Rotavirus

• The name is derived from the Latin rota, meaning "wheel" because of its characteristic wheel-like appearance.
• Rotaviruses are nonenveloped, double-shelled viruses. The genome is composed of 11 segments of double-stranded RNA, which code for six structural and five nonstructural proteins. The virus is stable in the environment. They are 70 nm icosahedral viruses that belong to the family Reoviridae.
• Rotavirus infection is an infection of the digestive tract that causes severe diarrhea, usually with fever and vomitting.
• There are a number of different strains of rotavirus than cause severe diarrhea (gastroenteritis) in humans.
• Children aged 3 months to 2 years have the highest risk of getting infected with this virus.
• Virtually all children become infected with rotavirus in the first 3 to 5 years of life, but severe diarrhea and dehydration occur mainly among children aged 3 to 35 months.
• Adults infected with rotavirus have few or non symptoms at all.
• There is no cure to a rotavirus infection.
• Rotavirus causes seasonal peaks of gastroenteritis from November to May each year while tropical countries receive a all-year-round exposure.
• Children can be infected with rotavirus more than once, but usually the first infection is most severe.
• Though the rotavirus is not always deadly, it is the dehydration that proves fatal in infants.
• Breastfeeding can lower the risk of getting infected with rotavirus or reduce the risk of severe diarrhea should the child get infected. The child has to continue to be breastfed to reduce the risks.
• Blood or stool samples will have to be taken to determine if the virus is present.

Signs And Symptoms

• Usually starts with fever, vomitting and abdominal cramps then watery diarrhea. The infected child may also have a cough or runny nose before the onset of the diarrhea and vomitting symptoms.
• The watery diarrhea can be mild to severe and will last for 3 to 9 days.
• Severe diarrhea can lead to dehydration. Signs of dehydration include thirst, restlessness, sleepiness, lethargy (unresponsive or won't make eye contact), irritability, sunken eyes, dry mouth and tongue, dry skin, fewer trips to the toilet to urinate and darker urine.
• For babies, due to dehydration, the diaper is dry for several hours.
• It takes about 2-3 days for symptoms to appear.

How Does It Spread

• An infected child will pass out large amounts of rotavirus out in the stools and if hands are not washed properly, anything that the infected child touches will become contaminated.
• Rotaviruses can spread easily when children touch contaminated objects and put their fingers into their mouths.
• Parents taking care of an infected child can also spread if they do not wash their hands after handling the child's stools, e.g. during diaper changes.
• Unfortunately, improved hygiene, sanitation and water quality does not stop the virus.

Vaccines

• In the 1999, the US Advisory Committee on Immunisation Practices removed a vaccine called RotaShield (Wyeth Laboratories) was removed from the market as it was found to be associated with a rare type of bowel obstruction where the bowel folds in on itself, called intussusception.
• Currenty the oral (swallowed) vaccines that are approved for use are RotaTeq™ (Merck) and Rotarix™ (GlaxoSmithKline).
• RotaTeq™ is an oral, three-dose, live vaccine containing a strain of rotavirus isolated from a cow combined with proteins from five other strains of human rotavirus, namely G1, G2, G3, G4 and P1 which are the common human rotavirus strains responsible for more than 90 percent of rotavirus infections worldwide. The vaccine can be administered to infants between the ages of 6 to 32 weeks in three oral doses four to 10 weeks apart.

  According to the information provided by The Children's Hospital of Philadelphia, the introduction of the cow rotavirus (which will not cause infection in children) and the human rotavirus proteins (which will produce protective antibodies but will not cause an infection), will help infants build immunity. This vaccine contains no thimerosal, which is a preservative that is 50% ethyl mercury by weight.

• Rotarix is an oral, two-dose, live attenuated vaccine, a weaker form of the virus that has been developed from a single human rotavirus strain. According to GlaxoSmithKline, "The vaccine works by stimulating the body to mimic the immune response to natural rotavirus infection, which protects against the subsequent development of moderate to severe rotavirus disease." The vaccine can be administered to infants about two and three months of age (the first dose can be given as early as 6 weeks and the second dose before 6 months of age), in two oral doses one to two months apart.
• Two studies published in The New England Journal of Medicine reported that both RotaTeq and Rotarix were effective in protecting infants against severe rotavirus gastroenteritis, significantly reduced the rate of severe gastroenteritis from any cause and were not associated with an increased risk of intussusception. The 2 clinical trials involved some 130,000 children from Belgium, Finland, Germany, Italy, Latin America (e.g. Brazil, Mexico, Venezuela), Sweden, Taiwan and the US.
• Some children may develop a low-grade fever (99 to 100.9 degrees or 37.3 to 38.3 Celcius), which is a common side effect.

What Should You Do

• Parents of children with severe or prolong period of diarrhea or are unable to retain oral feedings should seek medical evaluation.
• Breastfed babies should continue to be breastfed throughout. When the child experiences vomitting, feed smaller amounts but increase frequency.
• Children with mild to moderate dehydration should receive small but frequent amounts of fluid for a few hours until there is good urinary flow, afterwhich they can start to eat normally.
• Children with mild diarrhea but are not dehydrated should continue to eat normally but should receive more fluids.
• Children who vomit will need to eat smaller amounts more frequently.
• Avoid fruit juices and frizzy drinks as they can worsen the diarrhea.
• Frequent hand washing can help contain the spread.