What is rotavirus?
Rotavirus is a virus that causes diarrhea among persons in all
age groups, but is most common among children between 6 months
and 2 years old. Infants less than 3 months old rarely develop
diarrhea from rotavirus infection. Since rotavirus infection
is not a reportable disease in Wisconsin, the specific incidence
is unknown.
What are the symptoms of rotavirus infection?
Symptoms of rotavirus infection include watery diarrhea, usually
preceded or accompanied by vomiting and a low-grade fever. Severe
dehydration may occur in young children. Symptoms typically
last from 4-6 days.
How soon do symptoms appear?
The symptoms appear 1-3 days after a person is infected with
rotavirus.
What is the treatment for rotavirus infections?
No specific treatment for rotavirus infection is available.
Oral rehydration or intravenous fluids may be needed for severe
cases. Antibiotics and antimotility drugs such as Lomotilâ
or Imodiumâ , used to control diarrhea should not be used.
How are rotavirus infections spread?
The virus is spread through the ingestion of water or food contaminated
with feces from an infected person. Inanimate objects such as
toys and other surfaces contaminated with feces from an infected
person have also been identified as a mechanism for spreading
the virus. The virus can occasionally be spread in discharges
from the nose or throat.
For how long is an infected person able
to spread rotavirus?
Individuals with rotavirus infection may shed the virus in the
stool for as long as 10 days after the onset of symptoms.
How can rotavirus infection be prevented?
Strict adherence to good hand washing techniques and the proper
disposal of contaminated wastes (including diapers) are effective
in preventing the spread of the disease. Environmental surfaces
contaminated with rotavirus should be cleaned with soap and
water and disinfected with a bleach solution. Disinfectants
other than bleach are not effective against rotavirus. Children
with diarrhea should not attend day care until the diarrhea
has stopped.
Does past infection make a person immune?
By age three most individuals have acquired some immunity to
rotavirus-associated disease. Although reinfection with rotavirus
may occur, the infected person usually does not develop symptoms.
Rotavirus
(click the CDC icon for the whole
document)
Umesh D. Parashar, Joseph S. Bresee, Jon R. Gentsch, and Roger
I. Glass
Centers for Disease Control and Prevention, Atlanta, Georgia,
USA
In 1973, Bishop and colleagues observed by electron microscopy,
in the duodenal epithelium of children with diarrhea, a 70-nm
virus, subsequently designated rotavirus (Latin, rota = wheel)
because of its appearance (Figure 1) (1). Before this discovery,
a bacterial, viral, or parasitic etiologic agent could be detected
in only 10% to 30% of children with diarrhea. Within 5 years,
rotavirus was recognized as the most common cause of diarrhea
in infants and young children worldwide, accounting for approximately
one third of cases of severe diarrhea requiring hospitalization
(2-4). In the United States, approximately 2.7 million children
< 5 years of age are affected by rotavirus diarrhea each
year, resulting in 500,000 physician visits and 50,000 hospitalizations
at an estimated $274 million in medical care and more than $1
billion in societal costs (5,6). The cost of rotavirus diarrhea
is even higher in developing countries, where 20% to 70% of
hospitalizations and 800,000 of the three million deaths per
year from diarrhea are caused by this pathogen (Figure 2) (7,8).
Recognition of rotavirus as a major cause of diarrhea in children
led to extensive research for interventions to reduce the incidence
of this disease.
Figure 2. Estimated global distribution of the
800,000 annual deaths caused by rotavirus diarrhea.
Because rotavirus infects virtually all children £ 3
to 5 years of age in both industrialized and developing countries,
improving water, food, and sanitation appeared unlikely to reduce
disease incidence. Instead, early studies identified epidemiologic
features indicating that rotaviral disease might best be controlled
through vaccination. Natural immunity was suggested by the infrequent
occurrence of more than one episode of rotavirus diarrhea in
a child and decreased incidence of disease with increasing age
(9). Furthermore, protection increased with each new infection
and was greatest against moderate to severe disease, less against
mild illness, and least against asymptomatic infection (10).
These findings implied that an attenuated rotavirus vaccine
that simulates natural infection could induce protective immunity
and that more than one dose of vaccine may be required
