Rotavirus infection

Rotaviruses are a common cause of viral gastroenteritis in infants and young children and are transmitted via the 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 through antigen detection in stool. Treatment is supportive and mainly involves replacing fluids, although infection may be prevented altogether by vaccination.

• A major cause of severe diarrhea in infants and children in the US (especially during the winter) ^[1]
• Leading cause of severe diarrhea among infants and children worldwide, although all age groups are susceptible to infection.
• Most commonly occurs in daycare centers and kindergartens

References:^[2][3][4]

Epidemiological data refers to the US, unless otherwise specified.

• Pathogen: Rotavirus is a nonenveloped, segmented, double-stranded RNA reovirus.
• Transmission: fecal-oral route (e.g., by contact with hands, objects, food, water contaminated with the virus)

References:^[5][6]

• Mucosal damage and villous atrophy in the gastrointestinal tract impair absorption of sodium and loss of potassium → nonbloody, watery diarrhea

• Incubation period: 1–3 days
• Fever, malaise
• Abdominal pain
• Vomiting and watery diarrhea
  • Can be severe: > 10 loose, watery stools within 24 hours
  • Usually lasts 3–7 days
• Mild to severe dehydration: See clinical signs of significant dehydration.

References:^[3]

• Antigen detection in stool via enzyme immunoassay (EIA): a highly sensitive test that can be performed quickly and easily

References:^[7]

• Norovirus infection
• Bacterial gastroenteritis
• Food poisoning

The differential diagnoses listed here are not exhaustive.

• Supportive
  • Oral rehydration
  • IV fluids in patients with severe dehydration

References:^[8]

• Vaccination
  • Rotavirus vaccination (a live attenuated vaccine) is recommended for all infants unless there is a contraindication. Contraindications include:
    • Infants with severe combined immunodeficiency (SCID)
    • Infants with a history of intussusception: rotavirus vaccine is associated with intussusception
    • Individuals with a history of severe allergic reaction after exposure to a previous rotavirus vaccine or to any of its components
  • Immunization schedule
    • Dose 1: 2 months of age
    • Dose 2: 4 months of age
    • Dose 3: 6 months of age (if required)

References:^[9][10][11]