Rotavirus

Definition
Rotavirus is part of a group of viruses that belongs to the Reoviridae family. In the United States, these viruses are the leading cause of infectious diarrhea and viral gastroenteritis (inflammation of the stomach and intestinal tract). In children, it's the most common cause of severe diarrhea.

Causes/associated factors
Rotavirus infections are so common that most people experience a rotavirus infection by age 2 or 3, but the virus can affect people of any age. These infections are most common from November through April. It's possible to be reinfected with the rotavirus, but later infections are often milder or have no symptoms at all.

Transmission
Rotavirus is present in an infected person's stool before symptoms appear and up to 10 days after. However, if you have a weak immune system (from HIV, cancer or steroid use, for example), the virus may remain in your stool for 30 days or longer. If you or your child has rotavirus and you don't wash your hands after using the toilet or changing your child's diaper, the bacteria can spread easily to anything you touch, including food, toys and utensils. If someone touches your unwashed hand or an object contaminated with infected stool and then puts their hands into their mouth, he or she may contract the infection. It's also possible for rotavirus to spread through infected respiratory droplets coughed or sneezed into the air.
The incubation period (time from exposure until symptoms appear) is one to three days.


Signs/symptoms
Symptoms often start with vomiting and a low-grade fever, followed by five to eight days of watery diarrhea. Severe symptoms develop more often in premature infants, children age 3 months to 2 years, those who have weak immune systems and the elderly. For otherwise healthy adults, rotavirus may cause no symptoms.

Diagnosis
If you think you or your child has been exposed to rotavirus, contact your doctor as needed about the symptoms. The doctor will ask questions about medical history and possible exposure to the virus, as well as do a physical exam. A stool sample may be used to help the doctor confirm the diagnosis.

Treatment
There is no antiviral medication for rotavirus. Instead, any treatment is aimed at preventing complications and making you comfortable. It's essential to prevent dehydration by replacing the fluids and electrolytes that are being lost through diarrhea. This can often be done orally at home, but in severe cases intravenous (IV) fluids and possibly hospitalization may be necessary. Ask your doctor about appropriate fluids to use for oral rehydration. If you have small children, the Centers for Disease Control and Prevention (CDC) recommends keeping oral rehydration solution at home at all times in case your child develops diarrhea.

Complications
Dehydration is possible if the fluid lost due to diarrhea isn't replaced, especially for children ages 3 months to 15 months. Contact your doctor right away if you notice any of the following symptoms in yourself or your child:
severe diarrhea
inability to take in fluids
decreased urination (fewer wet diapers or trips to the bathroom)
no tears when crying
dry mouth, no drooling
extreme thirst
sunken eyes or soft spot
sleepiness, weakness, listlessness
fussiness

Pregnancy-specific information
Rotavirus infection is not generally considered a pregnancy-related condition. However, it's best to avoid contact with anyone who is actively ill while you're pregnant.

Senior-specific information
Outbreaks of rotavirus diarrhea are common in nursing homes. Older adults with chronic health conditions or weak immune systems are especially vulnerable to the infection. If you have any of the symptoms described above, call your doctor right away. If you have a weak immune system, you may want to avoid changing an ill baby's diapers.

Prevention
Rotavirus survives for long periods of time on hard surfaces, in contaminated water and on hands. Even strict hand washing may not always prevent transmission. The virus can be inactivated by chlorine, but it's resistant to many common disinfectants.
Here are some other prevention tips from the CDC:

Keep any child or adult with diarrhea out of child care settings until the diarrhea has resolved.
Infants, young children, elderly persons and those with weak immune systems should avoid exposure to anyone with acute symptoms of vomiting and/or diarrhea.
Wash your hands before eating and after using the toilet, changing a diaper, or helping a child in the bathroom.
Make sure your child understands the importance of proper hand washing.
Dry your hands with disposable paper towels.
In child care settings, disinfect toys, bathrooms, diaper changing stations and surfaces where food is prepared every day.
Immunization
The CDC has indefinitely suspended the use of the rotavirus vaccine for infants due to the discovery of a small but real risk of intussusception (a form of bowel obstruction requiring either radiology or surgery to repair). Children who received the vaccine while it was still recommended are no longer at an increased risk of developing intussusception. Research continues to develop a safe, effective rotavirus vaccine.