From the Guidelines
Rotavirus is a highly contagious virus that causes severe diarrhea and vomiting primarily in infants and young children, with the potential to lead to dehydration, electrolyte imbalance, and even death, as highlighted in the most recent study from 2009 1.
Key Characteristics of Rotavirus Infection
- The virus infects almost all children by age 5 years, but severe, dehydrating gastroenteritis occurs primarily among children aged 3-35 months, as noted in a study from 2006 1.
- The spectrum of rotavirus illness ranges from mild, watery diarrhea of limited duration to severe diarrhea with vomiting and fever that can result in dehydration with shock, electrolyte imbalance, and death, as described in a study from 2009 1.
- The incubation period for rotavirus diarrheal illness is typically less than 48 hours, with symptoms including fever, vomiting, and frequent, watery stools, as reported in a study from 2009 1.
Prevention and Treatment
- Vaccination is the most effective prevention method, with the rotavirus vaccine typically administered orally to infants at 2,4, and sometimes 6 months of age, depending on the specific vaccine brand used, as recommended in a study from 2009 1.
- Treatment focuses on preventing dehydration through oral rehydration solutions like Pedialyte, given in small, frequent amounts, with intravenous fluids necessary in severe cases, as noted in a study from 2007 1.
- Proper handwashing, especially after diaper changes and before food preparation, is crucial for prevention, as the virus spreads through the fecal-oral route, as highlighted in a study from 2009 1.
Clinical Implications
- Rotavirus is particularly dangerous because it can cause rapid dehydration in young children, with symptoms including decreased urination, dry mouth, excessive sleepiness, and sunken eyes or fontanelle (soft spot) in infants, as described in a study from 2009 1.
- The virus damages the cells lining the small intestine, reducing the absorption of water and nutrients, which explains the characteristic watery diarrhea and potential for severe dehydration, as noted in a study from 2009 1.
From the Research
Definition and Cause of Rotavirus Infection
- Rotavirus is the single most important cause of both nosocomially-acquired and severe, dehydrating diarrhea 2, 3.
- It occurs with equal frequency throughout the world, regardless of the level of sanitation 2.
- Fecal-oral transmission is the most likely route of virus spread 3.
Symptoms and Treatment
- Rotavirus gastroenteritis is characterized by fever, vomiting, and diarrhea, with vomiting particularly prominent 3.
- Dehydration is a frequent complication because of the severity of the diarrhea and the associated vomiting 3.
- Treatment of rotavirus disease consists mainly of oral or intravenous rehydration, using World Health Organization-recommended oral rehydration solutions or lactated Ringer's solutions, respectively 4.
- Rehydration and maintenance of proper fluid and electrolyte balance remain the mainstay of treatment 3.
Prevention and Vaccination
- The development of rotavirus candidate vaccines is reviewed, one of which, the tetravalent, rhesus rotavirus-based human reassortant vaccine, was licensed for universal use in the US in 1998 4.
- Universal rotavirus vaccination can effectively control the disease 3.
- New approaches in oral rotavirus vaccines, such as live-attenuated vaccines, virus-like particles, and biodegradable polymer-encapsulated vaccines, are being developed to circumvent the problems associated with existing vaccines 5.
Epidemiology and Burden
- Rotavirus causes 200,000 deaths per year and imposes a serious burden to public health and livestock farming worldwide 6.
- Virtually all children are infected with rotavirus by 3 years of age 3.
- Group A serotype strains G1 through G4 account for more than 90% of rotavirus gastroenteritis in humans, with G1 being the predominant serotype 3.