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Rotavirus Infection

by Mary T. Caserta, MD

Rotavirus is a common and very contagious virus that causes vomiting and diarrhea.

  • Rotavirus is a viral infection of the digestive tract that and can cause severe dehydration.

  • Typical symptoms include fever, vomiting, and watery diarrhea.

  • The diagnosis is based on symptoms.

  • Routine vaccination can prevent rotavirus infection.

  • Most children get better by resting and drinking fluids, but a few are given fluids by vein (intravenously).

Rotavirus is the most common cause of severe, dehydrating diarrhea in young children age 3 to 15 months. It is one of the viruses that causes gastroenteritis. In the United States, about 50,000 children each year are hospitalized for diarrhea caused by rotavirus. Although hardly any children die in the United States from rotavirus, worldwide the virus causes about 500,000 deaths a year, mostly in developing countries.

The virus is spread from person to person, especially if people with diarrhea do not thoroughly wash their hands after a bowel movement. Infection also can occur if people touch their mouth after touching an object (such as a diaper or toy) contaminated by infected stool. All such transmission involving infected stool is called fecal-oral transmission. People can also become infected if they eat food or drink water that is contaminated with the virus. Adults can become infected after close contact with an infected infant, but serious illness is rare.

During the winter in temperate climates, rotavirus causes most cases of diarrhea that are serious enough to send infants and toddlers to the hospital. Before the use of rotavirus vaccine in 2006, a wave of rotavirus illness would begin in the Southwest in November and end in the Northeast in March. Now, the disease occurs less predictably and can occur year round.

Symptoms of Rotavirus Infection

Rotavirus symptoms begin with fever and vomiting, followed by watery diarrhea, which typically lasts 5 to 7 days. If fluid losses are not replaced, dehydration develops. Dehydration makes the child weak and listless, with a dry mouth and rapid pulse.

Diagnosis of Rotavirus Infection

  • A doctor's evaluation

Doctors do not usually perform tests to detect rotavirus unless they are trying to identify an outbreak. When necessary, samples of stool are sent for a rapid antigen test.

Prevention of Rotavirus Infection

  • Good hygiene

  • Rotavirus vaccine

Practicing good hygiene is the best way to prevent gastroenteritis . A sick child and the people in the household should wash their hands frequently.

Two vaccines to prevent rotavirus are available. Rotavirus immunization is now one of the routinely recommended infant vaccines. Depending on the vaccine used, two or three doses of the vaccine are given by mouth at ages 2 months, 4 months, and 6 months or at ages 2 months and 4 months.

Treatment of Rotavirus Infection

  • Bed rest and fluids

There is no specific treatment for rotavirus. Most children get better with bed rest and by drinking an adequate amount of fluids (see also treatment of gastroenteritis). Seriously ill children require fluids given by vein (intravenously).