What is rotavirus?
Rotavirus is classified in the Reoviridae family and is one of several viruses known to affect the intestinal tract causing gastroenteritis and diarrhoea.
Symptoms can include severe diarrhoea, fever, vomiting and dehydration. Rotavirus is often the most common cause of diarrhoea in babies and young children worldwide. It has been noted that almost all children under the age of 5 will likely have at least one rotavirus infection.
Although an unpleasant infection, symptoms can be easily treated at home. If symptoms are not properly treated, death is not uncommon due to severe dehydration, particularly in developing countries.
It is very important to treat rotavirus with extra fluids to prevent dehydration in the body. On occasion, dehydration may require intravenous fluids in hospital.
Infections are most easily spread between young children, and sometimes adults. Once an infection occurs it can take up to 2 days before a person begins to feel unwell. Vomiting and diarrhoea may last between 3 and 8 days.
Vaccination against the virus can help prevent infections, particularly in infants. The best means of prevention for older children and adults is frequent hand-washing.
What to expect
Common signs and symptoms of an infection are:
- Severe watery diarrhoea
- Abdominal pain and discomfort
- Loss of appetite
- Loss of bodily fluids (dehydration)
Vomiting is often the first symptom, followed by diarrhoea and a fever. The combination of vomiting and diarrhoea is what brings on dehydration in the body.
Signs of dehydration include a decrease in urination, a dry mouth and throat, as well as dizziness (particularly when standing up). A dehydrated child or baby may also cry with few or no tears, and become unusually fussy or even sleepy. Babies and very young children with rotavirus infections do need to be monitored closely. Dehydration can occur quickly and if the body loses more water than is replaced, severe health problems can arise.
Although children can be vaccinated against the virus, they may still become unwell (and more than once too) due to the possibility of different viral strains developing in the future. Thus, current vaccinations may not provide full protection from future infections, but the likelihood of contracting the virus is reduced and any symptoms experienced are milder. Adults infected with rotavirus tend to experience less severe symptoms as well.
Factors to consider
Causes of rotavirus
Hygiene is key with any rotavirus infection. The virus is easily spread through hand-to-mouth contact once an infection is present. Rotavirus is present in an infected person’s stool a few days before they begin to experience common symptoms, and remains for up to ten days after symptoms clear up.
How is rotavirus transmitted? The virus can spread through anything an infected person touches. Hand-washing, particularly after using the toilet, helping another to use the toilet, or changing a baby’s nappy (diaper) is very important. If hand-washing is insufficient and any contaminated object is touched, and a person then touches their own mouth, the infection is spread. The virus can remain infectious on contaminated surfaces for weeks if not disinfected properly.
It is possible to be infected with rotavirus more than once in your lifetime because there are several types of viruses, even if you have been vaccinated before. Typically, any repeat infections will be less severe.
Risk factors and complications
Rotavirus infections can occur in anyone, but are most common in young children, particularly between the ages of 3 to 35 months. Children, and adults alike, who spend time in child care facilities (nursery school, crèche or play school) are often most at risk of infection.
Dehydration is the biggest red flag for serious complications, especially in youngsters. If insufficiently treated, dehydration can become life-threatening, regardless of its cause.
Treatment Procedures – Remedies and Relief
When should you see a doctor?
Due to the nature of symptoms experienced, it is more than likely that your primary healthcare provider will be your first port of call. From there, if he or she suspects it may be necessary, you or your child may be referred to a gastroenterologist or infectious disease specialist.
In the case of a baby or young child, signs you should see your doctor are:
- Diarrhoea for more than 24 hours
- Frequent episodes of vomiting
- Stool that is black or tarry, and or / contains any blood or pus
- A high temperature or fever (higher than [celcius:38-40])
- Signs of pain
- Lethargy (unusual sleepiness) or irritability
- Signs of dehydration (dry mouth, crying without the presence of tears, little or no urination, or unresponsiveness)
Adults should consult their physician when:
- Unable to keep fluids down for at least 24 hours
- Experiencing diarrhoea for more than 2 days (24 – 48 hours)
- There is the presence of blood in stools (bowel movements) or vomit
- Experiencing a high temperature or fever (higher than [celcius:38-40])
- Experiencing signs of dehydration, excessive thirst, severe weakness, or light-headedness and dizziness, especially when standing.
Diagnosis and tests
A diagnosis is generally made following an assessment of symptoms (this includes a physical examination) experienced in person during a consultation. In some instances, a stool sample may be requested for analysis to confirm a diagnosis.
Testing of stool (faeces) will only be necessary if your physician needs to confirm, or rule out, any other causes of your overall symptoms. Bowel movements can provide your doctor with valuable insight and information as to what may be happening in the stomach, intestines or other part of the gastrointestinal system.
Other conditions your physician may want to check include:
- An allergy (such as a milk protein allergy) or other inflammation in the body.
- Other types of bacterial or viral infections. In some instances, an infection is caused by a parasite.
- Other digestion problems such as the malabsorption of certain sugars, fats or nutrients.
- Bleeding inside the gastrointestinal tract.
During the consultation, your physician may ask the following:
- How long ago did symptoms begin?
- Have the symptoms been continuous, or do they come and go?
- Are the symptoms experienced mild or severe?
- Have you tried to treat any of the symptoms? And if so, has any means of treatment appeared to improve or worsen symptoms?
Treatments and homecare
If you or your child has been diagnosed with rotavirus, he or she isn’t likely to prescribe a specific medicine to treat an infection. He or she will, however, recommend medicines to help alleviate or treat specific symptoms.
Antiviral or antibiotics may not be necessary. Antibiotics are only helpful when treating bacterial infections, not viruses. Anti-diarrhoeal medications aren’t usually recommended for a rotavirus infection either, but probiotics (bacteria that can help maintain the natural balance of organisms or microflora in the intestinal tract) may be recommended for a young child.
The most effective way to treat, and protect against further dehydration, is to drink plenty of fluids. In most instances a rotavirus infection will run its course and clear within 3 to 8 days.
In the case of mild dehydration, over-the-counter oral rehydration solutions can help replenish the body. Rehydration fluids often replace lost minerals more effectively than plain water or other liquids.
Before giving a young child any rehydration solution, check with your doctor or pharmacist first. Sometimes over-the-counter solutions do not have the proper balance of nutrients and electrolytes for small children.
In more severe cases of dehydration, hospitalisation may be necessary for treatment with intravenous (IV) fluids.
In the case of babies and small children, it is important to not only alleviate or prevent dehydration, but also keep them as comfortable as possible. Comfortably-fitted clothing and frequently changing nappies (diapers) or underpants as needed will help to prevent other problems such as nappy rash.
It is recommended that along with drinking plenty of fluids, you consume (or feed your child) bland foods such as crackers and toast. This will help to alleviate any stress on an already sensitive digestive system. It is best to avoid foods or liquids which aggravate symptoms of diarrhoea such as apple juice, dairy products, caffeine, alcohol or highly seasoned and sugary foods. Nicotine will also aggravate symptoms.
Sucking on ice chips and small sips of water or clear drinks (such as ginger ale or broths) can help alleviate dehydration symptoms.
Moms who are breastfeeding or giving their child formula should be able to continue normally by offering small amounts of liquid at a time. It is not recommended to dilute your baby’s formula, but it can help to offer a small amount of oral rehydration (approved by your medical health professional) to help replenish the body.
A follow-up with your primary physician (or specialist if you or your child has been referred to one) may be recommended to ensure improvement of the symptoms experienced. If an infection results in severe dehydration, and a person or child cannot tolerate oral liquids (can’t keep anything down) or has been admitted to hospital for treatment, a medical professional may request a follow-up.
Hygiene and healthy sanitation habits are important to help reduce the risk of frequent rotavirus infections. Strict hand-washing, however, doesn’t offer any guarantees of prevention altogether. It can only significantly minimise the risk.
Vaccines can also help minimise risk. There are two known vaccines against the rotavirus:
- RotaTeq: This vaccine is usually given orally in 3 doses to babies and small children. The vaccine is safe to be given at the ages of 2 months, 4 months and 6 months.
- Rotarix: This liquid vaccine is given in two doses to infants between the ages of 2 and 4 months.
How long does rotavirus last?
Most will develop symptoms within 48 hours of an infection. Symptoms can last between 3 and 8 days. High concentrations of the virus, however, can remain in the stool for between 10 and 12 days after symptoms begin.
Is rotavirus just a kids’ illness?
No, adults can get infected with rotavirus too, in much the same way as children. Adults, however, tend to experience milder symptoms.
Infants and young children between the ages of 6 and 24 months are at a greater risk of more severe rotavirus infections. Babies and young children can easily become dehydrated and severely so. Severe dehydration can be life-threatening.
There’s no reliable way to predict how an infection will affect your little one, and so it is important to monitor and treat symptoms carefully.
If in any doubt, consult your physician or medical professional as soon as possible.
Why is dehydration serious for babies and small children?
Rapid loss of fluids accompanied by vomiting and diarrhoea can lead to either a mild or severe case of dehydration. Thus, the body loses valuable nutrients and salts (electrolytes) that it needs.
This is particularly dangerous for babies under 1 year of age due to their small body weights, and even more so if there are symptoms of fever too. If severe dehydration occurs, rehydration using intravenous fluids (IV) in hospital may be necessary.
Shock or convulsions are common complications with severe dehydration symptoms and can be life-threatening if not adequately treated.
Can I keep my child from being exposed to rotavirus?
Rotavirus is widespread and as such, is difficult to prevent altogether. Better hygiene and sanitation helps, but cannot prevent even a vaccinated person, from becoming infected and falling ill.
Infections can occur in even the cleanest of environments and can happen to a person more than once during their lifetime.
Recurring infections, however, do tend to be less severe. Vaccinations and good hygiene practices are your best odds of reducing the likelihood of infections.