N AT I O N A L C E N T R E O F I N F E C T I O U S A N D

PA R A S I T I C D I S E A S E S

VIRAL ENTERITIS
 ABOUT ROTAVIRUS
• Rotavirus commonly causes severe, watery diarrhea and vomiting in
infants and young children. Children may become dehydrated and
need to be hospitalized and can even die. Nearly every child in the
world is infected with a rotavirus at least once by the age of five. 
Adults are rarely affected. In developing countries it is responsible for
a estimated 600 000-870 000 diarrheal death each year.
 INFECTIOUS AGENT
Rotavirus is a genus of double-stranded RNA viruses in
the family Reoviridae. There are nine species of the
genus, referred to as A, B, C, D, E, F, G, H and
I. Rotavirus A, the most common species, causes more
than 90% of rotavirus infections in humans.
 Symptoms
• Symptoms usually start about 2
days after a person is exposed to
rotavirus.
• Vomiting and watery diarrhea can
last 3 to 8 days.
• Additional symptoms may include
loss of appetite and dehydration
(loss of body fluids), which can be
especially dangerous for infants and
young children.
Rotaviruses replicate mainly in the gut, and infect enterocytes of the villi
of the small intestine, leading to structural and functional changes of
the epithelium. There is evidence in humans, and particularly in animal
models of extraintestinal dissemination of infectious virus to other organs
and macrophages.
 TRANSMISION
Rotavirprobably fecal- with possible contact or respiratory spreadus spreads
easily among infants and young children
They can spread rotavirus to family members and other people with whom they have
close contact.
Children are most likely to get rotavirus in the winter and spring (January through
June).
TRANSMISION
The primary mode of transmission is the fecal-oral route, usually through
direct contact between people. Because the virus is stable in the environment,
transmission also can occur through ingestion of contaminated water or food and
contact with contaminated surfaces or objects.

Reservoir- probably humans, the animal viruses do not

produce disease in humans.
Incubation period- Approximately 24- 72 hours.
Period of communicability – During the acute stage and
later while virus shedding continues.
Susceptibility- Susceptibility is greatest between 6
and 24 months. By age 3, most individuals acquired
rotavirus antibodies.
 DIAGNOSIS
Diagnosis of infection with a rotavirus normally follows diagnosis
of gastroenteritis as the cause of severe diarrhea. Most children
admitted to hospital with gastroenteritis are tested for rotavirus
A. Specific diagnosis of infection with rotavirus A is made by finding
the virus in the child's stool by enzyme immunoassay; ELISA kits and
PCR methods. 
TREATMENT
There is no specific medicine to treat rotavirus infection, but your
doctor may recommend medicine to treat the symptoms.
Antibiotics will not help because they fight bacteria not viruses.

Symptoms of dehydration include:

• decreased urination
• dry mouth and throat
• feeling dizzy when standing up
• crying with few or no tears and
• unusual sleepiness or fussiness
METHODS OF CONTROL
Preventive measures-
Rotaviruses are highly contagious and cannot be treated with
antibiotics or other drugs. Because improved sanitation does not
decrease the prevalence of rotaviral disease, and the rate of
hospitalizations remains high despite the use of oral rehydrating
medicines, the primary public health intervention is
vaccination.  
Clinical trials in the United States, Finland, and Venezuela had
found it to be 80 to 100% effective at preventing severe diarrhoea
caused by rotavirus A, and researchers had detected
no statistically significant serious adverse effects.]
The incidence and severity of rotavirus infections has declined
significantly in countries that have acted on this recommendation.
Good hygiene like hand-washing and cleanliness are important,
but are not enough to control the spread of the disease. Rotavirus
vaccination is the best way to protect your child from rotavirus
disease.
ROTAVIRUS VACCINES

• RotaTeq® is given in 3 doses at ages 2 months, 4 months, and 6

months
• Rotarix® is given in 2 doses at ages 2 months and 4 months
• The first dose of either vaccine should be given before a child is 15
weeks of age. Children should receive all doses of rotavirus vaccine
before they turn 8 months old.
• Both vaccines are given by putting drops in the child’s mouth.
 Contraindications and Precautions for
Rotavirus Vaccination
You should not give rotavirus vaccine to babies with:
• a severe (life-threatening) allergic reaction to a previous dose of
rotavirus vaccine,
• a severe (life threatening) allergy to any component of rotavirus
vaccine,
• severe combined immunodeficiency (SCID), or
• a previous episode of intussusception.
• Babies who are mildly ill can get the vaccine. Babies who are
moderately or severely ill should wait until they recover.
• You may consider vaccinating  babies with weakened immune
systems due to:
• HIV/AIDS, or any other disease that affects the immune system
• treatment with drugs such as steroids
• cancer, or cancer treatment with x-rays or drugs
Conditions commonly misperceived as contraindications for rotavirus
vaccine include:
• Prematurity
• Household members who are immunosuppressed
• Household members who are pregnant
The effectiveness of hygienic measures to
diseases transmitted via fecal-oral route may
not be effective.
Prevent exposure of infants and young children to
individuals with acute gastroenteritis in family and
institutional settings by maintaining high level of
sanitary practices.
CONTROL OF PATIENTS, CONTACTS AND
IMMEDIATE ENVIRONMENT
• Report to local health authority
• Isolation: Enteric precaution, with frequent hand-washing by
caretakers.
• Concurrent disinfection: Sanitary disposal of diapers.
• Immunization of contacts: Not applicable.
• Quarantine: Not applicable.
• Specific treatment: None, oral rehidration therapy.

Epidemic measures:
Search for vehicles of transmission and source.
THANK YOU!