Rotavirus Diarrhea (Children) – Causes, Symptoms, Treatment

There are many possible causes of diarrhea but among children, viral diarrhea tends to be the most common. It is usually self-limiting meaning that it resolves within a few day and does not lead to complications in most cases.

However, dehydration from diarrhea is still the number one cause of death among infants and rotavirus infection is the leading cause of dehydrating gastroenteritis in children younger than 5 years. It causes over 500,000 child deaths across the globe every year.

What is rotavirus diarrhea?

Rotavirus is a type of virus that causes gastroenteritis. One of the main symptoms of gastroenteritis is diarrhea, hence the term rotavirus diarrhea. Viral gastroenteritis may also cause nausea, vomiting, abdominal cramps and fever. There are many different types of viruses that can cause viral gastroenteritis and rotavirus is only one type.

It is easily spread among children, especially when children are in close contact like within a daycare. The incidence of rotavirus and hospitalization due to rotavirus gastroenteritis has sharply declined since the advent of the rotavirus vaccine. While vaccination is advisable, there are a host of different ways to prevent the spread of virus although it is not always as reliable as immunization.

Read more on viral gastroenteritis.

Causes of Rotavirus Diarrhea

Rotavirus is a double-stranded RNA virus that infects almost every child by the age of 5 years. Most cases of rotavirus gastroenteritis occurs in the ages between 3 months and 3 years. It is less likely to cause serious disease in infants under 3 months since the baby has antibodies from the mother to guard against the virus.

There are eight different species of rotavirus denoted as A, B, C, D, E, F G and H. Rotavirus A is the most common cause of rotavirus gastroenteritis. Before the development of the rotavirus vaccine, most infections occurred during the winter and spring months. This winter occurrence and the viral nature of the disease led to it being commonly referred to as the stomach flu.

Spread of Rotavirus

Rotavirus is found throughout the world. It is mainly spread through the feco-oral route. This means that fecal particles contaminated with the rotavirus from an infected child enters the mouth of an uninfected child to cause the disease. Spread may occur when an infected child makes direct contact with an uninfected child, through daycare workers or through contaminated objects (fomites).

What happens in rotavirus diarrhea?

Once the virus enters the mouth, it travels down the esophagus to the stomach and then the small intestine. This occurs with most viruses that are primarily spread through the feco-oral route. Rotavirus tends to target the cells of the small intestine. It causes inflammation of the small intestine (enteritis) and causes a host of disruptions that leads to diarrhea.

It hampers the absorption of nutrients like carbohydrates as well as electrolytes and water. The unabsorbed substances can affect the osmotic concentration and further draw out more water from the body. In addition, the disruption caused by the virus results in the body pushing out water into the lumen of the small intestine. Furthermore movement through the bowels becomes faster.

Signs and Symptoms

Rotavirus gastroenteritis presents with most of the same signs and symptoms as other types of gastroenteritis. There are usually no specific symptoms to differentiate rotavirus gastroenteritis from other types of viral gastroenteritis. There is an approximately two day incubation period. This is the time from the point of infection to the appearance of the first symptoms.

• Low-grade fever
• Vomiting
• Abdominal pain
• Watery diarrhea

The symptoms can last for 3 to 8 days. It is important to note that rotavirus gastroenteritis presents with severe diarrhea. The symptoms tend to be more severe in unvaccinated children. Dehydration is the main complication and can be life-threatening if not treated promptly. It is therefore important to monitor the signs and symptoms of dehydrations, such as:

• Sunken eyes
• Dry mouth and lips
• Dry skin
• Crying with no tears
• Lethargy and restlessness

Read more on deadly diarrhea in children.

Treatment of Rotavirus Gastroenteritis

Rotavirus gastroenteritis usually does not require any specific medication. The symptoms resolve within a few days or up to one week after it is onset. However, there is a constant risk of dehydration while the symptoms are present.

Dehydration can be prevented with proper oral rehydrating solutions. Breastfeeding should not be stopped for infants. Intravenous (IV) fluids administration may be necessary in severe cases where there is dehydration, especially if it is progressing. Hospitalization may therefore be necessary.

Prevention and Rotavirus Vaccine

A number of different measures can help to prevent  rotavirus. However, it is difficult for rotavirus to be avoided altogether. In the event that a child does become infected, the focus should be on preventing complications like dehydration. The following preventative measures should always be practised to prevent rotavirus gastroenteritis as well as a host of other infections.

• Wash hands regularly. Children should be taught to do this on a regular basis and especially before eating or using the bathroom.
• Do not share food, drink or cutlery. Children need to be made aware of this despite being taught importance of sharing non-personal items.
• Dispose of diapers appropriately. Caregivers must discard diapers where it cannot contaminate food or water and not be easily reached by children.
• Practice good hygiene. Parents and caregivers must practice good hygiene at all times, especially when preparing food and after changing diapers.

It is important that parents understand the importance of keeping their infected child at home and away from other children.  Children may be infectious for several days after the symptoms resolve. It is therefore important that these preventative measures are practised at all times and not only when in contact with a child who is known to have rotavirus gastroenteritis.

Are vaccines effective and safe?

The rotavirus vaccine is effective in preventing rotavirus gastroenteritis or at least minimizing the severity of the disease Despite the misconceptions about vaccines, the rotavirus vaccine is very safe. Side effects are rare and most are mild in the event that it does occur. The rotavirus vaccine has to be administered more than once to be fully effective. It is important to consult with a medical professional about when the rotavirus vaccine should be administered.