Rotavirus Infections

Rotavirus is a contagious virus. Among children, it's the leading cause of severe diarrhea. In some infants and children, diarrhea may be so severe that they become dehydrated and require emergency care or hospitalization.

• Usually spreads because of improper hand-washing
• A vaccine helps prevent it in infants
• Most children will be infected by the time they are 3
• Causes as many as 55,000 children to be hospitalized each year in the United States
• Peaks in winter and spring
• May live on hard surfaces such as toys and door knobs for some time
• Treatment goal is to prevent complications from dehydration

Most children have been infected with rotavirus by the time they are 3. In fact, rotavirus infections are the most common cause of diarrhea in children. More specifically:

• Rotavirus causes more than 125 million cases of diarrhea each year in children and infants worldwide
• In the United States, the number of childhood deaths from rotavirus is between 20 to 40 each year (compared to 600,000 worldwide).

Symptoms of a rotavirus infection range from mild or severe. They may take up to two days to appear after coming in contact with the virus. While symptoms may vary child to child, the most common include:

• Fever, which usually subsides within the first couple of days
• Nausea and vomiting
• Abdominal pain
• Diarrhea (usually watery and frequent; may last between three to eight days)
• Dehydration, which can occur quickly, especially in infants. Symptoms of dehydration may include:
  • Lethargy or sleepiness
  • Irritability
  • Thirst
  • Pale color to skin or mottling
  • Less elasticity in the skin
  • Eyes appear deeply sunken
  • Baby's fontanelle (or soft spot) may feel sunken
  • Decreased or absent tears
  • Decreased urine output or fewer wet diapers
  • Dry mouth

Rotavirus usually spreads from fecal-oral contact. This normally happens because of poor hand-washing or from consuming contaminated food or water. In addition, the virus:

• May also be spread from sneezing or coughing, though it’s less common
• May live on surfaces such as doorknobs and toys for quite some time
• Peaks in the winter and spring

Proper hygiene, hand washing, and cleaning surfaces (such as toys and door knobs) are the best way to prevent catching a rotavirus. In addition, according to the Centers for Disease Control and Prevention, there are two brands of vaccines that can help prevent rotavirus infections, given when your child is 2 months, 4 months, and potentially 6 months.

In addition to a taking a complete medical history and physical examination, your doctor may request a stool culture.

There is no cure for rotavirus, so treatment of the disease is more for making your child feel better and to prevent any complications from dehydration.

Traditional treatments for a rotavirus infection

If your child develops rotavirus, she may not be able to attend daycare or school while ill. If your child is hospitalized, she will be isolated from other children to prevent an outbreak in the hospital. Treatment may include:

• Drinking plenty of water, formula, breast milk, and/or special electrolyte-containing fluids such as Pedialyte (young children should not drink soda or sports drinks)
• Feeding your child solid foods if she can tolerate them

About one out of every 40 children may develop severe enough dehydration to require hospitalization. In these children treatment may include:

• Intravenous (IV) fluids
• Nasogastric (NG) tube feedings (a small tube may be place into your child's stomach through their nose)
• Blood work (to measure your child's electrolyte levels)

The Children's Hospital Informatics Program created HealthMap, an online resource and smart phone app that helps track the spread of contagious diseases in real time, including rotavirus.