Topic: Rotavirus
Description
Rotaviruses are a group of viruses that can cause severe viral gastroenteritis in infants and young children. Rotavirus causes about half of all hospitalised cases of gastroenteritis in children less than five years of age. It is estimated that in Australia, about 4% of children are admitted to hospital with rotavirus gastroenteritis in their first five years of life.
The virus is highly contagious and can cause outbreaks among children in day care settings. By five years of age, almost every child will have been infected with rotavirus.
In temperate climates, rotavirus diarrhoea occurs in seasonal peaks during cooler months. In tropical climates, cases occur throughout the year.
Symptoms
The main symptoms are vomiting, fever and watery diarrhoea. Symptoms can be mild, but some children, especially those under two years of age can, require hospital treatment for dehydration. Onset is often sudden and the illness mainly affects infants and young children under 3 years of age.
The time from contact with the virus to the development of symptoms is approximately 24-72 hours. The diarrhoea usually lasts from two to five days.
Transmission
Rotaviruses are highly infectious and can be passed from person to person very easily. The virus is in the faeces of a person while they have diarrhoea and for some days after the diarrhoea stops.
Rotavirus infections are spread when:
- infected people do not wash and dry their hands adequately after going to the toilet.
- contaminated hands then spread the virus to other people and surfaces that may be touched by others.
- hands can become contaminated while changing the nappy of an infected infant.
Treatment
A child with vomiting and diarrhoea should be taken to the doctor who will advise if treatment is needed. Most rotavirus infections resolve without treatment. It is very important for the child to drink plenty of fluids to avoid dehydration. Rehydration with oral glucose/electrolyte solution is particularly effective. If children refuse this solution, or it is unavailable, diluted fruit juice or soft drinks may be given (1 part juice/soft drink to 3 parts water). Babies should continue to be offered their normal milk feeds plus extra fluids in between feeds.
Control
Children should not return to childcare or school until after diarrhoea has stopped. People who work in the food industry or healthcare professionals should not return to work until 48 hours after diarrhoea has stopped.
Prevention
Oral vaccines are available for young infants to prevent severe diarrhoea and vomiting caused by rotavirus. However there are strict timeframes for the administration of these vaccines. It is important to discuss this with your doctor.
Vaccination of older infants is not recommended.
Rotavirus vaccination is included in the National Immunisation Program (NIP) from 1 July 2007. All children born on or after 1 May 2007 are eligible for free rotavirus vaccine.
RotaTeq is the rotavirus vaccine recommended for use in Queensland. It consists of 3 oral (swallowed) doses given at 2, 4 and 6 months of age. Dose 1 cannot be given after the infant reaches 13 weeks of age and dose 3 cannot be given after the infant reaches 33 weeks of age.
Rotavirus vaccine can be safely given at the same time as other recommended vaccines on the childhood schedule.
Vaccination will reduce the risk of developing severe rotavirus gastroenteritis by 85-100% and any rotavirus gatroenteritis by around 70%.
Infants who are vaccinated with rotavirus vaccine may have slightly increased risk (1-3%) of developing diarrhoea or vomiting in the week after vaccine administration. Serious side effects are rare.
Overall good hygiene is felt to be the best way to prevent rotavirus infection spreading. Hands should be washed thoroughly with warm soapy water for at least 15 seconds and dried thoroughly on a disposable or clean towel:
- after going to the toilet
- before preparing or handling food
- after every nappy change
- after changing soiled linen.
Other measures include:
- never change nappies on tables or counters where food is prepared or eaten
- clean change areas with warm soapy water and disinfectant after every nappy change
- clean books, toys, equipment, furnishings, floors and toilets regularly (including toilet door handles).
People with diarrhoea should not prepare or handle food that will be eaten by others.
Anyone with diarrhoea should not attend childcare/school/work until the diarrhoea has ceased.
Anyone with diarrhoea should not swim, wade or paddle in a public pool.
Because vomit or diarrhoea can be very infectious, it is most important that any spills are cleaned up quickly and appropriately. See the Queensland Health fact sheet on gastroenteritis for further advice.
Help and Assistance
For further information please contact your local doctor, community health centre, nearest population health unit or contact Queensland Health information phone number 13HEALTH.
Other Resources
Queensland Health website - A healthier you
Immunise Australia website
References
Australian Government, Department of Health and Ageing. 2005. Staying Healthy in Child Care. 4th edition. NHMRC
Heymann, D., ed. 2004. Control of Communicable Diseases Manual, 18th edition. Washington, DC: American Public Health Association.
National Centre for Immunisation Research and Surveillance. Rotavirus vaccines for Australian children: information for GPs and immunisation providers. The University of Sydney.
Related Content
Rotavirus and immunisation fact sheet
Last Updated: 11th May, 2010
Date Valid to: 31st December, 2010
