Rotavirus is the most common cause of intestinal infections characterized by vomiting, diarrhea and fever. Rotavirus can infect people of any age, but children under 5 are most vulnerable. Rotavirus is extremely resistant and can survive in the environment for up to 10 days. Rotavirus is usually transmitted through fecal-oral contact, i.e. through contaminated food or water, or through direct contact with an infected person. The World Health Organization states that rotavirus is the leading cause of diarrheal death in children worldwide and is therefore an important public health issue.
What are the causes of this infection?
Rotavirus is the most common cause of diarrhea in children worldwide. Rotavirus causes about 40% of all hospitalizations for diarrhea in children under five. According to statistics, the rotavirus causes about 128,000 deaths. deaths among children under five, especially in developing countries.
Rotavirus is usually transmitted through fecal-oral contact. This can happen through direct contact with an infected person, through food or water contaminated by the feces of infected persons, or through shared objects, surfaces, or premises that may be contaminated with the virus. Rotavirus is extremely resistant and can survive on hard surfaces for up to seven days and on hands for up to six hours. In addition, rotavirus is resistant to many disinfectants and can survive in water or food for a long time.
Infection usually occurs in late autumn, winter and early spring in countries with cold climates, but rotavirus can occur at any time in tropical countries. Rotavirus is universal and there are no geographical areas where it has not been recorded.
How does rotavirus occur?
Rotavirus usually starts suddenly, after an incubation period of 1-3 days. The main symptoms are severe diarrhea, vomiting, fever, abdominal pain, general weakness and malaise.
Diarrhea characteristic of infection is frequent and profuse, usually watery. This can lead to dehydration, especially in young children who cannot replenish lost fluids on their own. Symptoms of dehydration can include dry lips, increased sleepiness or irritability, less frequent urination, sunken eyes and head in babies, and in severe cases, shock and loss of consciousness.
Vomiting is another symptom of rotavirus infection, which often occurs before the onset of diarrhea and can last for 1-2 days. Vomiting can make rehydration difficult and is an important risk factor for dehydration.
Fever is usually mild to moderate, but can be high in some cases. Sometimes there may also be respiratory symptoms such as cough or nasal congestion.
Rotavirus can present with other symptoms such as loss of appetite, nausea, muscle pain, lethargy and fatigue. These symptoms usually go away within a week, but the patient may feel weak for a while.
Rotavirus in adults
Rotavirus most commonly affects young children, but adults can also become infected. In adults, rotavirus is usually mild, and in some cases it may not even cause any symptoms. However, this does not eliminate the possibility of transmitting the infection to others, especially if the person works in healthcare or food production.
Adults with rotavirus have symptoms similar to those seen in children: vomiting, diarrhea, fever, weakness, and abdominal pain.
Diarrhea may be less severe in adults than in children, and fever may be less common. However, in adults, especially the elderly or those with compromised immune systems, rotavirus can cause more severe symptoms and complications such as dehydration.
The causes of rotavirus infection in adults are similar to those in children. Rotavirus is usually transmitted through fecal-oral contact, i.e. food or water contaminated with the virus or through direct contact with an infected person. Adults who work with young children, such as in nurseries or schools, or in the health care sector, are particularly vulnerable to a higher risk of infection. Also, adults with weakened immune systems may be more vulnerable to rotavirus infection.
Diagnostics
Diagnosis of rotavirus is usually carried out by a laboratory test, which includes the analysis of stool samples. There are several methods for detection of rotavirus, among which are detection of antigens, detection of RNA.
Antigen detection, often performed using immunochromatographic tests or immunoenzymatic tests, is the fastest and most common method of rotavirus diagnosis. These tests detect rotavirus antigens in stool and can be performed on an outpatient basis or in a laboratory. They can give a result in a few hours and are a fairly accurate diagnostic tool.
RNA detection using a method called reverse transcriptase-mediated polymerase chain reaction (RT-PCR) is highly accurate, but takes longer and requires specialized laboratory equipment. This method can detect viral genetic material in feces and can be used to isolate other enteropathogens or to determine rotavirus serotype.
In addition, consideration of clinical symptoms and history is important, as rotavirus can present with typical symptoms such as severe diarrhea, vomiting, and fever, especially during seasonally increased infection rates.
Treatment of infection
Treatment of rotavirus is mostly symptomatic, as there are no specific antiviral drugs that work against this virus. The most important aspect of treatment is the prevention and control of dehydration, since diarrhea and vomiting, which are typical symptoms of rotavirus infection, can cause significant fluid and electrolyte loss.
Fluid therapy can be given orally or, in more severe cases, intravenously. Oral rehydration therapy (ORT) is the first-line treatment strategy for mild to moderate dehydration. It involves the use of specially formulated rehydration solutions that contain the right amount of salt and glucose. Intravenous rehydration is indicated for severely dehydrated patients or those unable to take oral fluids due to severe vomiting.
Symptom control may include antipyretics such as paracetamol if there is a high fever and antibiotics if there is severe vomiting. However, anti-diarrheal medications should be avoided as they can cause complications such as constipation.
Nutrition is another important aspect of treatment. It is not recommended to follow a strict diet, as it can reduce the body's resistance and slow down recovery. Ensuring that the patient consumes a diet rich in nutrients and calories is important to their recovery.
Ultimately, prevention, including rotavirus vaccination, is a very important strategy to reduce the spread and severity of rotavirus infection.
How can rotavirus be prevented?
Prevention of rotavirus includes both personal hygiene measures and vaccination.
Personal hygiene is the main way to reduce the risk of rotavirus transmission. This includes frequent hand washing with soap and water, especially before eating and after using the toilet or bathing the baby. Food and water that may be contaminated with feces should also be avoided. These measures are important for everyone, but especially for individuals working in health care facilities, childcare facilities or food production facilities.
Rotavirus vaccination is an effective means of preventing rotavirus infection. There are several rotavirus vaccines that are recommended for infants because they are most vulnerable to rotavirus infection. Vaccination is given orally, not by injection, and is usually given as a series of two or three doses.
These vaccines are well tolerated and effective in reducing the risk of severe rotavirus infection and associated hospitalizations. However, like all medicines, they can cause side effects such as diarrhea or vomiting, but these symptoms are usually mild and short-lived.
Rotavirus vaccination, combined with appropriate personal hygiene measures, is an effective strategy for the prevention and control of rotavirus infection. However, regardless of vaccination, it is still important to pay attention to symptoms and seek medical attention if you develop diarrhea, vomiting, fever, or other symptoms of rotavirus infection.
Although rotavirus is very common and can cause severe symptoms, we have effective strategies to help prevent this infection, control its symptoms, and provide safe and effective treatment. With continued research and improved prevention strategies, we can hope to achieve even better control of rotavirus infection in the future.
Sources of information:
Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI. Global illness and deaths caused by rotavirus disease in children. Emerging infectious diseases. 2003
Dennehy PH. Transmission of rotavirus and other enteric pathogens in the home. The Pediatric infectious disease journal. 2000
Tate JE, Burton AH, Boschi-Pinto C, Parashar UD, World Health Organization–Coordinated Global Rotavirus Surveillance Network. Global, regional, and national estimates of rotavirus mortality in children< 5 years of age, 2000–2013. Clinical Infectious Diseases. 2016
Dóró R, László B, Martella V, Leshem E, Gentsch J, Parashar U, Bányai K. Review of global rotavirus strain prevalence data from six years post vaccine licensure surveillance: is there evidence of strain selection from vaccine pressure?. Infect Genet Evol. 2014
Patel MM, Glass R, Desai R, Tate JE, Parashar UD. Fulfilling the promise of rotavirus vaccines: how far have we come since licensure?. The Lancet infectious diseases. 2012
Santos VS, Marques DP, Martins-Filho PR, Cuevas LE, Gurgel RQ. Effectiveness of rotavirus vaccines against rotavirus infection and hospitalization in Latin America: systematic review and meta-analysis. Infectious Diseases of Poverty. 2016
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