Rotavirus
Rotavirus is a highly contagious virus that primarily affects the gastrointestinal system, leading to viral gastroenteritis, particularly in children. Characterized by a wheel-like appearance under an electron microscope, the virus is transmitted through contaminated food or water, as well as fecal-oral contamination and contact with infected surfaces. Symptoms typically include severe watery diarrhea, vomiting, nausea, and fever, lasting from three to ten days. Dehydration is a significant concern, especially in young children, and may manifest through signs like dry mouth and sunken eyes.
While rotavirus infections are more common in cooler months in temperate climates, they can occur year-round in tropical regions. Although children usually experience more severe symptoms, adults can also contract the virus but with milder effects. Prevention strategies focus on good hygiene practices, such as handwashing and disinfection of surfaces. A vaccine to protect against rotavirus was approved in 2006 and is recommended by the World Health Organization as part of routine immunization, yet access to the vaccine remains limited in some regions. Understanding these aspects of rotavirus is crucial for awareness and prevention efforts globally.
Rotavirus
ALSO KNOWN AS: Sporadic or severe viral gastroenteritis, rotaviral enteritis, infantile diarrhea, winter diarrhea
ANATOMY OR SYSTEM AFFECTED: Gastrointestinal system
DEFINITION: A virus with a characteristic wheel-like appearance when viewed under an electronic microscope that causes viral gastroenteritis in children worldwide
CAUSES: Viral infection transmitted through contaminated food or water, fecal-oral contamination, or contact with contaminated surface
SYMPTOMS: Severe watery diarrhea, vomiting, nausea, fever
DURATION: Three to ten days
TREATMENTS: Fluids to prevent dehydration, prevention through handwashing and disinfection of surfaces
Causes and Symptoms
Rotavirus is classified into groups A through G, with group A responsible for gastroenteritis in children. Adults can also contract the virus but will experience milder symptoms. The virus is very contagious, with oral-fecal occurring through ingestion of contaminated water or food or contact with an infected surface such as a toy or hand. Airborne infection is rare. In temperate climates, the disease occurs more often in the cooler months, from late autumn to early spring, with year-round infection present in tropical climates. Almost all children have been infected more than once by the time they are four years old.
Symptoms are manifested after two days from the initial exposure and include severe watery diarrhea, vomiting, nausea, and fever, with the lasting from three to ten days. Dehydration may result if fluids are not adequately replenished. Symptoms of severe dehydration include dry mouth, dry skin, sunken eyes, no tears when crying, lethargy, irritability, and reduced or no wet diapers over three hours. A physician should be notified if symptoms of severe dehydration are observed. Because the virus is highly contagious, outbreaks may be seen in childcare centers.
Treatment and Therapy
Clinical diagnosis is made from detection of the virus in a sample. Detection of rotavirus is also possible with an electron microscope or tissue culture. Treatment involves drinking plenty of fluids to prevent dehydration. Antidiarrheal medication should not be given to children unless prescribed by a doctor. Hospitalization may be required for intravenous (IV) rehydration if severe dehydration occurs. Immunity develops after repeat infections, with subsequent infections exhibiting less severe symptoms. The virus may survive on hard surfaces for years. Diligent hand washing and disinfection of surfaces with a diluted bleach solution or 70 percent may help slow the spread of the virus.
Perspective and Prospects
Rotavirus was discovered in 1973 from intestinal biopsies of children diagnosed with winter disease. The name is derived from the Latin word rota, which means “wheel.” In February, 2006, the US Food and Drug Administration (FDA) approved a live, oral for use in children. In 2018, the World Health Organization, which estimates that rotavirus kills about 527,000 people annually, recommended that the vaccine be made a routine part of national immunization programs around the world. Despite this, children in some countries do not have access to the vaccination.
Bibliography
Aronson, Susan S., and Timothy R. Shope, eds. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide. Elk Grove Village, Ill.: American Academy of Pediatrics, 2005.
Kohnle, Diana. "Rotavirus." Health Library, February 20, 2013.
“Rotavirus.” Centers for Disease Control and Prevention, October 28, 2010.
“Rotavirus.” Mayo Clinic, 28 Apr. 2021, www.mayoclinic.org/diseases-conditions/rotavirus/symptoms-causes/syc-20351300. Accessed 8 Aug. 2023.
“Rotavirus.” World Health Organization, 16 July 2021, www.who.int/teams/immunization-vaccines-and-biologicals/diseases/rotavirus. Accessed 8 Apr. 2024.
"Rotavirus Vaccine Live (oral route)." Mayo Clinic, 1 Apr. 2024, www.mayoclinic.org/drugs-supplements/rotavirus-vaccine-live-oral-route/description/drg-20071625. Accessed 8 Apr. 2024.
Heymann, David L., ed. Control of Communicable Diseases Manual. 19th ed. Washington, D.C.: American Public Health Association, 2008.
Matson, David O. “Rotaviruses.” In Principles and Practice of Pediatric Infectious Diseases, edited by Sarah S. Long, Larry K. Pickering, and Charles G. Prober. 3d ed. Philadelphia: Churchill Livingstone/Elsevier, 2008.