- Spreads easily among infants and young children.
- Causes severe watery diarrhea, vomiting, fever, and abdominal pain.
- Children can get dehydrated very quickly, and may need to be hospitalized.
- Two oral vaccines are licensed for use in the United States: RotaTeq (RV5) – 3 doses (2, 4, 6 months) and Rotarix (RV1) – 2 doses (2 & 4 months)
National Immunization Survey Data:
Percent Children 19-35 Months Who Have Received Rotavirus Vaccination
(2020 Goal: 80.0%)
For Your Patients
From the CDC’s Pink Book.
Rotavirus is a double-stranded RNA virus of the family Reoviridae. The virus is composed of three concentric shells that enclose 11 gene segments. The outermost shell contains two important proteins—VP7, or G-protein, and VP4, or P-protein. VP7 and VP4 define the serotype of the virus and induce neutralizing antibody that is probably involved in immune protection. Rotavirus is very stable and may remain viable in the environment for weeks or months if not disinfected.
The virus enters the body through the mouth. Viral replication occurs in the villous epithelium of the small intestine. Recent evidence indicates that up to two-thirds of children with severe rotavirus gastroenteritis show the presence of rotavirus antigen in serum (antigenemia). Infection may result in decreased intestinal absorption of sodium, glucose, and water, and decreased levels of intestinal lactase, alkaline phosphatase, and sucrase activity, and may lead to isotonic diarrhea.
Recovery from a first rotavirus infection usually does not lead to permanent immunity. After a single natural infection, 38% of children are protected against any subsequent rotavirus infection, 77% are protected against rotavirus diarrhea, and 87% are protected against severe diarrhea. Reinfection can occur at any age. Subsequent infections confer progressively greater protection and are generally less severe than the first.
The incubation period for rotavirus diarrhea is short, usually less than 48 hours. The clinical manifestations of infection vary and depend on whether it is the first infection or reinfection. The first infection after 3 months of age is generally the most severe. Infection may be asymptomatic, may cause self-limited watery diarrhea, or may result in severe dehydrating diarrhea with fever and vomiting. Up to one-third of infected children may have a temperature greater than 102°F (39°C). The gastrointestinal symptoms generally resolve in 3 to 7 days.
The clinical features and stool characteristics of rotavirus diarrhea are nonspecific, and similar illness may be caused by other pathogens. As a result, confirmation of a diarrheal illness as rotavirus requires laboratory testing.