Viral

Gastroenteritis
What is viral gastroenteritis?
➔ Viral gastroenteritis is inflammation of the lining of the stomach, small
intestine, and large intestine caused by viruses
➔ Viral gastroenteritis is acute, meaning it happens suddenly and lasts a short
time.
➔ Most cases of viral gastroenteritis last less than a week, and most people get
better on their own without medical treatment.
➔ In some cases, viral gastroenteritis may cause severe symptoms or may lead
to dehydration.
Symptoms
The main symptoms of viral gastroenteritis include
● watery diarrhea
● Vomiting

Other symptoms include

● pain or cramping in abdomen

● sometimes fever/ headache
Complications
A majority of Viral Gastroenteritis cases are mild. Individuals with this infection will
usually have a full recovery, without any kind of complications. However, the
following may be observed, in severe cases:
● Severe dehydration
● Excessive vomiting and diarrhea can result in a loss of body fluids and salts,
causing severe muscle cramps
● Severe muscle cramping may even result in acute kidney failure
Symptoms of dehydration may include the following in adults
● extreme thirst and dry mouth
● urinating less than usual
● feeling tired
● dark-colored urine
● decreased skin turgor, meaning that when a person’s skin is pinched and
released, the skin does not flatten back to normal right away
● sunken eyes or cheeks
● Light-headedness or fainting
If you are the parent or caretaker of an infant or young child with viral
gastroenteritis, you should watch for the following signs of dehydration
● thirst
● urinating less than usual, or no wet diapers for 3 hours or more
● lack of energy
● dry mouth
● no tears when crying
● decreased skin turgor
● sunken eyes or cheeks
Etiology
Four types of viruses cause most cases of viral gastroenteritis:

❖ Rotavirus
❖ Calcivirus
❖ Adenovirus
❖ Astrovirus
Rotavirus
Family: Reoviridae
Genome: ds RNA in 11 segments
Capsid: icosahedral
Envelope: no envelope

➔ Rotavirus is the leading cause of gastroenteritis among infants and young

children
➔ Rotavirus infections are most common in infants 3 to 15 months old
➔ Symptoms usually begin about 2 days after coming in contact with the virus
and last for 3 to 8 days, along with fever and abdominal pain
➔ It can also infect adults who are in close contact with the infected children, but
the symptoms in adults are milder.
➔ By the age of 3 years, almost all children have serum antibody to most types
of rotavirus. Re-infection is common, but most are sub clinical
Calcivirus
Family: Calciviridae
Genome: ss (+) RNA
Capsid: icosahedral
Envelope: no envelope

➔ Norovirus is the most common calcivirus

➔ Both children and adults are highly vulnerable to noroviruses, the most widely
recognized reason for foodborne sickness around the world.
➔ It spreads rapidly amongst individuals in restricted spaces.
➔ Symptoms usually begin 12 to 48 hours after you come into contact with the
virus and last 1 to 3 days
Adenovirus
Family: Adenoiviridae
Genome: ds DNA
Capsid: icosahedral
Envelope: no envelope

➔ Of the 49 types of adenoviruses only Enteric adenovirus serotypes 40 and 41

cause acute gastroenteritis primarily in children
➔ Symptoms typically begin 3 to 10 days after coming in contact with the virus
and last 1 to 2 weeks.
Astrovirus
Family: Astroiviridae
Genome: ss(+) RNA
Capsid: icosahedral
Envelope: no envelope

➔ astroviruses are recognised as a cause of gastroenteritis in children, whose

immune systems are underdeveloped, and elderly adults, whose immune
systems are generally somewhat compromised.
➔ Symptoms typically begin 4 to 5 days after you coming in contact with the
virus and last 1 to 4 days.
Norovirus causes infections in people of all ages. Rotavirus, adenovirus, and
astrovirus most often infect infants and young children, but they can also infect
adults.
An estimate of the role of etiologic agents in severe diarrheal illnesses requiring
hospitalization of infants and young children in developed countries (left) and in
developing countries (right).
Transmission
Viral gastroenteritis spreads from person to person through contact with an
infected person’s stool or vomit.
Viruses will be present in the stool and vomit of infected persons. Infected person
may spread the virus in small bits of stool or vomit, especially if they don’t wash
their hands thoroughly after using the bathroom and

● touch surfaces or objects used by other people

● prepare or serve foods and drinks for other people
● shake hands with or touch another person
Infected people who do not have symptoms can still spread viruses. For example,
norovirus may be found in the stool before an infected person have symptoms and
up to 2 weeks after they recover.
Diagnosis
➔ Usually diagnosed based on symptoms alone
➔ In severe cases, a stool sample is required to test for rotavirus or norovirus or
to rule out bacteria or parasites as the cause of the gastroenteritis
Treatment
In most cases, people with viral gastroenteritis get better on their own without
medical treatment.

Viral gastroenteritis can be treated by replacing lost fluids and electrolytes to

prevent dehydration.

In some cases, over-the-counter medicines (eg. loperamide, bismuth

subsalicylate) may help relieve symptoms.These medicines are not
recommended for children.
Prevention
People can reduce their chances of getting or spreading viral gastroenteritis if they

● Wash their hands thoroughly with soap and warm water for 20 seconds after
using the bathroom or changing diapers and before eating or handling food
● Disinfect contaminated surfaces such as countertops and baby changing
tables with a mixture of 2 cups of household bleach and 1 gallon of water
● Avoid food and drinks that might be contaminated
 Vaccines: US FDA approved two vaccines, which infants receive by mouth,
are approved to protect against rotavirus infections
● RotaTeq: Infants receive three doses, at ages 2 months, 4 months, and 6
months
● Rotarix: Infants receive this vaccine in two doses, at ages 2 months and 4
months
For the rotavirus vaccine to be most effective, infants should receive the first dose
by 15 weeks of age. Infants should receive all doses by 8 months of age.