Routine use of Ondansetron in Children

I want opinion regarding use of ondansetron in children as antiemetic in ac.gastroenteritis. Because literature indicates its use in drug induced emesis (like anticancer drugs) only. However, one comes across prescriptions (including those of very senior colleagues and medical college faculty) using this drug in vomiting associated with ac GE. Has the safety pattern of ondansetron been approved for such use?
-Dr Sanjeev Aggarwal, Delhi.

Though it is being promoted as a general anti-emetic by pharma companies, to the best of my knowledge, its role is proven in cases of vomiting associated with chemotherapy/radiotherapy/post-surgical/drug-overdosage/metabolic causes only.
-Dr. Puneet Kumar, New Delhi
(from www.iapindia.org/cfforum)

Post exposure MMR
Can MMR vac given during the incubation period of mumps provide protection against clinical mumps? If so within what time(from the point of exposure) should the vac be administered to be protective? Of course the child in question (12 year old female) didn’t receive the vaccine in time.
-Dr Amit K.Sanyal

As far as I know, no vaccine can be protective in incubation period unless it is IgG!
Vaccines take around 2 to 3 weeks to generate response while the incubation period ends in disease within a week.
-Dr Santosh V Kondekar; Mumbai

Yes, and moreover, in case of mumps one can never be sure of “point of exposure” as the case of mumps is infective even in late incubation period !!
(To be precise, it is infective from 3 days before swelling to 7 days after.)
-Dr. Puneet Kumar, New Delhi

Varicella vaccine can be protective if given within 5 days of exposure.
And all of us know that ARV is mostly given post exposure.
-Dr Amit K.Sanyal

To correct myself..
“there are many illnesses where incubation period is prolonged (Rabies,/HIV), more than 2 weeks to 2 months, and in these cases the vaccine induced CMI and antibodies are formed relatively early (or as in varicella absolutely early, within 7 days after immunization), and thus the post exposure prophylaxis is beneficial in these cases.
Thus, the diseases that have short postexposure incubation period, (eg. Mumps,) the PEP has least role to play.
In such cases pharmacological (e.g. in meningococcal) rather than vaccination prophylaxis carries more importance.
-Dr Santosh V Kondekar; Mumbai

I quote from the red book ”Exposed susceptible people are not necessarily protected by postexposure administration of live-virus vaccine. However, a common practice for people exposed to mumps or rubella is to administer vaccine to presumed susceptible people so that permanent immunity will be afforded by immunization if mumps or rubella does not result from the current exposure. Administration of live-virus vaccine is recommended for exposed adults born in the United States in 1957 or after who previously have not had or been immunized against mumps or rubella.”
For varicella: ”Varicella. Susceptible immunocompetent children and household contacts exposed to a person with varicella disease should be given varicella vaccine within 3 days of the appearance of the rash in the index case”
For measles ”Measles. Live-virus measles vaccine given within 72 hours of exposure will provide protection against measles in some cases.”
-Dr. Sanwar Agrawal, Raipur
(from www.iapindia.org/cfforum)