From the Guidelines
Rotavirus is a highly contagious virus that causes severe diarrhea and vomiting, primarily affecting infants and young children worldwide, resulting in approximately half a million deaths each year among children aged <5 years, with >80% of deaths occurring in developing countries 1.
Key Characteristics of Rotavirus Infection
- Rotavirus is the most common cause of severe gastroenteritis in infants and young children worldwide 1.
- The virus spreads through the fecal-oral route, with symptoms typically lasting 3-8 days 2.
- Good hygiene practices, including thorough handwashing and proper diaper disposal, help prevent transmission.
- Rotavirus infection is self-limiting, but complications from dehydration can be serious, especially in young children, the elderly, and immunocompromised individuals.
Prevention and Treatment
- Vaccination is the most effective prevention strategy, with two vaccines currently available: Rotarix (given in two doses at 2 and 4 months) and RotaTeq (given in three doses at 2, 4, and 6 months) 3, 4.
- Treatment focuses on preventing dehydration through oral rehydration solutions like Pedialyte, given in small, frequent amounts.
- In severe cases, intravenous fluids may be necessary.
- Breastfeeding should continue during infection, and regular diet can resume as tolerated.
Epidemiology and Burden of Disease
- Before initiation of the rotavirus vaccination program in the United States in 2006, approximately 80% of U.S. children had rotavirus gastroenteritis by age 5 years 1.
- Each year during the 1990s and early 2000s, rotavirus resulted in approximately 410,000 physician visits, 205,000-272,000 emergency department visits, and 55,000-70,000 hospitalizations among U.S. infants and children, with total annual direct and indirect costs of approximately $1 billion 1, 4.
From the Research
Definition and Characteristics of Rotavirus Infection
- Rotaviruses are genetically highly variable, non-enveloped viruses with a double-stranded, segmented ribonucleic acid genome 5.
- They are a major cause of gastroenteritis worldwide, particularly in children aged less than 5 years, where they are the most frequent agent of severe acute diarrheal illnesses 5, 6.
- Rotavirus infections can lead to severe, dehydrating gastroenteritis, with symptoms including sudden onset of watery diarrhoea, vomiting, and unspecific respiratory symptoms such as cold and sore throat 5, 6.
Transmission and Prevention
- Rotaviruses are transmitted primarily from person-to-person by the faecal-oral route 5.
- Prevention of rotavirus infections involves paying special attention to adequate hygienic rules, and disinfection should be performed using disinfectants with proven activity against rotaviruses 5.
- Two efficient and secure live vaccines against rotaviruses have been approved, although their application is not generally recommended in some countries 5.
- Routine immunization of all infants with rotavirus vaccines is recommended, and has been shown to be effective in reducing severe rotavirus-related hospitalizations and emergency room visits 7.
Treatment and Management
- Treatment of rotavirus diarrhoea is usually symptomatic and comprises a sufficient fluid and electrolyte substitution 5.
- Oral rehydration therapy is the mainstay of treatment, with early feeding of an age-appropriate diet also recommended 8, 9.
- Antiviral therapy is not currently recommended, although some drugs have shown efficacy against rotavirus in vitro and in vivo 5, 9.
- Probiotics have been developed as adjuncts to rehydration therapy, and may play a role in future treatment 7.