Rotaviruses infect the gastrointestinal tract (stomach and intestines). The name rotavirus comes from the wheel-like look of the virus as seen with an electron microscope. Rotavirus infections are the most common cause of severe diarrhea in babies and young children. In the United States, these infections may be seasonal (winter) but can occur anytime of the year. Almost all children have had a rotavirus infection by age 3. They can get repeated infections with different strains but then can have immunity to rotaviruses. Children 6 to 24 months old have the greatest risk of getting a severe illness. These infections cause many visits to hospitals and health care providers. Rotavirus affects all social and economic groups, in both industrialized and developing countries. In developing countries, however, rotavirus infections cause many childhood deaths.
Rotaviruses are passed in stool of one child to the mouth of another child (fecal-oral route). Not washing hands before eating or after using the toilet can pass the virus. Health care and child-care workers can spread virus if they don’t wash their hands after changing diapers. Touching contaminated surfaces and then touching the mouth area can cause infections. Virus can live for days on hard, dry surfaces and for hours on human hands. The infection is highly contagious.
Risk factors include feeding with formula instead of breast-feeding, low birth weight, attending child-care centers, and having young or inexperienced child-care givers. Children with weak immune systems can have serious infections.
Symptoms depend on age. Newborns have very mild illness or no symptoms. Older babies and toddlers have sudden vomiting and fever, and then watery diarrhea. Symptoms start 1 to 2 days after infection. Vomiting is brief and diarrhea lasts 3 to 7 days. Pain or cramps in the abdomen (belly) may occur. Severe dehydration can develop. Its symptoms include lethargy; cool, dry skin; irritability; no tears when crying; dry or sticky mouth; sunken eyes; and extreme thirst.
Diagnosis is made from symptoms and by finding rotavirus in stool samples.
Infections usually go away without needing specific treatment. Treatment is mainly supportive, giving increased fluid intake and trying to maintain good nutrition during the illness. Special drinks (oral rehydration fluids) can replace body fluids, especially if diarrhea lasts for more than 2 or 3 days. Fruit juices and soft drinks shouldn’t be given; water, diluted formula, diluted clear fruit juices, and clear soups are best. Breastfeeding should continue. Older babies and children should start solid food as soon as possible. Sometimes, children with serious illness need a hospital stay. Immunization against rotavirus provides protection against infections.
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