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Rotavirus Infections

What is rotavirus?

Rotavirus is a contagious virus and, among children, is the leading cause of severe diarrhea. In some infants and children, diarrhea may be so severe that they become dehydrated and may require emergency care or hospitalization.

  • Across the world, rotavirus is thought to be responsible for more than 130 million cases of diarrhea each year in children and infants.
  • As many as 55,000 children are hospitalized each year in the US due to rotavirus infections.
  • Across the world, rotavirus is responsible for the death of as many as 600,000 children each year.
  • The virus peaks during the cooler months of the year starting in the fall and ending in the spring.
  • Most children have been infected with rotavirus by the time they are 2 years old.
  • The majority of children acquire the virus between 3 months and 35 months.
  • A child or adult may become infected with rotavirus more than once, but, usually, the initial case is the most severe and subsequent infections are more mild.

How is rotavirus spread?

Transmission of rotavirus most often occurs through fecal-oral contact. Usually, this occurs from poor hand washing or from ingestion of contaminated food or water. The virus may also be transmitted through the respiratory tract or by other body fluids, but these routes are less common. The virus may live on inanimate surfaces, such as doorknobs, toys, and hard surfaces, for quite some time. For this reason, outbreaks can occur in child care centers and within families who share a household. The hospitalized child will need to be isolated from other children to prevent transmission of the virus.

  • After coming in contact with the virus, it may take up to two days for symptoms to develop.

What are the symptoms of rotavirus?

The symptoms for rotavirus can range from mild to severe. The following are the most common symptoms of rotavirus. However, each child may experience symptoms differently. Symptoms may include.

  • fever, which usually subsides within the first couple of days
  • nausea and vomiting
  • abdominal pain
  • diarrhea (usually watery and frequent; may last between three to eight days)
  • dehydration, which can occur quickly, especially in infants. Symptoms of dehydration may include:
    • lethargy or sleepiness
    • irritability
    • thirst
    • pale color to skin or mottling
    • less elasticity in the skin
    • eyes appear deeply sunken
    • baby's fontanelle (or soft spot) may feel sunken
    • decreased or absent tears
    • decreased urine output or fewer wet diapers
    • dry mouth

How is rotavirus diagnosed?

In addition to a complete medical history and physical examination, a stool culture may be used to detect the virus.

Treatment for rotavirus:

Specific treatment for rotavirus will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • extent of the disease
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

There is no cure for rotavirus, so treatment of the disease is supportive (aimed at treating the symptoms present). Treatment may include:

  • oral re-hydration with water, formula, breast milk and/or special electrolyte-containing fluids (fluids containing sugars and salts) such as Pedialyte® (very young children should NOT be re-hydrated with soda, juices, or sports drinks)
  • continue feeding your child solid foods (if he/she is able to tolerate it)

About one out of every 40 children may develop severe enough dehydration to require hospitalization. In these children treatment may include:

  • intravenous (IV) fluids
  • nasogastric (NG) tube feedings - a small tube may be place into your child's stomach through his or her nose so that formula or fluids may be administered.
  • blood work (to measure your child's electrolyte levels: sugar, salt, and other chemicals in the blood).

How can rotavirus be prevented?

The following will help to prevent the spread of the rotavirus:

  • proper hygiene and hand washing technique
  • cleaning hard surfaces, toys, and doorknobs
  • proper handling and disposal of dirty diapers, even after your child no longer has symptoms

If your child develops rotavirus, he/she may not be able to attend daycare or school while he/she is ill. If your child is hospitalized, he/she will be isolated from other children to prevent an outbreak in the hospital.

A rotavirus vaccine that was approved by the US Food and Drug Administration (FDA) in 1998 was pulled from the market in 1999 because of an association between the vaccine and an increased risk for intussusception in infants aged one year or younger. However, no direct link was established to the vaccine as a cause of intussusception.

A new rotavirus vaccine was approved by the FDA in 2006. The risk for intussusception with the new vaccine was evaluated in a large clinical trial of over 70,000 children, and no increased risk was found. The manufacturer of the vaccine will continue to closely monitor the vaccine’s safety in additional clinical studies.

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Online Resources of Infectious Diseases

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