Rotavirus infections

Rotavirus is the most common cause of severe diarrhoeal disease in infants and young children globally. It is transmitted through the oral-faecal route, directly from person to person, or indirectly through contaminated objects. People that are infected experience an abrupt onset of fever and vomiting followed by explosive, watery diarrhoea. Rotavirus diarrhoea is profuse, often leading to dehydration which can be severe, requiring hospitalization. The cornerstones of treatment of severe rotavirus diarrhoea are fluid replacement and zinc supplementation. 

Vaccines against rotavirus are available and vaccination is an important measure to reduce severe rotavirus-associated diarrhoea and mortality. 

Rotavirus causes watery diarrhoea, vomiting and severe dehydration in young children. Rotavirus diarrhoea is ubiquitous and, unlike bacterial diarrhoea, is not more prevalent in settings with poor water, sanitation and hygiene. Rotavirus peaks in cool, dry seasons in temperate climates but exhibits less pronounced seasonality in tropical settings. 

The clinical spectrum of rotavirus disease is wide, ranging from transient loose stools to severe diarrhoea and vomiting causing dehydration, electrolyte disturbances, shock, and death if rehydration is not provided. In typical cases, following an incubation period of 1–3 days, the onset of disease is abrupt, with fever and vomiting followed by watery diarrhoea. Gastrointestinal symptoms normally resolve within 3–7 days but may last for up to 2–3 weeks. 

Rotavirus has a case-fatality rate of approximately 2.5% among children in low-income countries who present to health facilities. This rate is higher in areas without good access to health care.