By: Yarlini Vipulanandan, MD, FAAP
Rotavirus causes intestinal infections, leading to vomiting, diarrhea and dehydration. It's a highly contagious virus that damages the cells of the small intestine. Outbreaks often happen in child care centers and spread through ingestion of contaminated food or water.
Before the vaccine was available, rotavirus infections were very common in schools and at home. Many kids lost valuable time to learn, play with their friends or share with their families because they got sick. Other had to be hospitalized and some even died. The vaccine against rotavirus, along with an effective cleaning routine, can protect your child from these infections so they can focus on learning and growing.
Where we stand: rotavirus vaccine for children
The American Academy of Pediatrics (AAP) believes that a federal advisory panel's decision to make the rotavirus vaccine optional for children is dangerous and could put children at risk. AAP still strongly
recommends that all children get all doses of the rotavirus vaccine as part of routine care.
How do rotaviruses spread?
Rotaviruses live in human feces (poop). They spread when traces of poop from an infected person make their way into the mouth of a non-infected person. Only a small amount of contact with infected poop is enough for this to happen.
People can become infected with a rotavirus through:
Eating contaminated food, especially when food handlers don't wash their hands well after using the bathroom.
Touching contaminated surfaces or objects, such as toys, bathroom fixtures or shared classroom items. Rotavirus can survive on surfaces for weeks to months, which makes it easy for children to pick up.
Contact with droplets of saliva, snot or other body fluids from an infected person. Droplets from coughing or sneezing are less infectious compared with contaminated food or surfaces, but they can still spread the infection.
Signs & symptoms of rotavirus
In most cases, viral gastrointestinal illnesses are not serious, but children can feel quite sick. The symptoms of a rotavirus infection begin 1 to 2 days after exposure to the virus. Healthy children have symptoms for 3 to 7 days and then recover.
Unvaccinated children between 3 and 35 months of age are more likely to have moderate to severe infections. Children with high-risk health conditions are especially vulnerable because symptoms can be extreme and harm their health.
Children with a rotavirus infection have:
- Watery diarrhea
- Vomiting
- Fever
- Abdominal pain
In severe cases, children may become dehydrated and require admission to the hospital. Prolonged or severe diarrhea, particularly when accompanied by vomiting, can lead to dehydration.
Signs of dehydration include:
- Increased thirst
- Less urine or decreased wet diapers
- Dry mouth
- Fewer tears
- Weight loss
As dehydration becomes more severe, your child may become cranky and irritable, their eyes will appear sunken, and they may have a faster heart and breathing rate. If dehydration continues, the kidneys will stop making urine, and the heart will not have enough fluid to pump. Your child's blood pressure will then drop, causing them to go into shock and become very sick.
What parents can do to prevent rotavirus
The rotavirus vaccine is one of the
recommended childhood immunizations. Here's what to know:
Instead of a shot, babies swallow the vaccine by mouth.
Your pediatrician might recommend one of the two different vaccine versions (RV5, known as RotaTeq or RV1, known as Rotarix).
Each version has different timing but provides the same protection.
RV5 (RotaTeq): First dose at 2 months, second dose at 4 months and third dose at 6 months.
RV1 (Rotarix): First dose at 2 months and second dose at 4 months.
If your child has rotavirus
In most cases, rotavirus illnesses resolve on their own with time and without any specific treatment. Make your child as comfortable as possible and take steps to
prevent dehydration. Encourage them to rest, drink extra fluids and continue to eat a regular diet.
It's important that the fluids they drink contain salt. The body loses salts when someone has diarrhea.
Rehydration fluids to restore the salts level back to normal are sold over the counter, but you can also make them at home. Talk to your pediatrician to be sure you have the correct amount of salt and water if you decide to make them at home.
Why the rotavirus vaccine is important for
all of us
Rotavirus used to be the number one cause of gastroenteritis and diarrhea in young children. After the vaccine was introduced between 2006 and 2008 and added to routine childhood immunizations, rotavirus infections dropped dramatically. Hospitalizations among U.S. children under 5 years of age have decreased by about 75% since then. The vaccine has prevented hundreds of thousands of ER visits and more than a million outpatient visits for diarrhea. It has also reduced the risk of seizures in children with severe rotavirus infections by about 20%.
For children with weakened immune systems
Children with weakened immune systems (called "immunocompromised) are especially at risk of getting infected with rotavirus. Because their bodies can't fight infections as well, they may develop very severe or long‑lasting diarrhea that can be life‑threatening.
When most other children around them are vaccinated, the virus has fewer chances to spread. That means immunocompromised children are less likely to be exposed in the first place and less likely to face the serious symptoms that could put their health or even their life at risk.
For severe cases of rotavirus:
Admission to the hospital for intravenous (IV) fluids may be required.
If your child is vomiting, continue to offer fluids but give small amounts and more frequent feedings.
Be careful with apple juice; too much of it can cause diarrhea, even in healthy children.
The use of antibiotics will not help, since they have no effect on viruses and may make the diarrhea worse.
Older children may benefit from antidiarrheal medicines, but only under the advice of your pediatrician.
Talk with your doctor
Tell your doctor if your child has known life-threatening allergies or a history of intussusception (when the intestine folds into itself and causes significant stomach pain). Children with minor illnesses, with or without low-grade fever, can get vaccinated, but you should consult first with your doctor.
Talk to your pediatrician before getting the shot if your child has a weakened immune system from a chronic health condition or medications. Do the same if your child is experiencing gastroenteritis (the "stomach flu") or has any chronic intestinal tract disease.
Possible effects after vaccination
After receiving the vaccine, babies can become fussy and occasionally have a fever. In very rare occasions, babies can develop intussusception. This is a health condition where the intestine folds into itself. Keep an eye for significant irritation or stomach pain after the vaccine. Your child should see a doctor if that happens, to prevent any possibility there is intussusception, but be aware that the chance is very small. For any other signs that concern you, call your doctor. If someone has a serious reaction to a vaccine, there are two government agencies that monitor vaccine reactions and safety through the Vaccine Adverse Reporting System (VAERS).
Remember
Talk with your child's doctor if you have any questions about rotavirus and how to prevent your child from becoming infected.
About Dr. Vipulanandan
Yarlini Vipulanandan, MD, FAAP, is a combined Pediatric Infectious Disease and Pediatric Hospital Medicine Fellow at the University of Alabama in Birmingham and is pursuing research in both congenital infections and osteoarticular infections. She completed her pediatric residency training at University of Texas Southwestern Medical Center in Dallas. Dr. Vipulanandan is a post-residency training member of the American Academy of Pediatrics.
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