Rotavirus infection
Rotavirus is a segmented double-stranded RNA reovirus and the classic cause of acute watery diarrhea and vomiting in young children, with fecal-oral transmission and a wintertime, daycare-associated pattern. Diagnosis is clinical; management is rehydration, and prevention rests on the live oral rotavirus vaccine.
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What this article covers
- Overview
Rotavirus is the classic viral cause of acute gastroenteritis in infants and young children, historically the most common cause of severe pediatric diarrhea worldwide before routine vaccination.
- Epidemiology
Most common in children 2 years of age and younger, with the highest severity of disease concentrated in infancy.
- Risk factors
Young age (under 2 years) is the dominant risk factor for both acquisition and severe disease.
- Pathophysiology
Transmission is fecal-oral, with the virus ingested and infecting mature enterocytes at the tips of small intestinal villi.
- Clinical features
Vomiting is typically the first and most prominent early symptom, often preceding watery diarrhea onset by hours.
- Differential diagnosis
Norovirus infection: the most common overall cause of acute viral gastroenteritis in developed countries and of cruise-ship/school outbreaks; clinically similar but a single-stranded RNA calicivirus…
- Diagnosis
Rotavirus gastroenteritis is a clinical diagnosis in a young child with the characteristic pattern of vomiting followed by watery diarrhea and fever during winter months, often with a daycare…
- Management
First, assess dehydration severity and treat accordingly, because most morbidity from rotavirus comes from fluid loss, not the virus itself.
- Complications
Dehydration and hypovolemic shock are the principal complications and the main driver of hospitalization and, in resource-limited settings, mortality.
- Prognosis
Excellent in an otherwise healthy child who is adequately rehydrated, with resolution of symptoms over several days.
- Prevention
The live attenuated oral rotavirus vaccine is the cornerstone of prevention and is part of the routine childhood immunization schedule, given as either a 2-dose series (RV1) or a 3-dose series (RV5)…
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Related articles
- Norovirus infection
Norovirus is the most common cause of acute gastroenteritis in the United States, producing watery, noninflammatory diarrhea with prominent vomiting after a short incubation period, spreading efficiently via the fecal-oral route with an infectious dose under 100 viral particles and viral shedding for up to two weeks after symptoms resolve; diagnosis is clinical or by nucleic acid amplification testing, and treatment is entirely supportive oral or IV rehydration since no antiviral or antimicrobial therapy exists.
- Cholera
Cholera is a toxigenic Vibrio cholerae infection causing sudden, voluminous rice-water diarrhea from cyclic-AMP-driven intestinal secretion, diagnosed clinically and confirmed by stool culture, and treated primarily with volume-for-volume rehydration plus a single-dose antibiotic.
- Campylobacter infection
Campylobacter is a comma-shaped, gram-negative bacillus and a leading cause of bacterial bloody diarrhea from undercooked poultry, unpasteurized milk, or infected animal contact, usually self-limited but treated with azithromycin for severe or high-risk disease, and a recognized trigger of Guillain-Barre syndrome and reactive arthritis.
- Escherichia coli infection
Escherichia coli is a gram-negative bacillus that causes most urinary tract infections and catheter-associated bloodstream infections, plus distinct diarrheagenic syndromes including travelers' diarrhea (ETEC) and hemorrhagic colitis with hemolytic uremic syndrome (EHEC/STEC). Diagnosis rests on culture with syndrome-specific colony-count thresholds, and management ranges from short-course oral antibiotics for cystitis to strictly supportive, antibiotic-avoiding care for EHEC.
- Vaccines
Vaccines are live attenuated, inactivated, subunit, conjugate, or toxoid preparations that induce antigen-specific active immunity to prevent infection or its complications before exposure occurs. Selection follows the age- and risk-based Advisory Committee on Immunization Practices schedule, with routine adult boosting such as Tdap every 10 years, and inactivated regimens substituted whenever a live vaccine is contraindicated by pregnancy or immunosuppression.