Rotavirus: Causes, Symptoms, Transmission, Treatment and Prevention

Rotavirus is a highly contagious virus that infects almost all children by the age of 5. Infection with this virus is the most common cause of gastroenteritis in infants and children under 2 years of age.

Viewed under a microscope, the virus has the shape of a wheel, which is where its name comes from ("rota" meaning "wheel" in Latin).

The virus causes inflammation of the stomach and intestines. It can cause severe diarrhea, vomiting, fever, stomach pain, and dehydration in infants, young children, and some adults.

Infections occur most often in winter and spring. Most outbreaks are present in childcare settings, as children are the most susceptible to contracting the virus.

Mode of transmission

It is transmitted via the fecal-oral route, facilitated by improper hand hygiene after using the toilet or changing diapers, but also through the consumption of contaminated food or liquids.

While fecal-oral spread is the most common, rotavirus can also be caught through any type of contact with the bodily fluids of an infected person, such as sneezing or touching door handles or shared toys.

The virus can be transmitted even if the infected person shows no symptoms.

Symptoms

Symptoms tend to be more severe in children. These include fever, vomiting, and watery diarrhea. Symptoms can begin within 2 days of exposure to rotavirus. Symptoms usually last between three and nine days.

Dehydration is the biggest concern in children. This age group is more vulnerable to loss of fluids and electrolytes through vomiting and diarrhea because they have a lower body weight. You will need to carefully monitor your child for signs of dehydration, such as:

• dry mouth
• cool skin
• lack of tears when crying
• reduced frequency of urination
• sunken eyes

Adults may also experience some of the symptoms of rotavirus, such as:

• vomiting
• fatigue
• high fever
• irritability
• dehydration
• abdominal pain

However, many adults have minor symptoms or are asymptomatic.

Diagnosis

Diagnosis is made based on symptoms and a physical examination. Stool samples are required to detect viral antigens.

For certain types of rotavirus, other types of tests are recommended, such as enzyme immunoassay tests or polymerase chain reaction (PCR).

Treatment

There is no specific treatment for rotavirus infection. Gastroenteritis caused by rotavirus is generally a self-limiting disease, and treatment is largely supportive. Initial treatment should focus on identifying and correcting any underlying fluid and electrolyte imbalance.

Undernourished children are particularly at risk of experiencing severe and/or persistent symptoms, and great attention should be paid to encouraging the early resumption of normal nutrition, usually including breastfeeding.

A high intake of fluids (water, soups, broths, natural juices) is recommended to prevent dehydration. Avoid apple juice, as it can worsen diarrhea. It is important that liquids contain salt, as salts are eliminated during diarrhea. Talk to your pediatrician to ensure you have the correct amount of salt and water. In severe cases, your doctor may recommend intravenous administration of additional fluids.

Older children may benefit from anti-diarrheal medication, but only on the advice of a pediatrician. The administration of antibiotics is not recommended as it has no effect in fighting the virus.

Prevention

Rotaviruses are relatively resistant to chemical disinfectants widely used in hospitals. Effective agents include chlorhexidine gluconate and quaternary ammonium compounds with high alcohol content (70%).

Washing hands with plain soap is often ineffective against rotavirus and may even spread the virus over a larger surface area of the hands, so it is recommended to use a waterless hand cleanser, alcohol-based. In rooms where people infected with rotavirus have been present, the use of micro-aeroflora disinfectants and surface disinfectants is recommended.

Rotarix is indicated for the active immunization of infants aged 6 to 24 weeks for the prevention of gastroenteritis caused by rotavirus infection. The vaccine is administered only on medical advice.

The vaccination schedule consists of two doses. The first dose can be given starting at 6 weeks of age. There must be an interval of at least 4 weeks between doses. It is preferable that the vaccination schedule be administered before the age of 16 weeks, but it must be completed by the age of 24 weeks.

Rotarix should never be injected; it is administered orally.

Since there are multiple types of rotavirus, children—vaccinated or unvaccinated—can get sick more than once, as vaccination or having had the disease does not confer complete immunity. It has been observed that those unvaccinated usually present more severe symptoms upon initial contamination.

References
https://www.webmd.com/children/guide/what-is-rotavirus
https://historyofvaccines.org/diseases/rotavirus
https://www.healthychildren.org/English/health-issues/vaccine-preventable-diseases/Pages/Rotavirus.aspx
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7176162/
https://www.medicover.ro/despre-sanatate/infectia-cu-rotavirus-simptome-investigatii-si-tratament,385,n,295
https://www.cdc.gov/rotavirus/vaccination.html
https://www.healthline.com/health/rotavirus
https://www.ema.europa.eu/en/documents/product-information/rotarix-epar-product-information_ro.pdf
https://www.reginamaria.ro/utile/dictionar-de-afectiuni/rotavirus