Rotavirus

Topic Overview

What is rotavirus, and what causes it?

Rotavirus is a virus that infects the intestinal tract of almost all young children by age 5. In the United States, most children get sick from rotavirus by age 2. A rotavirus infection causes stomach upset and diarrhea.

Babies and very young children with rotavirus infections need to be watched closely because they can become dehydrated very quickly. Dehydration occurs when the body loses water more quickly than it is replaced. When your child becomes dehydrated, severe health problems can arise.

Rotavirus infections spread easily. Outbreaks usually occur in the winter and early spring, between about November and April. Rotavirus infections often spread in settings where many children are together, such as day care centers.

The virus spreads through contact with the stools from an infected child. But the virus spreads easily even when people try very hard to keep places clean. For example, when a caregiver changes the messy diaper of a child who has rotavirus infection, germs can get on the changing table, the caregiver's hands, or the hands of the already infected child. The rotavirus germs can then spread to other children from the caregiver's or child's unwashed hands. It may be only a few steps to the sink, but the germs may get on surfaces that the caregiver or child touches along the way. For example, the germs may get on toys, doorknobs, or sink surfaces. The germs can live for days on objects and surfaces if they are not immediately disinfected.

Other children who get the rotavirus germs on their hands can get the infection when they put their hands in their mouths. They can also get infected with rotavirus by chewing on a toy that has the germs on it.

What are the symptoms?

It takes about 1 to 2 days for a child who is exposed to the rotavirus germs to start having symptoms.

Vomiting is often the first symptom. Usually, a fever and diarrhea follow. Most children with rotavirus have very watery diarrhea that seems like a large amount for a baby or small child. The most severe diarrhea lasts 4 to 8 days. But episodes of diarrhea can last long after your child starts feeling better. In some children, diarrhea can last for a few weeks.

Diarrhea, especially when it occurs along with vomiting, can quickly lead to dehydration in babies and young children who have rotavirus. For this reason, it is important to keep feeding your baby breast milk or formula.

Watch your child closely for signs of dehydration, such as having only 1 wet diaper in a 12-hour period. Call your doctor right away if you think your child may be dehydrated.

How is rotavirus diagnosed?

Your doctor will probably diagnose your child with rotavirus infection based on his or her symptoms. The time of year also is an important clue. If your child has diarrhea and other symptoms during the winter or early spring (about November through April), your doctor will often suspect rotavirus as the cause.

A test of stool can be done to confirm a diagnosis. This kind of test is not needed unless your child has other health conditions that make it important to know the exact cause of symptoms.

How is it treated?

It is most important to help keep your child comfortable and prevent dehydration.

Hold your child as much as he or she wants. Keep your child in comfortable clothes, and change his or her diaper or underpants as needed. Your child may get a diaper rash. To treat diaper rash, you may need to use warm washcloths to wipe your child's bottom and creams to help prevent soreness. In some cases, you may want to hold your baby and rinse his or her bottom in running bath water to clean the area well.

Don't give your child any over-the-counter medicines unless you've checked with the doctor first.

To prevent dehydration, your doctor may recommend a rehydration drink designed for babies and young children, such as Pedialyte, Infalyte, or Rehydralyte. This may be especially helpful if your child's diarrhea lasts longer than a few days. Rehydration drinks help replace fluids and electrolytes. Plain water doesn't provide necessary nutrients or electrolytes and may not be absorbed when your child has diarrhea. Rehydration drinks do not make diarrhea go away faster, but they can prevent serious dehydration from developing.

Do not give your baby or young child rehydration drinks for adults or sports drinks, such as Gatorade. These drinks do not have the proper balance of nutrients and electrolytes for small children.

A baby or young child needs to be treated in a hospital if dehydration becomes severe. Call 911 or go to the emergency room if your baby has signs of severe dehydration, which include:

  • A lack of interest in playing and extreme sleepiness. (The child may be so sleepy that he or she is difficult to wake up.)
  • A dry mouth and tongue.
  • A sunken soft spot (fontanel) on top of the head.
  • Sunken eyes without tears.
  • Fast breathing and rapid heartbeat.
  • No wet diapers (a dry diaper) for 12 or more hours.

Can I prevent my child from getting rotavirus?

You can help prevent the spread of rotavirus by washing your hands thoroughly and often. But it is very hard to prevent your child from getting this infection. Most children get a rotavirus infection by age 2, and almost all have had it by age 5. Your child can get rotavirus more than once, but the first infection is usually the worst.

Rotavirus vaccine (What is a PDF document?) helps protect against rotavirus disease. Depending on which brand of vaccine is used, children should get 2 or 3 doses. Talk to your doctor about whether this vaccine is available and recommended for your child.

Other Places To Get Help

Organizations

Centers for Disease Control and Prevention (CDC)
1600 Clifton Road
Atlanta, GA  30333
Phone: 1-800-CDC-INFO (1-800-232-4636)
TDD: 1-888-232-6348
E-mail: cdcinfo@cdc.gov
Web Address: www.cdc.gov
 

The Centers for Disease Control and Prevention (CDC) is an agency of the U.S. Department of Health and Human Services. The CDC works with state and local health officials and the public to achieve better health for all people. The CDC creates the expertise, information, and tools that people and communities need to protect their health—by promoting health, preventing disease, injury, and disability, and being prepared for new health threats.


KidsHealth for Parents, Children, and Teens
10140 Centurion Parkway North
Jacksonville, FL  32256
Phone: (904) 697-4100
Fax: (904) 697-4125
Web Address: www.kidshealth.org
 

This Web site is sponsored by the Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This Web site offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly e-mails about your area of interest.


References

Other Works Consulted

  • Bass DM (2007). Rotaviruses, caliciviruses, and astroviruses. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 1399–1401. Philadelphia: Saunders Elsevier.
  • Clark HF, et al. (2008). Rotavirus vaccines. In SA Plotkin et al., eds., Vaccines, 5th ed., section 2, pp. 715–734. Philadelphia: Saunders Elsevier.
  • Offit PA (2003). Viral gastroenteritis section of Infectious diseases. In CD Rudolph, AM Rudolph, eds., Rudolph's Pediatrics, 21st ed., pp. 1023–1024. New York: McGraw-Hill.
  • Sondheimer JM (2007). Acute infectious diarrhea (gastroenteritis) section of Gastrointestinal tract. In WW Hay Jr et al., eds., Current Pediatric Diagnosis and Treatment, 18th ed., pp. 619–621. New York: McGraw-Hill.
  • U.S. Department of Health and Human Services (2006). Prevention of rotavirus gastroenteritis among infants and children: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 55(RR-12): 1–14.
  • Vesikari T, et al. (2006). Safety and efficacy of a pentavalent human bovine (WC3) reassortant rotavirus vaccine. New England Journal of Medicine, 354(1): 23–33.

Credits

Author Debby Golonka, MPH
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
Last Updated July 24, 2008

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