Posts Tagged ‘Rotavirus’

Few Important Aspects about Rota Virus

Rota virus is a double stranded RNA (ribonucleic acid) virus. It belongs to Reoviridae family. Rota virus has five different species A, B, C, D and E. The first species or rotavirus A accounts for majority (more than 90%) of infections and other species are less commonly involved in human infections.

Rotavirus is unquestionably and undoubtedly most common cause of diarrhea among infants (babies below one year of age) and young children in underdeveloped, developing as well as in developed countries. It is estimated that by the age of five years most children around the globe has been infected by rota virus at least once. But the best aspect of rotavirus infection is that, with each infection the infected child develops immunity and the subsequent infections become less and less severe and by the time the child become adult, he/she rarely get infected and also infections are too mild for adults to cause any problem.

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What are the Symptoms of rotavirus infection?

Rotavirus infection (and diarrhea due to infection) is the commonest cause of severe forms of diarrhea among infants and young children below 5 years of age. The rotavirus diarrhea is extremely common in developing as well as in developed countries (except in countries where rotavirus vaccine is given as routinely to all children) and it is important for all to know and understand the rotavirus diarrhea, symptoms and treatment. Understanding of the diarrhea and its basic principles of management can save millions of lives. All mothers should be aware of the symptoms of rotavirus diarrhea.

Symptoms of rotavirus diarrhea:

The incubation period of rotavirus infection is approximately 2 days (which means it takes about two days for symptoms to appear after infection). The symptoms of rotavirus diarrhea or gastroenteritis vary from mild to severe form of disease and include watery diarrhea (watery stools), vomiting and low grade fever. The first symptom of rotavirus diarrhea is usually vomiting, which is followed by watery profuse diarrhea (lasting four to eight days if left untreated or inadequately treated) and low grade fever.

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Transmission and Prevention of Rotavirus Infection

How rotavirus infection is transmitted?

The route of transmission of rotavirus is feco-oral. Contact with contaminated hands, surfaces and objects can transmit the virus and initiate infection and diarrhea. Respiratory route is also considered to transmit the virus from one person to another. The number of rotavirus particle in infected person’s feces is estimated to be more than 10 trillions and the infective dose is only 10-100 virus particles. Presence of such huge numbers of virus and the small size of infective dose required makes it ideal for mass transmission of rotavirus. Another important aspect in high incidence and infectivity of rotavirus is the less effectiveness (may be ineffectiveness) of standard sanitary measures used for elimination of bacteria, virus and parasites. This can be easily understood by the fact that the incidence of rotavirus infection is similar in countries with high as well as low health standards, unless there is mass and routine vaccination program against rotavirus infection. The stability of rotavirus in normal environment also makes the transmission of the virus easy.

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How common is Rotavirus Infection?

A commonly asked question is How common is rotavirus infection or rotavirus diarrhea? The answer to this question is, rotavirus diarrhea is very common and have worldwide distribution. There are five types of rotavirus (A, B, C, D and E) and rotavirus A is the most common, which constitute more than 90% of human infections. Rotavirus diarrhea is most common among infants and young children and rare among adults as immunity develops with each infection and subsequent infections become less severe and by the time a child becomes adult, immunity is strong enough to counter rotavirus infection.

Rotavirus is transmitted by feco-oral route, mainly through drinking water and is most common in developing countries, where safe drinking water is not available to majority of citizens. Rotavirus infection is responsible for hospitalization of up to 50% diarrhea cases among children and infants. The major problem in developing countries is unawareness about the infection and its importance by general public.

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Prevention of Traveler’s Diarrhea

Traveler’s diarrhea can be prevented if precautions are observed properly during international travel. The main preventive measures of traveler’s diarrhea are related to food and water precautions. But studies indicate that indiscretion in eating and drinking water is done by approximately 98% of traveler’s upon arrival of their destination within 72 hours. That means only a handful of cautious travelers follow the precautions for prevention of traveler’s diarrhea. No wonder that such a large percentage of travelers suffer from traveler’s diarrhea. There is a popular slogan for travelers “Boil it, cook it, peel it, or forget it!” and it is easier to remember than following it as the studies indicate.

In general a traveler should follow some precautions for prevention of traveler’s diarrhea. The food precautions are eating food when it is still hot, avoid foods that are raw, poorly cooked, or sold by street vendors etc. Water precautions include drinking only boiled or commercially bottled beverages (preferably those that are carbonated). Heating can kill organisms that cause traveler’s diarrhea (entero-toxigenic Escherichia coli, entero-aggregative E. coli, Campylobacter, Salmonella, Shigella, rotavirus, norovirus etc.), but freezing can not kill them and due to this reason ice cubes made from unpurified water should be avoided.

Prophylaxis of traveler’s diarrhea:

The most commonly used prophylaxis for traveler’s diarrhea is bismuth subsalicylate, but it is only 60% effective. In special cases (athletes, persons with a repeated history of travelers’ diarrhea, and persons with chronic diseases) a single daily dose of a quinolone or azithromycin or a once-daily rifaximin regimen during travel of more than 1 month’s duration is effective in preventing travelers’ diarrhea in 75% to 90% of cases.

Self treatment of traveler’s diarrhea:

Ideally all travelers should carry some medication for traveler’s diarrhea for self-treatment, as it can occur despite rigorous food and water precautions. An antibiotic can reduce the frequency of stools and duration of illness in moderate to severe diarrhea. The standard regimen for traveler’s diarrhea is a single daily dose of quinolone (ofloxacin, ciprofloxacin etc.) for 3 successive days. Rifaximin, a poorly absorbed rifampin derivative and is highly effective against noninvasive bacterial pathogens like entero-toxigenic E. coli and entero-aggregative E. coli. But if you acquire traveler’s diarrhea, in Thailand, where more than 90% of Campylobacter infections are quinolone resistant, azithromycin can be a good choice.