Rotavirus infection is the major cause of severely dehydrating diarrhea in early childhood.
Rotavirus replicates in the epithelial (lining) cells of the intestine and is a cause of acute gastroenteritis (inflammation of the stomach and intestines) with diarrhea, particularly in infants.
Various strains also infect domestic and wild animals. Human infections tend to peak during the winter months.
Diarrhea is a major cause of illness in children - ages six months to two years. It is one of the most communicable diseases encountered and can be particularly devastating in situations where children congregate repeatedly. Daycare and nursery schools serve as a major reservoir of this condition.
In the U.S., rotaviruses are responsible for about 70,000 hospital admissions each year and over 100 deaths. Although the number of rotavirus-related fatalities in this country is low, the economic effect of rotaviral infections remains significant, due to the considerable amount of time lost from school and work.
Rotavirus and other gastrointestinal viruses spread efficiently via the fecal-oral route. The virus is shed in stool at very high concentrations before clincal illness and days after. Outbreaks are common in daycare centers.
Rotavirus infection typically starts with mild to moderate fever and vomiting, followed by the onset of watery stools. The fever and vomiting usually subside by day 2, but the diarrhea may continue for five to seven days. Dehydration may develop and progress rapidly, especially in infants.
In most cases, diagnosis is made on the basis of clinical findings and most commonly in the winter months. A commercial immunoassay (test) may be used to detect group A rotavirus and enteric adenovirus.
Avoiding dehydration is the main goal. Another goal is maintaining the nutritional status of the patient.
Oral rehydration must include appropriate quantities of sodium and glucose to promote optimum absorption of fluid from the gut (e.g., Pedialyte). Clear liquids, such as flat soda, fruit juice and sports drinks are inappropriate for rehydration of young children with significant stool loss. Intravenous fluids may be required as well.
There is no clear role for drug treatment of viral gastroenteritis. (Antibiotics are used to treat bacterial infections, not viral infections.)
It is important that the child is seen by a physician for evaluation and treatment.
Are there any tests that need to be done to diagnose rotavirus versus some other disease?
What caused this condition?
How serious is the infection?
What are the complications with this disease?
What treatment will you be recommending?
What is RotaShield vaccine? What are the side effects?
The organism is difficult to eradicate by usual disinfectant methods. Disinfectants shown to kill bacteria will often not have an effect on the rotavirus. Hand washing is extremely important in containing spread, and should be practiced diligently.
A new and effective oral vaccine for the prevention of rotaviral gastroenteritis is now available (RotaShield). It is given by mouth to infants at the ages of two, four and six months. It has been shown to be effective in preventing dehydration and hospitalization. Talk with your doctor about whether or not this vaccine is appropriate for your child.