It is known to cause acute gastroenteritis, an inflammation of the stomach and intestine, especially in children. Here are the signals to recognize it, what treatments and what to do for prevention
The Rotavirus It is the main cause of viral gastroenteritis in babies and children under 5 years of age. Rotavirus infection can be prevented following daily hygiene rules and through vaccination, or the two strategies that, together, reduce the risks of complications, such as dehydration and hospitals.
What is Rotavirus?
Rotavirus is an RNA virus (which uses RNA as a genetic material) belonging to the family of Reoviridae. It is very resistant, because it is composed of a double layer of proteins that makes it more resistant.
Rotavirus is known to cause acute gastroenteritisan inflammation of the stomach and intestine, especially in children, even if it can infect people of all ages. There are six forms in nature, but type A is responsible for the most serious forms in babies and children, followed by types B and C.
Rotavirus in children under 5 years of age can cause more intense symptoms and, therefore, can involve a greater risk of dehydration. The “major peak” period is usually the winter one, from November until March. Some studies suggest that climate change could alter the seasonality of some viruses such as rotavirus, but research is still in progress. (1)
In the world, Rotavirus gastroenteritis need over 25 million medical visits and 2 million hospital hospitalizations every year. In Europe, every year, they require visits or access to the emergency room for gastroenteritis from Rotavirus between 150 thousand and 600 thousand children under 5 years, of which on average between 75 thousand and 150 thousand are hospitalized. In Italy, on an average of 80 thousand – 90 thousand visits for Rotavirus infections, about 10 thousand hospitalizations per year for gastroenteritis occur. The hospitalizations, especially in developed countries, are much lower than the cases of gastroenteritis from rolverus treated at home. (2)
This figure also includes adults, which albeit in milder form, can contract the Rotavirus. In fact, an infection in childhood does not make totally immune, and it is therefore possible to infect yourself again later, perhaps when you have a child at home with this form of viral gastroenteritis or work in contact with children and in contaminated environments.
What are the symptoms of the virus?
Rotavirus symptoms in children begin to manifest themselves after a period of incubation of at least two days and include:
- fever moderate around 37.9 ° C (but can be higher in some cases);
- vomiteven persistent;
- diarrhea with frequent and watery stools;
- abdominal pain;
The characteristics of the rotavirus may vary, depending on the more or less aggressive type of viruses, but the combination of diarrhea and vomiting is also typical of less virulent forms.
The most serious complications are linked to acute diarrhea and are consequent to possible dehydration (whose clinical signs are: decrease in the amount of urine, dry mouth, cry without tears, dry skin, sleepiness and torpor), which must be treated quickly to avoid problems to the functionality of other organs (liver, kidneys) and to prevent brain damage.
It is essential to know the mechanisms of contagion of the Rotavirus, in order to prevent the infection as much as possible, in particular through correct hygiene rules. The main transmission route is the gold-fecal one, followed by contact with contaminated objects and that through the respiratory tract. It may happen to contract the infection by ingesting water or contaminated foods, such as fruit and vegetables, or through the contact of the hands with contaminated surfaces; It is frequent that a small child can put his hands in his mouth after touching toys or other objects contaminated with stool residues.
But how to understand if the child has the rotavirus? The symptoms of the infection are non -specific, or fever (in at least 1/3 of cases), vomiting and diarrhea (which can be more or less acute), and must therefore be evaluated by the pediatrician, who will carry out any Rotavirus diagnosis And, in the event, it will provide therapy to prevent the consequences of the most acute forms and symptoms related to dehydration.
How to cure the Rotavirus in children
There is currently no specific antiviral treatment. So what to do for the care of the Rotavirus?
The cure focuses on the management of symptoms and on the prevention of dehydration, under control and prescription of the pediatrician. (3)
All mainly through:
- Rehydration. The administration of oral rehydrating solutions is crucial to replace liquids and electrolytes lost with vomiting and diarrhea.
- Diet. In all forms of diarrhea a free diet is advisable, which follows the appetite of the children. For infants, the advice is to continue with breastfeeding. For children nourished instead through the artificial formula, the pediatrician will evaluate the replacement of the product with a specific milk -free milk (substance that sometimes increases the laxative effect) and the administration of rehydrates.
- Assumption of an antipyretic To treat the malaise.
It is essential to remember that the infection, being caused by a virus, must not be treated with antibiotics.
After evaluating the symptoms, the pediatrician may request the search for rotavirus antigens on a patient’s sample of feces, to confirm the presence of the infection or not.
Risks and complications of the Rotavirus in children
The main risk associated with the Rotavirus in children is dehydration, which can be dangerous if not treated promptly and cause different complications, namely:
- Severe dehydration. It can request hospitalization and, when oral hydration is no longer sufficient, an intravenous therapy.
- Lethargy and fatigue. If dehydration is serious, it can lead to an electrolytic and metabolic imbalance, involving other organs such as kidneys, liver and nervous system. They are very limited cases, especially in our country, compared to developing areas, where rotavirus is the cause of mortality. The most serious complications are often associated with an existing fragility, a late diagnosis or a slow response to therapies.
Some children, in rarer cases, may develop a different type of complication, manifesting a temporary lactose intolerance (Lactose intolerance syndrome).
There Rotavirus prevention, In children as in adults, it starts from the simplest but essential hygiene practices, such as the frequent washing of hands with soap and water, surfaces, toys and all objects and spaces for the most frequent use in children’s services. The same goes for the manipulation and preparation of food: the hands are always washed, as well as the surfaces, the knives, the cutting boards.
If a Rotavirus infection has already been diagnosed, it is important to make even more attention, especially when the diaper change, since in case of diarrhea the feces represent a vehicle of contagion.
Rotavirus vaccine: is it better to do it?
In addition to hygiene, the Rotavirus vaccine It represents the most important and effective prevention tool, and is recommended for children starting from the sixth week.
The vaccine for the Rotavirus has in fact proved very effective in reducing the incidence of gastroenteritis and serious complications due to acute diarrhea and possible dehydration. In 2013, the WHO recorded about 200,000 deaths in the world from complications due to the virus; Vaccines drastically reduced mortality to European countries and the United States, while the situation is still very serious in developing countries.
The difference is also the presence, in the richest countries, of a health system, equipped with structures dedicated to child health care, capable not only of reducing the spread of the disease but also hospitalization. On the contrary, in developing countries, not only are vaccines are not available for the whole child population, but there are no means and structures to limit the complications of the disease, in less serious cases as in the most serious ones.
The vaccine is available in two typesboth in oral form: one that provides for the administration of two doses and one that includes three.
It is advisable not to wait over the 12th week of life for the first dose of the vaccine, and for the last no later than the 24th (in the case of the two -dose vaccine) or no later than 32^ (three -dose vaccine).
Both vaccines have shown a significant reduction in the severity of the infection and the need for hospitalization. Vaccination is particularly useful to protect the most vulnerable children and to reduce the spread of the virus in the community.
Before administering the vaccine, it is necessary to distinguish the specific cases for which it is not recommended, or in the presence of serious congenital immunodeficiencies such as Scid (serious -combined immunodeficiency), or in case of treatments with immunosuppressive therapies, or after an allergic event at a previous dose of the vaccine itself.
Another case in which the Rotavirus vaccine is not recommended is the presence of anIntestinal Infeginationan malformation that entails the folding within a part (or more parts) of the intestine and causes intestinal obstruction.
In the days following the administration of the vaccine, it is important to pay attention to symptoms with abdominal swelling, vomiting, presence of blood in the stool, accompanied by high fever. In these cases it is essential to contact the pediatrician or the nearest hospital, just to avoid more serious complications.
