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Rotavirus Gastroenteritis

By

Jonathan Gotfried

, MD, Lewis Katz School of Medicine at Temple University

Last full review/revision Oct 2021| Content last modified Nov 2021
CLICK HERE FOR THE PROFESSONAL VERSION
Topic Resources

Gastroenteritis is inflammation of the lining of the stomach and small and large intestines. It can be caused by the rotavirus.

  • Rotavirus is very contagious and spreads from person to person.

  • Typically, people have watery diarrhea, vomiting, and sometimes fever.

  • The diagnosis is based on a person’s history of recent contact with a contaminated object, person, food, or water and sometimes with laboratory tests.

  • Thoroughly washing the hands after a bowel movement or contact with fecal matter and avoidance of undercooked foods and contaminated water are the best ways to prevent infection.

  • Fluids are usually the only treatment needed, but some people may be given drugs to help stop diarrhea.

Rotavirus is the most common cause of severe, dehydrating diarrhea among young children worldwide. Its incidence in the United States has decreased by 80% since rotavirus vaccines were added to the routine vaccination schedule Childhood Vaccination Schedule Most doctors follow the vaccination schedule recommended by the Centers for Disease Control and Prevention (CDC—see the schedule for infants and children and the schedule for older children... read more . It usually affects those between the ages of 3 months and 15 months. Rotavirus is highly contagious. Most infections are spread by fecal-oral transmission. Fecal-oral transmission is contact with infected stool. For example, if people touch their mouth after touching an object (such as a diaper or toy) contaminated by infected stool, they can get sick. Adults may be infected after close contact with an infected infant, but the illness is generally mild.

In temperate climates, most infections occur in the winter. Each year in the United States, a wave of rotavirus illness begins in the Southwest in November and ends in the Northeast in March.

Symptoms of Rotavirus Gastroenteritis

Rotavirus typically causes diarrhea that is watery and does not have blood in it. Vomiting occurs in most people, and some have fever. Symptoms begin 1 to 3 days after infection.

In adults the symptoms of rotavirus gastroenteritis are usually mild. Rotavirus may last 5 to 7 days in infants and young children. In children, diarrhea is more likely to cause severe dehydration Dehydration Dehydration is a deficiency of water in the body. Vomiting, diarrhea, excessive sweating, burns, kidney failure, and use of diuretics may cause dehydration. People feel thirsty, and as dehydration... read more and even death.

Diagnosis of Rotavirus Gastroenteritis

  • A doctor's evaluation

  • Sometimes stool tests

The diagnosis of rotavirus is usually based on typical symptoms, especially if an outbreak is currently ongoing. Sometimes other family members or coworkers have recently been ill with similar symptoms. Other times, rotavirus can be traced to contaminated water or inadequately cooked, spoiled, or contaminated food.

To confirm the diagnosis of rotavirus, doctors sometimes test stool specimens.

Prevention of Rotavirus Gastroenteritis

  • Hygiene

  • Vaccination

Good hygiene practices are important at all times, not just when there is an outbreak of gastroenteritis.

Because most rotavirus infections are transmitted by person-to-person contact, particularly through direct or indirect contact with infected stool, good handwashing with soap and water after a bowel movement is the most effective means of prevention. To prevent foodborne infections, hands should be washed before touching food, knives and cutting boards used to cut raw meat should be washed before use with any other food, meat and eggs should be cooked thoroughly, and leftovers should be refrigerated promptly after cooking. Only pasteurized dairy products and pasteurized apple juice should be used. Travelers should try to avoid high-risk foods and beverages, such as those sold by street vendors.

To prevent recreational water illness, people should not swim if they have diarrhea. Infants and toddlers should have frequent diaper checks and should be changed in a bathroom and not near the water. Swimmers should avoid swallowing water while swimming.

For children, caregivers should wash their hands thoroughly with soap and water before preparing bottles for formula-fed infants. They should also wash their hands after changing diapers. Diaper-changing areas should be disinfected with a freshly prepared solution of household bleach (¼ cup bleach diluted in 1 gallon of water). Children with diarrhea should be excluded from day care centers for the duration of their symptoms.

Did You Know...

  • It takes 20 seconds to receive the full benefit of handwashing with regular soap and water.

Two vaccines to prevent rotavirus are available. Rotavirus vaccine Rotavirus Vaccine The rotavirus vaccine is a live-virus vaccine that helps protect against gastroenteritis caused by rotavirus, which causes vomiting, diarrhea, and, if symptoms persist, dehydration and organ... read more is 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 and 4 months or at ages 2 months, 4 months, and 6 months.

Treatment of Rotavirus Gastroenteritis

  • Fluids and rehydration solutions

  • Sometimes drugs

Rehydration

Usually the only treatment needed for rotavirus gastroenteritis is getting bed rest and drinking an adequate amount of fluids. Even a person who is vomiting should drink as much as can be tolerated, taking small frequent sips. If vomiting or diarrhea is prolonged or the person becomes severely dehydrated, fluids and electrolytes given by vein (intravenously) may be needed. Because children can become dehydrated more quickly, they should be given fluids with the appropriate mix of salts and sugars. Any of the commercially available solutions designed to replace lost fluids and electrolytes (called oral rehydration solutions Treatment Dehydration is loss of water from the body, usually caused by vomiting and/or diarrhea. Dehydration occurs when there is significant loss of body water and, to varying amounts, electrolytes... read more ) are satisfactory. Carbonated beverages, teas, sports drinks, beverages containing caffeine, and fruit juices are not appropriate. If the child is breastfed, breastfeeding Breastfeeding Breast milk is the ideal food for newborns. Although babies may be fed breast milk or formula, the World Health Organization (WHO) and American Academy of Pediatrics (AAP) recommend exclusive... read more Breastfeeding should continue.

As the symptoms subside, the person may gradually add foods to the diet. Although often recommended, there is no need to limit the diet to bland foods such as cereal, gelatin, bananas, rice, applesauce, and toast. However, some people are unable to tolerate milk products for a few days after having diarrhea.

Drugs

If the diarrhea continues for 24 to 48 hours and there is no blood in the stool to indicate a more serious bacterial infection, the doctor may prescribe a drug to control the diarrhea, such as diphenoxylate, or instruct the person to use an over-the-counter drug, such as loperamide. These drugs (called antidiarrheal drugs) are not given to children under 2 years of age, and their use is limited in children 2 to 18 years of age. Antidiarrheal drugs are also not given to people who have recently used antibiotics, who have bloody diarrhea, who have small amounts of blood in the stool that are too small to be seen, or who have diarrhea and fever.

Antibiotics and antiviral drugs are not given.

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