Rotavirus - Information for Clinicians
Type of infection
Rotavirus is a double-stranded RNA virus that looks like a wheel under an electron microscope. Viral diversity leads to some infection in vaccinated children.
Sources of infection
- More common in infants and young children but can cause symptoms in adults, which are usually mild.
- Virus is spread person-to-person by contact with stool from an infected person.
- Nosocomial outbreaks can occur.
- Primarily a winter time disease.
Usual symptoms
- Illness usually begins 24-72 (mean 48) hours after exposure.
- Vomiting, watery diarrhea, fever (which may be high).
- Respiratory symptoms reported in up to 30-50% of children.
Duration of illness
- Typically 3-8 days.
Treatment
- Fluid replacement and correction of electrolyte abnormalities often required. Antiemetics may be helpful.
- Antibiotics do not help and may make diarrhea worse.
Complications
- Dehydration is the major complication and can be severe. Electrolyte abnormalities are common.
- High fever, seizures, and encephalopathy can occur. Mild CSF pleocytosis can occur.
- Intussusception is a rare complication.
- Protracted and severe disease in immunocompromised patients.
Comments
- Household transmission up to 50% of susceptible children and 15-30% of adults.
- Rotavirus assays can be positive in children who have received rotavirus vaccine. 0-80% of children test positive 7 days after dose 1, but <20% test positive 7 days after dose 2.
- Virus can be detected in stool up to 2 weeks after illness resolves.
- Vaccine does not provide complete protection from illness but provides high level protection against severe disease and hospitalization.