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Saturday, April 18, 2009

Rotavirus Disease

Questions & Answers

What causes rotavirus disease?
Rotavirus disease is caused by a virus, the rotavirus. The name rotavirus is derived from the Latin rota, meaning "wheel," because the rotavirus has a wheel-like appearance when viewed by an electron microscope.

How does rotavirus spread?
The rotavirus enters the body through the mouth and then infects the lining of the intestines. Rotavirus is very contagious, spreading easily from children who are already infected to other children and sometimes adults. Large amounts of rotavirus are shed in the stool of infected persons and the virus can be easily spread via contaminated hands and objects, such as toys. Children can spread rotavirus both before and after they become sick with diarrhea.

Rotavirus is very stable and may remain viable in the environment for months if not disinfected.

How long does it take to show signs of rotavirus after being exposed?
The incubation period for rotavirus diarrhea is 1-3 days. Symptoms of infection vary and depend on whether it is the first infection or reinfection.

What are the symptoms of rotavirus?
Rotavirus disease usually starts with fever, an upset stomach, and vomiting, followed by diarrhea. Children who have rotavirus disease develop vomiting and watery diarrhea that may last from three to seven days. They may lose interest in eating and drinking and become dehydrated from loss of fluids.

How serious is rotavirus?
All three symptoms of rotavirus disease (fever, vomiting, and diarrhea) cause children to lose fluids. Vomiting is especially dangerous because it's difficult to replace fluids in children who are vomiting persistently.

Prior to the licensure of the rotavirus vaccine, rotavirus infection was responsible for more than 400,000 doctor visits, more than 200,000 emergency room visits, 55,000-70,000 hospitalizations, and 20-60 deaths in the U.S. on an annual basis. In the first five years of life, four of five children in the United States were expected to develop rotavirus gastroenteritis, one in seven would require a clinic or emergency room visit, one in 70 would be hospitalized, and one in 200,000 would die from this disease.

Rotavirus infection is even more problematic in the developing world because children with rotavirus disease are less likely to receive the medical intervention necessary to prevent death from dehydration. In developing countries, rotavirus causes more than 500,000 deaths each year in children younger than age five years.

What are possible complications from rotavirus?
Rotavirus infection in infants and young children can lead to severe diarrhea, dehydration, electrolyte imbalance, and metabolic acidosis. Immunodeficient children may have more severe or persistent disease.

How do I know if my child has rotavirus?
Rotavirus disease is difficult to differentiate from illness caused by other pathogens. As a result, laboratory testing of the stool is needed to confirm a diarrheal illness as rotavirus.

Are children more likely to become infected at certain times of the year?
In the United States, rotavirus is a winter disease (children are most likely to get infected between November and May). In tropical climates, the disease occurs year round.

Is there a treatment for rotavirus?
Children are typically treated by replacing lost body fluids through drinking products that contain water with sugar and minerals. In severe cases, body fluids are replaced with fluids given directly through the veins using an intravenous line in the hospital.

How long is a person with rotavirus contagious?
Infected persons shed large quantities of virus in their stool beginning 2 days before the onset of diarrhea and for up to 10 days after onset of symptoms. Rotavirus may be detected in the stool of persons with immune deficiency for more than 30 days after infection.

Are any people at greater risk than others of being infected with rotavirus?
Groups at increased risk for rotavirus infection are those with increased exposure to virus. This includes children who attend childcare centers, children in hospital wards, caretakers and parents of children in childcare or hospitals, and children and adults with immunodeficiency-related diseases.

Can you get rotavirus more than once?
A person may develop rotavirus disease more than once because there are many different rotavirus types, but second infections tend to be less severe than the original infections. After a single natural infection, 40% of children are protected against any subsequent rotavirus infection. Recurrent rotavirus infections affect persons of all ages.

Wouldn't good hygiene be enough to prevent rotavirus disease?
Better hygiene and sanitation have not been very effective in reducing rotavirus disease. This is illustrated by the fact that virtually everyone in the world is infected by rotavirus disease by age five years, despite differences in sanitation between countries.

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