Rotavirus
What is rotavirus?
Rotavirus is a virus that infects the bowels. It is the most common cause of severe diarrhea among children. It results in the hospitalization of approximately 55,000 children each year in the United States and the death of over 600,000 children worldwide each year. A rotavirus has a characteristic wheel-like appearance when viewed by electron microscopy (the name rotavirus is derived from the Latin rota, meaning "wheel").
What are the symptoms of rotavirus?
The time period from initial infection to symptoms (incubation period) for rotavirus disease is around 2 days. Symptoms of the disease include vomiting and watery diarrhea for 3 to 8 days. Fever and abdominal pain also occur frequently. Immunity from repeated infection is incomplete after a rotavirus infection, but repeated infections tend to be less severe than the original infection.
How is rotavirus transmitted?
The primary mode of transmission of rotavirus is the passage of the virus in stool to the mouth of another child. There also have been cases of low levels of rotavirus in respiratory tract secretions and other body fluids. Because the virus is stable (remains infective) in the environment, transmission can occur through ingestion of contaminated water or food and contact with contaminated surfaces.
In the United States and other countries with a temperate climate, rotavirus infection has a winter seasonal pattern, with annual epidemics occurring from November to April. The highest rates of illness occur among infants and young children. Most children in the United States have been infected by 2 years of age. Adults also can be infected, although the resulting illness tends to be mild.
How is the diagnosis of rotavirus made?
The diagnosis may be made by rapid detection of rotavirus in stool specimens. Strains of rotavirus may be further characterized by enzyme immunoassay or polymerase chain reaction, but such testing is not commonly available or necessary.
How is the disease treated?
There is no specific treatment for rotavirus. For persons with healthy immune systems, rotavirus infection of the bowel (gastroenteritis) is a self-limited illness, lasting for only a few days. The treatment consists of increased fluid intake to prevent dehydration . About one in 40 children with rotavirus infection of the bowel requires hospitalization for intravenous fluid.
How can rotavirus disease be prevented?
In August 1998, the U.S. Food and Drug Administration (FDA) approved a live virus vaccine for use in children at ages 2, 4, and 6 months. However, this recommendation was withdrawn in October 1999 because the vaccine appeared to increase the risk of intussusception (the prolapse or telescoping of a portion of the intestine into the immediately adjacent portion of the intestine). This condition can result in an intestinal obstruction in the first 2 weeks after vaccination. The Wyeth Lederle Vaccines unit of American Home Products Corp. simultaneously withdrew its RotaShield rotavirus vaccine from the market.
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