What Is Rotavirus Infection and How to Treat It? A Full Guide

Worldwide, rotaviruses represent the most common reason we see acute diarrhea in babies and children under 5. These viruses are highly contagious, spreading through the fecal-oral route (contact with an infected person’s stool) and from contaminated hands, objects, and surfaces. Commonly, dehydration results from often severe watery diarrhea and vomiting. Thanks to vaccinations, this cause of diarrhea is easily preventable. Understanding how to protect those you love with proper hygiene practices and immunizations and recognizing key symptoms and disease facts may help shield you and your loved ones in the future.

Rotavirus: what you need to know

Rotaviral diseases cause significant health burdens globally. Notwithstanding the presence of an effective vaccine, this viral disease still causes over 200,000 deaths per year worldwide. Thus, being able to recognize symptoms or, better yet, prevent disease is key to protecting one’s health and the health of others.

Rotaviruses are highly contagious and affect the gut. Specifically, they infect cells covering the small intestine’s inside, leading to viral gastroenteritis. Gastroenteritis, or stomach and intestinal inflammation, results in diarrheal illness.

Seasonality

Historically, before vaccinations, community outbreaks of rotaviral infections commonly occurred. Regional and community variations globally still occur despite vaccination, though to a lesser degree.

How does rotavirus spread?

Rotaviruses are found in an infected person’s feces (stool) and enter the body through the mouth. This represents the fecal-oral transmission route. In other words, someone can get a rotavirus infection if they accidentally swallow tiny bits of feces containing the virus from another person. These particles are usually invisible but can be found on contaminated surfaces, including hands when not properly washed.

Rotaviruses spread very quickly, mainly through direct contact between people. For example, a child can become infected by putting unwashed hands into the mouth after contact with the hands of an infected caregiver or child. Another way rotaviruses spread is by putting unclean hands in the mouth after touching contaminated objects or surfaces such as toys, diapers, and doorknobs.

Rarely, rotaviruses may spread through contaminated food or water. Although rotaviruses can spread anywhere, outbreaks most often occur in daycare or household settings, usually due to children not washing their hands after using the bathroom or where large groups of kids congregate.

Who is at risk?

Anyone can get sick from rotavirus infection. However, rotaviruses most commonly affect babies and children under the age of 5. Although adults can also get infected, especially while caring for a child infected with rotavirus, older adults and those with weakened immune systems are more likely to become ill and experience severe symptoms. For those with healthy immune systems, if adults develop rotavirus symptoms, they are usually very mild.

Caregivers of those with rotaviral infections, regardless of age, are at an increased risk for developing infection.

Rotavirus symptoms in children and adults

Rotavirus in children and adults can manifest similarly. Rotavirus symptoms usually begin about 1–3 days after contact with the virus but may appear sooner. Once symptoms start, they typically last for about 3–8 days.

Rotavirus infection in children manifests with symptoms of:

• Watery diarrhea
• Vomiting
• Abdominal pain (bellyache)
• Fever

Adults with rotavirus infection typically have symptoms similar to those in children. However, the symptoms are usually milder. Additionally, some adults may experience a general feeling of being unwell (malaise) and headaches. Other adults may have no symptoms at all.

Systemic complications, though uncommon, may occur, including inflammation of various parts of the brain and seizures.

Dehydration and rotavirus

Anyone who develops diarrhea can become dehydrated, losing body fluids through diarrhea, vomiting, and fever. However, if rotavirus leads to severe dehydration, this is more common in young children/infants.

Signs of dehydration in a baby or young child may include:

• Dry mouth and tongue
• Lack of tears when crying
• Extreme thirst
• Not wetting diapers for 3 hours or more or urinating less than usual
• Sunken eyes or cheeks
• A high fever
• Unusual drowsiness or sleepiness
• Lack of energy
• Irritability

Rotavirus diagnosis

Numerous causes of watery diarrhea (acute diarrheal illness) can possibly explain clinical symptoms of vomiting, diarrhea, dehydration, and belly pain. Viral disease accounts for almost 95% of this type of illness.

Causes include various viruses, including rotaviruses, norovirus, astroviruses, and adenoviruses. Bacterial and parasitic causes, e.g., Salmonella species, Campylobacter, Clostridial species, Giardia, and Cryptosporidium, are also feasible. Many of these diseases are also zoonotic (transmissible from animals to people). Finally, primary non-infectious GI disease should be ruled out. These can include acute appendicitis, endocrine problems (e.g., diabetes), bowel obstruction, irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD), among others.

However, is a rotavirus diagnosis necessary? Generally speaking, most people do not seek care for diarrheal diseases. However, if one does, your healthcare provider may do testing, including PCR, checking for parasites, and culture the feces for bacteria. However, diagnosis or not, a disease like this is considered contagious until proven otherwise, and people should behave accordingly. When sick, try to stay home and away from others and always practice proper hygiene.

How do you treat rotavirus infection?

Rotavirus treatment is symptomatic, as with most viral infections. There are no specific medications for rotavirus infection, and antibiotics used to treat bacterial diseases aren’t helpful. Instead, treatment aims to relieve symptoms and prevent dehydration.

Effective strategies for rotavirus relief include getting plenty of rest, eating well, and staying hydrated. In fact, the primary treatment is rehydration, which means drinking enough liquids to replace the fluids and electrolytes lost through diarrhea and vomiting.

When drinking water and eating soup don’t suffice, healthcare providers may recommend using oral rehydration solutions that are available over-the-counter (OTC). Additionally, they may recommend OTC medications to help control diarrhea (antidiarrheals). However, it is important not to give your child antidiarrheal medicines unless directed by a healthcare provider.

If vomiting and diarrhea are severe, treating dehydration may be challenging if a child cannot keep fluids or oral rehydration solutions down long enough for the body to absorb them. In these cases, hospitalization for IV fluid support may be necessary.

Can I prevent rotavirus infection?

Preventing rotavirus is our best defense. The saying goes, ‘An ounce of prevention is worth a pound of a cure.’ In other words, protecting yourself against the virus is much less painful, risky, and detrimental to health than getting the disease. Proper hygiene practices and vaccinations can easily defend us against rotavirus infections.

Is there a rotavirus vaccine?

The primary means of preventing rotavirus is through the use of vaccination. The Centers for Disease Control and Prevention (CDC) estimates that vaccinating children prevents up to 50,000 hospitalizations in the U.S. each year.

Current rotavirus vaccinations first became available in 2006. Two safe and effective vaccines protect against rotavirus infection in babies and young children. Both rotavirus vaccines are given to babies orally (by putting drops in the child’s mouth). Depending on the brand, the vaccine is administered in three doses at 2, 4, and 6 months or in two doses at 2 and 4 months. Children should receive the first dose of either vaccine before they turn 15 weeks old and all doses of either vaccine before they turn 8 months old.

Proper hygiene practices

Proper hygiene practices are crucial to preventing countless diseases worldwide, including rotaviruses. Ensure you teach your children at a young age to wash their hands thoroughly before and after eating, when handling/preparing foods, after playing outside, in the dirt, with animals, and in many other situations. Teach them to use sufficient soap and warm water and count 20 seconds (even have them sing Happy Birthday to themselves) to ensure enough contact time with soap and water.

If hand washing properly isn’t an option, ensure they have access to 60% or higher alcohol hand sanitizer, the next best thing to washing one’s hands.

Despite proper hand washing practices, vaccination remains the number one means to prevent rotavirus transmission/illness. Because of how common and infectious this virus is, hand washing is often not enough to protect people, especially young kids, the immunosuppressed, and those with underlying conditions.

Rotavirus vs. other GI illnesses

In high-income countries with successful vaccination campaigns, rotaviruses are no longer the primary cause of acute viral gastroenteritis in children. In these areas, noroviruses have emerged as the number one cause.

However, in medium and low-income countries, the burden of rotaviral diseases still remains the primary cause of diarrheal disease in children. Despite this shift in high-income countries, a large portion of the world still has a high incidence of rotaviral disease, and preventative strategies are key to minimizing the effects of rotavirus on public health.

Various other GI bugs exist; sometimes, symptoms can be too similar to differentiate. In contrast, others will have different characteristics of diarrhea (bloody vs. non-bloody), for example. While some conditions will cause vomiting, while others will not. Regardless, talk to your healthcare provider if you or a family member, including children, become ill with a GI illness and are not responding to supportive care.

Rotavirus and public health

Rotaviral infections, although easily preventable via immunizations and proper hygiene practices, still occur globally. Highly contagious, this disease can lead to watery diarrhea, vomiting, and significant dehydration if care isn’t taken to ensure those affected intake enough fluids and remain well hydrated. While adults and kids of all ages can become sick, children under 5 are at higher risk for severe disease. Recognizing symptoms and early diagnosis of rotavirus infections helps lessen their public health impact and save lives.