rotavirus infection
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Electron micrograph of a group of
rotavirus virions
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Rotavirus is the most common cause of severe diarrhea
among children, resulting in the hospitalization of approximately 55,000
children each year in the United States and the death of over 600,000 children
annually worldwide. The incubation period for rotavirus disease is approximately
2 days. The disease is characterized by vomiting
and watery diarrhea for 3–8 days, and fever
and abdominal pain occur frequently. Immunity after infection is incomplete,
but repeat infections tend to be less severe than the original infection.
The virus
A rotavirus has a characteristic wheel-like appearance when viewed by electron
microscopy (the name rotavirus is derived from the Latin rota, meaning "wheel").
Rotaviruses are nonenveloped, double-shelled viruses.
The genome is composed of 11 segments of
double-stranded RNA, which code for six structural
and five nonstructural proteins. The virus
is stable in the environment. Transmission and occurrence
The primary mode of transmission is fecal-oral, although some have reported
low titers of virus in respiratory tract secretions and other body fluids.
Because the virus is stable in the environment, transmission can occur through
ingestion of contaminated water or food and contact with contaminated surfaces.
In the United States and other countries with a temperate climate, the disease
has a winter seasonal pattern, with annual epidemics occurring from November
to April. The highest rates of illness occur among infants and young children,
and most children in the United States are infected by 2 years of age. Adults
can also be infected, though disease tends to be mild. Diagnosis
Diagnosis may be made by rapid antigen detection
of rotavirus in stool specimens. Strains may be further characterized by
enzyme immunoassay or reverse transcriptase polymerase chain reaction, but
such testing is not commonly done. Treatment
For persons with healthy immune systems, rotavirus gastroenteritis is a
self-limited illness, lasting for only a few days. Treatment is nonspecific
and consists of oral rehydration therapy to prevent dehydration. About one
in 40 children with rotavirus gastroenteritis will require hospitalization
for intravenous fluids. Prevention
The rotavirus vaccine is very effective in preventing rotavirus gastroenteritis.
The US Advisory Committee on Immunization Practices (ACIP) recommends routine
vaccination of infants with either of two available vaccines. RotaTeq®
(RV5), licensed in 2006, is given in 3 doses at ages 2, 4 and 6 months;
Rotarix® (RV1), licensed in 2008, is given in 2 doses at ages 2 and 4 months.
These vaccines differ in how they are made and when they are given, but
both are given orally and both provide protection against the disease.
Related category
• HEALTH
AND DISEASE Source: Centers for
Disease Control and Prevention
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