What is Rotavirus Infection

Viral gastroenteritis is an inflammation of the stomach and intestines caused by a viral infection. Rotavirus is the most common virus that causes viral gastroenteritis. It mainly affects the small intestines.

Who gets Rotavirus Infection?

Rotavirus infection is the most common cause of childhood viral gastroenteritis in both developed and developing countries. A significant proportion of illness and death in young children is linked to gastroenteritis, and rotavirus causes about 111 million episodes each year. About 25 million clinic visits are because of rotavirus, which is the reason for approximately 2 million hospital admissions and 352,000-592,000 deaths every year. The majority of rotavirus deaths are in developing countries, where about 82% of rotavirus infections result in death.

In Australia, rotavirus gastroenteritis is the causes almost 50% of paediatric admissions. In numerical terms, this is about 10,000 children in one year. Death because of rotavirus is rare in Australia, even though dehydration still causes death. Indigenous children are at a higher risk and have longer hospital stays. Winter and spring are the seasons with high infection rates.

Predisposing Factors

Rotavirus infection is spread predominantly by exposure to faeces or respiratory secretions.

Predisposing factors include:

* Poor hygiene, including inadequate handwashing.
* Outbreaks occurring in nurseries and primary schools.

Progression

Infection without any symptoms are common, and bottle-fed babies are more likely to show symptoms than breastfed babies. Adults who become infected with the virus usually have mild or no symptoms.

Probable Outcomes

Most infections will resolve spontaneously. Children may become severely ill from dehydration caused by diarrhoea. Occasionally a malabsorption syndrome with lactose intolerance can follow the infection, though this usually resolves spontaneously.

How Will Rotavirus Infection Affect Me?

An affected child may have acute vomiting, fever and diarrhoea. These are common symptoms of gastroenteritis. If there is dehydration, other symptoms of dehydration like low urine output (nappy is not as wet as usual), dry skin with poor elasticity, and other signs will be present. A child who has these symptoms, is not drinking well and has abdominal pain needs medical attention.

Clinical Examination

The physician will look for signs of dehydration like:

* Dry skin with poor elasticity
* Heart palpitations
* Reduced blood circulation
* Low urine output
* Sunken eyes
* Decreased blood pressure

How is Rotavirus Infection Diagnosed?

* Blood test results may reveal dehydration.
* Arterial Blood Gases may yield abnormal results in patients with severe dehydration.

How is Rotavirus Infection treated?

Treatment should be directed at replacing the fluid loss with adequate oral rehydration solution:

* A baby who is currently breastfeeding should continue being fed even when rehydration solution is used to replace lost fluid.
* Do not use undiluted cordial or carbonated drinks to replace fluids.
* If the child is severely ill then the physician will admit the child and give intravenous fluid.
* There are now vaccines available against rotavirus. In Australia, there are two kinds of vaccines. You can consult with your physician regarding the rotavirus vaccines.

Rotavirus Infection References

1. Elliott E. Management of acute gastroenteritis in children. Current Therapeutics. 2001; 42(10): 55-9.
2. Ramig RF. Pathogenesis of intestinal and systemic rotavirus infection. J Virol. 2004; 78(19): 10213-20.
3. Kirkwood CD, Cannan D, Bogdanovic-Sakran N, Bishop RF, Barnes GL. Australian Rotavirus Surveillance Program: Annual report, 2006-07. Communicable Diseases Intelligence Quarterly Report. 2007; 31(4): 375-6.
4. Schultz R. Rotavirus gastroenteritis in the Northern Territory, 1995–2004. Medical Journal of Australia. 2006; 185(7): 354-6.
5. Indumathy AD, Stanley B, Shobhna D, Bellamy RA, Berriman JA. Rotavirus spike structure and polypeptide composition. J Virol. 1991; 65(8): 4334-40.
6. Nelson R. Two vaccines show efficacy against rotavirus. Lancet Infectious Diseases. 2006; 6(2): 77.