From the Guidelines
Astrovirus infections in the stool do not require specific antiviral treatment, and management focuses on supportive care to maintain adequate hydration and relieve symptoms. The primary approach to treating astrovirus infections involves ensuring the patient stays hydrated, either through oral rehydration solutions for mild to moderate cases or intravenous fluids in more severe instances [ 1 ]. Most astrovirus infections are self-limiting, resolving on their own within 2-3 days without the need for specific antiviral medication.
For symptom management, over-the-counter medications such as acetaminophen (Tylenol) can be used to alleviate fever or discomfort, following appropriate age-based dosing guidelines. Additionally, probiotics may help in restoring normal gut flora, although the evidence supporting their effectiveness specifically for astrovirus infections is limited [ 1 ].
It's crucial to note that astrovirus primarily affects vulnerable populations, including children and immunocompromised individuals, leading to gastroenteritis characterized by diarrhea, vomiting, and abdominal pain. Prevention plays a significant role in managing the spread of the virus, which occurs through the fecal-oral route, emphasizing the importance of proper handwashing and hygiene practices [ 1 ].
Key considerations in the management of astrovirus infections include:
- Maintaining hydration through oral rehydration solutions or intravenous fluids
- Using over-the-counter medications for symptom relief, such as acetaminophen for fever or discomfort
- Considering the use of probiotics to restore gut flora, although evidence is limited
- Practicing strict hygiene and handwashing to prevent the spread of the virus
- Seeking medical attention if symptoms are severe, persistent beyond 3-4 days, or accompanied by high fever, bloody stools, or signs of dehydration [ 1 ].
From the Research
Treatment of Astrovirus in Stool
- The standard management of astrovirus infections is restoration of fluid and electrolyte balance and maintenance of hydration until the infection resolves 2.
- Specific antiviral therapy is not recommended for astrovirus infections, as they are usually mild to moderate in severity, self-limiting, and of short duration 2.
- WHO oral rehydration therapy (ORT) is effective in treating astrovirus infections, and hypotonic ORS appears to be safe and effective in all forms of acute diarrhea in childhood 2.
Antiviral Activity Against Astroviruses
- Ribavirin and favipiravir have been shown to have antiviral activity against human astroviruses, with EC50 values of 154 μM and 246 μM, respectively, against astrovirus VA1 3.
- Ribavirin also inhibited HAstV4 replication, but favipiravir only reduced replication by 44% at the highest dose 3.
- The in vivo efficacy of these drugs could be tested with the development of an animal model of human astrovirus infection 3.
Detection of Astroviruses in Stool
- Human stool contains a diverse range of astroviruses, including classic human astrovirus serotypes 1-8, as well as novel astroviruses such as astrovirus MLB1, VA1, VA2, MLB2, and VA3 4.
- Consensus astrovirus primers targeting the RNA polymerase can be used to define the diversity of astroviruses present in pediatric patients with diarrhea 4.
- The detection of astroviruses in stool specimens can help to diagnose and understand the epidemiology of astrovirus infections 5, 4.