Rotavirus is a viral infection that causes vomiting and diarrhoea, which can lead to dehydration. In most instances, the infection resolves within a few days; however, it may take longer in some cases. 

What is rotavirus?¹

Rotavirus is a viral infection, the most prevalent cause of gastroenteritis (inflammation of the stomach and intestine) in infants and young children (under 2 years of age), almost all children around the world come into contact with the virus by the time they are 5 years old. It is often believed that rotavirus primarily occurs during the winter months, particularly in more temperate regions of the world.
Rotavirus is a type of RNA virus from the Reoviridae family. It is divided into 7 groups, labelled A to G, with Group A causing over 90% of the cases of viral stomach infections (gastroenteritis) in humans.

What is the cause of rotavirus?²

Rotavirus infection occurs when viral particles are ingested. Once these particles reach the cells of the small intestine, they produce a toxin that can lead to an inflammatory process and absorption disorders, ultimately resulting in the occurrence of diarrheal stools.

It generally takes between 1 to 3 days after first coming into contact with rotavirus for symptoms to appear.

It may persist in bowel movements for up to 10 days after symptoms have resolved.

How is rotavirus spread?

Rotavirus is present in the intestines of an infected individual. It can be excreted in their faeces and is readily transmitted from one infected person to another through close contact.

Rotavirus can be transmitted through contact with the faeces of an infected person in several ways, including:

• Contact with unclean hands that have been in contact with contaminated faeces
• Handling objects that are contaminated with infected faeces, such as toys, toilet seats, or sinks
• Consuming food or water that may be contaminated with infected faeces

Has the potential to spread in households, schools, nursing homes, cruise ships, restaurants, and other venues where individuals stay in groups. 

When water is exposed to the stools of infected individuals, it may become contaminated with a virus. Also, people who swim in contaminated water may be at risk of infection. 

What are the rotavirus symptoms? ^5,6

Fever, diarrhoea, and vomiting are the most commonly observed symptoms. Typically, these symptoms may persist for a duration of up to eight days.

The initial symptoms typically include fever and vomiting, which is subsequently followed by the onset of watery stools, from 8 to 20 stools over 24 hours. 

• Fever is observed in approximately 33-34% of infected patients.
• The severity of the diarrhoea may vary from mild to severe. Vomiting and diarrhoea may lead to dehydration. Mild dehydration is a common condition that is typically easy and quickly addressed by increasing fluid intake. However, severe dehydration can be life-threatening if not promptly treated, as the body's organs require a sufficient amount of fluid to function properly.

Symptoms of dehydration include: intense thirst, dry mucous, reduced frequency of urination, dark colour of urine, tiredness, dizziness or fainting sensation. 

 Symptoms tend to be more severe in patients whose initial infection occurs after the age of 3 months. Infants typically have mild symptoms and are less likely to experience severe infection. 

Gastroenteritis symptoms in adults: changes in mental state such as increased irritability or decreased energy, diarrhoea persisting for more than 2 days, elevated temperature, vomiting and loose stools, severe abdominal pain, and signs of dehydration.

Older adults, pregnant women, and individuals with a weakened immune system or other health conditions should seek medical attention promptly if they experience any symptoms of viral gastroenteritis.

Gastroenteritis symptoms in infants and children: irritability or decreased energy, frequent vomiting, loose stools lasting more than 24 hours, severe abdominal pain, fever in infants, and signs and symptoms of dehydration. Doctor assistance is required if signs or symptoms of viral gastroenteritis are present, particularly if the child was born prematurely or has a history of other medical conditions.

What are the tests used to determine rotavirus infection?

In most instances, physical examinations and medical histories provide sufficient information for the diagnosis, however, tests of stool samples or vomit can confirm the underlying cause. These tests may include 

• PCR (polymerase chain reaction)- detect the virus in the stool
• Immunoassays- detect the virus in the faeces and is less sensitive than PCR
• multiplex gastrointestinal assays- relatively newer tests able to detect up to five  viruses

How is rotavirus infection treated?³

There is no specific medication available for the treatment of rotavirus, and it is anticipated that the symptoms will resolve after approximately one week.

It is very important to ensure that the child remains well-hydrated and does not become dehydrated. Wash hands after changing the child’s clothes, adequate rest, keep the child at home instead of going to school/daycare and provide small portions of food. 

In most cases, hospitalization may be required in instances of severe symptoms or to address any dehydration.

How can we prevent rotavirus infection?⁴

Rotavirus vaccination is the best way to keep your child safe from rotavirus disease. Has been used in many countries and has demonstrated its safety and efficacity. 

Keeping up with personal hygiene like washing hands often and storing food properly before eating can help to control the spread of infections. Wash hands after using the toilet or assisting a child in using the toilet or changing diapers; prior to preparing or handling food or beverages; before consuming a meal.

Summary

Rotavirus is the most prevalent virus responsible for gastroenteritis, especially among the pediatric population, responsible for 35-40% of hospital admissions due to gastroenteritis.

The most common symptoms found particularly in children with Rotavirus are high temperature, vomiting and watery diarrhoea.

The rotavirus vaccine is the most effective method for safeguarding children against rotavirus disease.