Rotavirus
The common name for a family of viruses that share several features. The group A rotaviruses are the most common cause of severe diarrhea in children, striking 130 million people a year. It causes a diarrhea so severe that 870,000 children die from this virus around the world every year.
While few U.S. children die, the disease still sends 50,000 of them to the hospital every year. If an infant or toddler develops diarrhea in the winter, there is a good chance that a rotavirus is the culprit.
By age four, most people have been infected and developed antibodies to the virus. While the disease is not particularly deadly in the United States among children with healthy immune systems, rotavirus in the developing world is often fatal because the children are already malnourished when they become infected. In the United States, the chance a child will be hospitalized with rotavirus is one in 40, and one in every 800 hospitalized children will die.
The rotavirus season begins in late fall and ends in the spring.
Cause
Rotavirus invades the cells of the small bowel, preventing the absorption of liquids and causing a severe diarrhea. While the rotavirus also infects animals, scientists do not believe it is passed from pets to humans. The virus is thought instead to be spread by the fecal-oral route. The virus must be swallowed in order for it to infect the digestive tract. Children who are infected once can be infected again.
Symptoms
Symptoms develop quickly; most babies begin with vomiting and a low fever followed by watery diarrhea lasting from three to eight days. The child is infectious until the diarrhea stops. It is not unusual for a child to experience as many as 20 vomiting and 20 diarrhea episodes a day.
Diagnosis
Physicians can diagnose rotavirus from symptoms alone, noting the age of the child and time of year. A new test of stool samples can detect rotavirus in 15 minutes.
Treatment
There is no cure for rotavirus infection. Nonprescription antidiarrhea medicine should not be given to infants and young children. Infants with severe dehydration and vomiting require intravenous-fluid replacement.
Prevention
Although a vaccine for rotavirus was approved by the U.S. Food and Drug Administration (FDA) in August 1998, it was abruptly withdrawn in 1999 after seven months of use because nine infants developed bowel obstruction after being vaccinated. This was more than double the cases reported in the previous seven years. Within the first 14 days after vaccination, the risk of obstruction was 10 times higher than normal, according to research, and within the first seven days after vaccination, the risk was 14 times higher than normal.
The AMERICAN ACADEMY OF PEDIATRICS had recommended routine use of the vaccine in November 1998, and the Centers for Disease Control (CDC) included it in the schedule of routine vaccinations for children in January 1999. But on October 22, 1999, the Advisory Committee on Immunization Practices (ACIP), after a review of scientific data from several sources, concluded that bowel obstruction occurs with significantly increased frequency in the first one to two weeks after the rotavirus vaccine is given, particularly following the first dose. Therefore, vaccination of infants is no longer recommended. Children who received rotavirus vaccine and remain well are not now at increased risk for bowel obstruction.
While few U.S. children die, the disease still sends 50,000 of them to the hospital every year. If an infant or toddler develops diarrhea in the winter, there is a good chance that a rotavirus is the culprit.
By age four, most people have been infected and developed antibodies to the virus. While the disease is not particularly deadly in the United States among children with healthy immune systems, rotavirus in the developing world is often fatal because the children are already malnourished when they become infected. In the United States, the chance a child will be hospitalized with rotavirus is one in 40, and one in every 800 hospitalized children will die.
The rotavirus season begins in late fall and ends in the spring.
Cause
Rotavirus invades the cells of the small bowel, preventing the absorption of liquids and causing a severe diarrhea. While the rotavirus also infects animals, scientists do not believe it is passed from pets to humans. The virus is thought instead to be spread by the fecal-oral route. The virus must be swallowed in order for it to infect the digestive tract. Children who are infected once can be infected again.
Symptoms
Symptoms develop quickly; most babies begin with vomiting and a low fever followed by watery diarrhea lasting from three to eight days. The child is infectious until the diarrhea stops. It is not unusual for a child to experience as many as 20 vomiting and 20 diarrhea episodes a day.
Diagnosis
Physicians can diagnose rotavirus from symptoms alone, noting the age of the child and time of year. A new test of stool samples can detect rotavirus in 15 minutes.
Treatment
There is no cure for rotavirus infection. Nonprescription antidiarrhea medicine should not be given to infants and young children. Infants with severe dehydration and vomiting require intravenous-fluid replacement.
Prevention
Although a vaccine for rotavirus was approved by the U.S. Food and Drug Administration (FDA) in August 1998, it was abruptly withdrawn in 1999 after seven months of use because nine infants developed bowel obstruction after being vaccinated. This was more than double the cases reported in the previous seven years. Within the first 14 days after vaccination, the risk of obstruction was 10 times higher than normal, according to research, and within the first seven days after vaccination, the risk was 14 times higher than normal.
The AMERICAN ACADEMY OF PEDIATRICS had recommended routine use of the vaccine in November 1998, and the Centers for Disease Control (CDC) included it in the schedule of routine vaccinations for children in January 1999. But on October 22, 1999, the Advisory Committee on Immunization Practices (ACIP), after a review of scientific data from several sources, concluded that bowel obstruction occurs with significantly increased frequency in the first one to two weeks after the rotavirus vaccine is given, particularly following the first dose. Therefore, vaccination of infants is no longer recommended. Children who received rotavirus vaccine and remain well are not now at increased risk for bowel obstruction.
