Rotavirus is a double-stranded RNA virus, that is categorized under the family of Reoviridae. It is responsible for the onset of severe gastroenteritis, being the primary culprit behind exhausting diarrhea amongst pediatric patients [1] [2].

Typical symptoms associated with a rotavirus infection encompass all the manifestations of acute gastroenteritis, that persists for 3 to 8 days on average. Multiple episodes of diarrhea are accompanied by vomiting, nausea, widespread abdominal pain, and cramping. Bloody diarrhea is not reported as a rotavirus infection-related manifestation. Patients are most commonly children, who may often be febrile and report a decreased appetite and fatigue.

Gastroenteritis that is caused by a rotavirus is usually attributed to the serogroup A rotavirus pathogen [3]. Symptomatology is profound and children run the risk of developing dehydration as a result of massive diarrhea. Dehydrated patients exhibit diminished urine output, decreased skin turgor, and hypotension. Rotavirus infection in infants leads to the same symptoms, including severe diarrhea, vomiting, and fever; dehydration also leads to sunken fontanelles, a decreased production of tears, lethargy, and irritability.

Adults are not frequently infected by rotavirus. When the infection does occur, manifestations vary between a complete absence of complaints and nausea, vomiting, diarrhea, fever, and fatigue [4]. An equally variable is the clinical presentation in immunodeficient adults [4].

Although gastroenteritis is the predominant manifestation of a rotavirus infection, isolated studies have proposed a potential causal association between rotavirus infection and manifestations encompassing epileptic seizures, inflammation of the cerebellum, pneumonia, and rash [5] [6] [7] [8] [9].

• Fever

  We investigated whether RV infection is a major cause of neonatal fever and compared the clinical characteristics of bacterial infection, viral infection and unknown causes of neonatal fever. [ncbi.nlm.nih.gov]

  When to call the healthcare provider Call your child’s healthcare provider right away if your child has any of the following: Your child has a fever (see fever and children section below) Your child has had a seizure caused by the fever Has been vomiting [fairview.org]

  Rotavirus infection in infants leads to the same symptoms, including severe diarrhea, vomiting, and fever; dehydration also leads to sunken fontanelles, a decreased production of tears, lethargy, and irritability. [symptoma.com]

  Symptoms include: vomiting fever watery diarrhoea. The onset is sudden and symptoms last for an average of 3 to 7 days. The illness may cause severe dehydration and require treatment in hospital. [sahealth.sa.gov.au]

• Pain

  Signs and symptoms of rotavirus infection include fever, chills, vomiting, watery diarrhea, abdominal pain, dehydration, and loss of appetite. The associated symptoms can lead to severe dehydration. Symptoms typically go away after 3 to 9 days. [medicinenet.com]

  Children signs of dehydration, such as thirst and decreased urination, lethargy, dry mouth, sunken eyes, feeling faint on standing fever abdominal pain bloody diarrhoea any symptoms in a child less than 12 months of age. [sahealth.sa.gov.au]

  Multiple episodes of diarrhea are accompanied by vomiting, nausea, widespread abdominal pain, and cramping. Bloody diarrhea is not reported as a rotavirus infection-related manifestation. [symptoma.com]

  Other symptoms include fever and stomach pain. Rotavirus spreads when a child has oral contact with stool (feces) containing the virus. [myhealth.alberta.ca]

• Asymptomatic

  […] genes of the exclusively asymptomatic G10P[11] strain I321. [ncbi.nlm.nih.gov]

  In 15 pairs of infections, both episodes were asymptomatic. [nejm.org]

• Weakness

  The pattern of onset of unilateral facial weakness in relation to GBS seems to be variable. [ncbi.nlm.nih.gov]

  Call your local emergency number (911 in the US) if: Your child's body seems floppy and weak, or he or she does not respond to you at all. Your child has trouble breathing or his or her heartbeat is faster than usual. [drugs.com]

  An infection with herpes simplex virus, which is often concentrated in only one part of the brain, may lead to seizures or weakness appearing in only one part of the body. [msdmanuals.com]

  Abstract Guillain–Barré syndrome is characterized by progressive motor weakness, sensory changes, dysautonomia, and areflexia. Cranial nerve palsies are frequent in Guillain–Barré syndrome. [journals.sagepub.com]

• Malnutrition

  Therefore, we hypothesized that malnutrition exacerbates rotavirus disease severity in infants. [ncbi.nlm.nih.gov]

  Rotavirus diarrhea in Jewish and Bedouin children in the Negev region of Israel: epidemiology, clinical aspects and possible role of malnutrition in severity of illness. Pediatr Infect Dis J 1990; 9:314–21 4. [hisunim.org.il]

  This is more likely to occur in developing countries, where pre-existing malnutrition and enteropathies may lead to protracted diarrhoea in 8–20% of children initially presenting with acute gastroenteritis. 9 In developed countries this happens in up [adc.bmj.com]

• Diarrhea

  Multiple episodes of diarrhea are accompanied by vomiting, nausea, widespread abdominal pain, and cramping. Bloody diarrhea is not reported as a rotavirus infection-related manifestation. [symptoma.com]

  KEYWORDS: Antibody; Diarrhea; Immunity; Protection; Rotavirus [ncbi.nlm.nih.gov]

• Recurrent Diarrhea

  need for rehydration, duration of viral excretion, duration of infection control measures, length of hospital stay in days, recurrent diarrhea or chronic diarrhea. [cochrane.org]

  […] stay in days, recurrent diarrhea and chronic diarrhea. [cochranelibrary.com]

In order to accurately diagnose a rotavirus infection, a complete medical history is required. Patients are typically in their childhood and present with signs and symptoms consistent with profound gastroenteritis, such as many reported episodes of diarrhea, vomiting, fatigue, and nausea; they may also be dehydrated to a severe extent.

A complete blood count (CBC) and a thorough biochemical profile is the first step towards a successful diagnosis. Leucocytosis and leukocyte type, inflammation markers, and electrolytes levels can help to confirm inflammation and its general origin. The detection of rotavirus is rendered possible through the analysis of a stool sample. Various techniques can be employed towards this aim, including a culture, electron microscopy, latex agglutination, reverse transcriptase polymerase chain reaction (RT-PCR), and an enzyme immunoassay; the latter is the most common method used [10]. Studies have revealed high levels of sensitivity and specificity (over 91%) for an enzyme immunoassay and latex agglutination, although a considerable variability in the results has been reported [11].

In general, despite the fact that a rotavirus infection can be identified by laboratory tests, those tend to be time-consuming and do not contribute to the acute therapeutic plan in an emergency department. Viral detection is carried out for public health or research purposes.

• Colitis

  Forum Medycyny Rodzinnej, 6, 491-498. [ 7 ] De Villiers, F.P. and Driessen, M. (2012) Clinical Neonatal Rotavirus Infection: Association with Necrotizing Entero-colitis. [dx.doi.org]

Importantly, continuous treatment with MPA for 30 passages did not attenuate its antiviral potency, indicating a high barrier to drug resistance development. [ncbi.nlm.nih.gov]

Treatment Gastroenteritis is a common illness which can be particularly serious in young children. No specific antiviral treatment is available and antibiotics are not effective. [sahealth.sa.gov.au]

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Antibiotics are not used to treat this illness. The goal of treatment is to help reduce symptoms. [urmc.rochester.edu]

There is no clear role for drug treatment of viral gastroenteritis. (Antibiotics are used to treat bacterial infections, not viral infections.) It is important that the child is seen by a physician for evaluation and treatment. [healthcentral.com]

The disease most commonly targets children but can affect adults who tend to have a worse prognosis. [ncbi.nlm.nih.gov]

Prognosis Most of the infections resolve spontaneously. Dehydration due to severe diarrhea is one of the major complications. [medical-dictionary.thefreedictionary.com]

Appropriate microbiologic investigations are advisable to confirm the possible etiologic role of rotavirus. [ncbi.nlm.nih.gov]

Etiology Clinical features Diagnostics Differential diagnoses The differential diagnoses listed here are not exhaustive. Treatment Prevention [amboss.com]

Publication Expert opinion on rotavirus vaccination in infancy Peer-Reviewed Publication PRECEPT: An evidence assessment framework for infectious disease epidemiology, prevention and control Publication Expert opinion on rotavirus vaccination in infancy [ecdc.europa.eu]

Our study supported the association between rotavirus infection and the host HBGA phenotypes, which would help further understanding of rotavirus host range and epidemiology. [ncbi.nlm.nih.gov]

Epidemiology References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. Etiology Clinical features Diagnostics Differential diagnoses The differential diagnoses listed here are not exhaustive. Treatment Prevention [amboss.com]

The pathophysiology of a HLH associated encephalopathy was considered to be a local immune response within the CNS, because interferon-gamma can induce the expression of major histocompatibility complex class I and II antigens on glial cells in the CNS [ncbi.nlm.nih.gov]

Despite its significant clinical importance, the pathophysiological mechanisms by which rotavirus induces fluid and electrolyte secretion are still not fully understood. [news-medical.net]

However, much remains to be learned about the epidemiology, transmission and pathophysiology of the virus. [samj.org.za]

Christian Medical College, Vellore, Tamil Nadu 632004, India. 2 National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-G04, Atlanta, GA 30333, USA. [ncbi.nlm.nih.gov]

[…] research team that described the method as a novel means to prevent and treat viral infection. [medicalxpress.com]

Prevention of rotavirus infecions Proper hygiene and timely care can help one limit the severity of the viral attack, but a vaccination can be the safest way to prevent a bout of rotavirus infection. [thehealthsite.com]

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9. Ruzicka T, Rosendahl C, Braun-Falco O. A probable case of rotavirus exanthem. Arch Dermatol. 1985;121:253–254.
10. Cortese MM, Parashar UD. Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2009;58:1-25.
11. Ruggeri FM, Marziano ML, Salvatori E, et al. Laboratory diagnosis of rotavirus infection in diarrhoeal patients by immunoenzymatic and latex-agglutination assays. Microbiologica. 1992;15(3):249-257.