Mucosal Vaccination against Enteric Pathogens in the Developing World

Of the approximately 9 million children under the age of 5 yr that die annually in developing nations, about 5.1 million will die from preventable infectious diseases. This disastrous human and economic loss is caused in large part by three types of acute diarrhea and attendant respiratory tract infections that are responsible for approximately 2.6 million of these deaths. Thus, enteric pathogens remain a major factor contributing to persistent poverty and poor health in developing nations. Novel mucosal vaccination strategies are emerging that can protect epithelial surfaces and therefore promise a simple, effective and safe interventional therapy to overcome the mortality generated by these debilitating infectious diseases. Before the full potential for mucosal vaccination against enteric diseases can be realized, the innate immune system must be strengthen by addressing secondary problems such as malnutrition, malabsorption and gastrointestinal tract impairment.
Here we describe the major enteric pathogens responsible for childhood morbidity and mortality in developing and resource-limited countries. We also discuss the development of mucosal vaccination strategies that when combined with modern principles of nutritional therapy may help improve the health and socio-economic status of developing nations.