- Clinical science
Rotavirus infection (Rotavirus gastroenteritis)
Abstract
Rotaviruses are a frequent cause of viral gastroenteritis in infants and young children that are transmitted via a fecal-oral route. After a short incubation period of one to three days, patients present with vomiting, watery diarrhea, high-grade fever, and malaise. Diagnosis is established via antigen detection in stool. Treatment is supportive and mainly involves replacing fluids, although infection may be prevented altogether following vaccination.
Epidemiology
- Infants and young children are most often affected, although all age groups are susceptible to infection.
- A leading cause of severe (> 10 loose, watery stools within 24 hours) diarrhea in infants and children
- Rotavirus infections are a major cause of death among children in developing countries
- Before the introduction of the rotavirus vaccine in the US, rotavirus annually caused
- > 400,000 physician visits
- > 200,000 emergency department visits
- 55,000–70,000 hospitalizations
- 20–60 deaths
References:[1][2]
Epidemiological data refers to the US, unless otherwise specified.
Etiology
Clinical features
Diagnostics
- Antigen detection in stool via enzyme immunoassay (EIA): a highly sensitive test that can be performed quickly and easily
- Direct virus detection via electron microscopy is done only for research purposes.
References:[5]
Differential diagnoses
The differential diagnoses listed here are not exhaustive.
Treatment
-
Supportive
- Oral rehydration
- IV fluids in cases of severe dehydration
References:[6]
Prevention
-
Vaccination
-
Rotavirus vaccination (a live attenuated vaccine) is recommended unless there is a contraindication. These may include:
- A history of severe allergic reaction after exposure to a previous rotavirus vaccine or to any of its components
- Infants with severe combined immunodeficiency (SCID)
- Infants with a history of intussusception
-
Vaccination schedule
- Dose 1: at 2 months of age
- Dose 2: at 4 months of age
- Dose 3: at 6 months of age (if required)
-
Rotavirus vaccination (a live attenuated vaccine) is recommended unless there is a contraindication. These may include:
References:[7][8][9]