What is rotavirus, and what causes it?
Rotavirus is a virus that infects the intestinal tract. You can get rotavirus more than once, but the first infection is usually the worst. This infection causes stomach upset and diarrhea.
Babies and very young children who have rotavirus infections need to be watched closely, because they can become dehydrated very quickly. Dehydration occurs when the body loses water more quickly than it is replaced. When your child becomes dehydrated, severe health problems can arise.
Rotavirus infections spread easily. Outbreaks usually occur in the winter and early spring. Rotavirus infections often spread in settings where many children are together, such as day care centers.
The virus spreads through contact with the stool from an infected child. The virus can spread easily even when people try very hard to keep places clean. For example, when a caregiver changes the messy diaper of a child who has rotavirus infection, germs can get on the changing table, the caregiver's hands, or the hands of the already-infected child. The rotavirus germs can then spread to other children from the caregiver's or child's unwashed hands. It may be only a few steps to the sink, but the germs may get on surfaces that the caregiver or child touches along the way. For example, the germs may get on toys, doorknobs, or sink surfaces. The germs can live for days on objects and surfaces if they are not disinfected right away.
Other children who get the rotavirus germs on their hands can get the infection when they put their hands in their mouths. They can also get infected with rotavirus by chewing on a toy that has the germs on it.
Keep your child at home while he or she is sick and for a few days after they feel better. That's when the virus most likely can be spread to others. The virus can remain in your child's stool for weeks after the symptoms are gone.
What are the symptoms?
It takes about 1 to 3 days for a child who is exposed to the virus to start having symptoms.
Vomiting is often the first symptom. Usually, a fever and diarrhea follow. Most children with rotavirus have very watery diarrhea that seems like a large amount for a baby or small child. The most severe diarrhea lasts 3 to 8 days. But episodes of diarrhea can last long after your child starts feeling better. In some children, diarrhea can last for a few weeks.
Diarrhea, especially when it occurs along with vomiting, can quickly lead to dehydration in babies and young children who have rotavirus. For this reason, it is important to keep feeding your child and to watch him or her closely for signs of dehydration.
How is rotavirus diagnosed?
Your doctor will probably diagnose your child with rotavirus infection based on his or her symptoms. The time of year also is an important clue. If your child has diarrhea and other symptoms during the winter or early spring (about November through April), your doctor will often suspect rotavirus as the cause.
A test of stool can be done to confirm a diagnosis. This kind of test is not needed unless your child has other health conditions that make it important to know the exact cause of symptoms.
How is it treated?
It is most important to help keep your child comfortable and prevent dehydration.
Hold your child as much as he or she wants. Keep your child in comfortable clothes, and change his or her diaper or underpants as needed. Your child may get a diaper rash. To treat diaper rash, you may need to use warm washcloths to wipe your child's bottom and creams to help prevent soreness. In some cases, you may want to hold your baby and rinse his or her bottom in running bath water to clean the area well.
Don't give your child any over-the-counter medicines unless you've checked with the doctor first.
Your doctor may recommend a rehydration drink such as Pedialyte. This may be especially helpful if your child's diarrhea lasts longer than a few days. Rehydration drinks help replace fluids and electrolytes. Plain water doesn't provide necessary nutrients or electrolytes and may not be absorbed when your child has diarrhea.
Do not give your baby or young child rehydration drinks for adults or sports drinks, such as Gatorade. These drinks do not have the proper balance of nutrients and electrolytes for small children.
Your doctor may suggest probiotics for your child. They are bacteria that help keep the natural balance of organisms (microflora) in the intestines. For more information, see the topic Probiotics.
A baby or young child needs to be treated in a hospital if dehydration becomes severe. Call 911 or go to the emergency room if your baby has signs of severe dehydration, which include:
- Being very sleepy and hard to wake up.
- A very dry mouth and very dry eyes.
- Being limp and floppy like a rag doll.
- No wet diapers (a dry diaper) for 12 or more hours.
Can you prevent your child from getting rotavirus?
It is hard to prevent your child from getting this infection. Studies show that breastfeeding may help prevent rotavirus or reduce its severity.
Rotavirus vaccine helps protect against rotavirus disease. Depending on which brand of vaccine is used, infants need 2 or 3 doses starting at 2 months of age.
To help prevent the spread of rotavirus, wash your hands thoroughly and often.
Other Works Consulted
- Allen SJ, et al. (2010). Probiotics for treating acute infectious diarrhoea. Cochrane Database of Systematic Reviews (12).
- American Academy of Pediatrics (2015). Rotavirus infections. In DW Kimberlin et al., eds., Red Book: 2015 Report of the Committee on Infectious Diseases, 30th ed., pp. 684–688. Elk Grove Village, IL: America Academy of Pediatrics.
- Bass DM (2011). Rotaviruses, caliciviruses, and astroviruses. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1134–1137. Philadelphia: Saunders.
- Centers for Disease Control and Prevention (2009). Prevention of rotavirus gastroenteritis among infants and children: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 58(RR-2): 1–25. Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5802.pdf. [Erratum in MMWR, 59(33): 1074.]
- Clark HF, et al. (2008). Rotavirus vaccines. In SA Plotkin et al., eds., Vaccines, 5th ed., section 2, pp. 715–734. Philadelphia: Saunders Elsevier.
- Dalby-Payne JR, Elliot EJ (2011). Gastroenteritis in children, search date March 2010. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
- Hoffenberg E, et al. (2014). Gastrointestinal tract. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 22nd ed., pp. 651–691. New York: McGraw-Hill.
- Ward RL, et al. (2009). Rotaviruses. In RD Feigin et al., eds., Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed., vol. 2, pp. 2245–2270. Philadelphia: Saunders Elsevier.
Current as of: August 22, 2019
Author: Healthwise Staff
John Pope MD - Pediatrics
Kathleen Romito MD - Family Medicine
Elizabeth T. Russo MD - Internal Medicine
Christine Hahn MD - Epidemiology