Rotavirus most often infects infants and young children, and in children ages 3 months to 2 years, is one of the most common causes of diarrhea. In the United States, it leads to outbreaks of diarrhea during the winter and spring months. It is particularly a problem in child-care centers and children’s hospitals. Almost all children have had a rotavirus infection by the time they are 5 years old. Severe infection, rotavirus gastroenteritis, is the leading cause of severe, dehydrating diarrhea in infants and young children.
Rotavirus infections are responsible for approximately 3 million cases of diarrhea and 55,000 hospitalizations for diarrhea and dehydration in children under 5 years old each year in the United States. Although these infections cause relatively few deaths in the United States, diarrhea caused by rotavirus results in more than half a million deaths worldwide every year. This is especially true in developing countries, where nutrition and health care are not optimal.
Signs and Symptoms
Children with a rotavirus infection have fever, nausea, and vomiting, which are often followed by abdominal cramps and frequent, watery diarrhea. Children who are infected may also have a cough and runny nose. As with all viruses, though, some rotavirus infections cause few or no symptoms, especially in adults.
Sometimes the diarrhea that accompanies a rotavirus infection is so severe that it can quickly lead to dehydration. Signs of dehydration include: thirst, irritability, restlessness, lethargy, sunken eyes, a dry mouth and tongue, dry skin, fewer trips to the bathroom to urinate, and (in infants) a dry diaper for several hours.
Rotavirus infection is very contagious. The virus passes in the stool of infected persons before and after they have symptoms of the illness. Children can become infected if they put their fingers in their mouths after touching something that has been contaminated by the stool of an infected person. Usually this happens when children forget to wash their hands often enough, especially before eating and after using the toilet. People who care for children, including health-care and child-care workers, can also spread the virus, especially if they do not wash their hands after changing diapers.
Frequent hand washing is the best tool to limit the spread of rotavirus infection. Children who are infected should stay home from child-care groups until their diarrhea has resolved. In hospitals, rotavirus outbreaks are controlled by isolating infected patients and ordering strict hand-washing procedures.
The American Academy of Pediatrics (AAP) recommends that the rotavirus vaccine be included in the lineup of routine immunizations given to all infants. The recommendation calls for three doses by mouth at around 2, 4, and 6 months of age.
The vaccine, which is called RotaTeq, has been found to prevent approximately 75% of cases of rotavirus infection and 98% of severe cases. Your child’s doctor will have the most current information.
In 1999, a rotavirus vaccine was taken off the market because it was linked to an increased risk for intussusception, a type of bowel obstruction, in young infants. In more than 70,000 children studied, RotaTeq has not been found to have this increased risk.
An infant or toddler who becomes moderately or severely dehydrated may need to be treated in a hospital with intravenous (IV) fluids to bring the body’s fluid and salt levels back to normal. Most older children can be treated at home.
Your doctor may need to test your child’s blood, urine, or stool to confirm that the diarrhea is being caused by rotavirus and not by bacteria. Because antibiotics do not work against illnesses caused by viruses, your doctor will not give your child antibiotics to treat a rotavirus infection.
To prevent dehydration, follow your doctor’s guidance about what your child should eat and drink. Your doctor may suggest that you give your child special drinks that replace body fluids, especially if the diarrhea has been going on for longer than 2 or 3 days.
In general, kids with mild diarrhea who are not dehydrated should continue to eat normally but should receive more fluids. (Fruit juices and soft drinks can make diarrhea worse and should be avoided.) Those who have mild to moderate dehydration should be given an oral rehydration solution in small, frequent amounts to correct the dehydration and then should go back to eating normally. Children who are breastfed should be breastfed throughout. A child who is vomiting will need to eat smaller amounts more frequently. Follow your doctor’s guidance and avoid giving your child store-bought medicines for vomiting or diarrhea unless your doctor recommends them.
When to Call Your Child’s Doctor
Call the doctor for advice if your child has signs of a rotavirus infection, including watery diarrhea, fever, nausea, and vomiting. Call immediately if your child is showing signs of dehydration.