverty, poor sanitation, and limited access to clean drinking water. An estimated 3-5 million cases and over 100,000 deaths occur each year around the world. Left untreated, symptoms such as diarrhea and vomiting, can cause severe dehydration and lead to shock and death within hours. Diarrhea fluids contain large amounts of the bacteria and in unsanitary conditions, can rapidly spread to others, leading to epidemics. Historically, devastating outbreaks of cholera have resulted in millions of cases and hundreds of thousands of deaths.

  • Solution: prevent infections and contain spread, save lives

    While access to other primary prevention measures such as safe water and sanitation improve globally, cholera vaccination is a complementary prevention and control measure, which can be implemented in the short-to-medium term.

  • Global guidance: cholera

    A stockpile of oral cholera vaccine (OCV), initially created by the World Health Organization in 2013, ensures rapid access to OCVs in outbreak and humanitarian emergency situations, managed by the International Coordinating Group (ICG) and for use in endemic areas, managed by the OCV working group of the Global Task Force on Cholera Control (GTFCC).

    For more information, read the World Health Organization Cholera vaccines position paper or visit

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