Rotavirus

• ALSO KNOWN AS: Sporadic or severe viral gastroenteritis, rotaviral enteritis, infantile diarrhea, winter diarrhea
• ANATOMY OR SYSTEM AFFECTED: Gastrointestinal system
• CAUSES: Viral infection transmitted through contaminated food or water, fecal-oral contamination, or contact with contaminated surfaces
• SYMPTOMS: Severe watery diarrhea, vomiting, nausea, fever
• DURATION: Three to ten days
• TREATMENTS: Fluids to prevent dehydration, prevention through handwashing, and disinfection of surfaces

DEFINITION: A virus with a characteristic wheel-like appearance when viewed under an electron microscope that causes viral gastroenteritis in children worldwide

Causes and Symptoms

Rotavirus is classified into groups A through G, with group A responsible for gastroenteritis in children. Adults can also contract the virus, but they will experience milder symptoms. The virus is very contagious, with oral-fecal transmission occurring through ingestion of contaminated water or food or contact with an infected surface, such as a toy or hand. Airborne infection is rare. In temperate climates, the disease occurs more often in the cooler months, from late autumn to early spring, with year-round infection present in tropical climates. Almost all children have been infected more than once by the time they are four years old.

Symptoms are manifested after two days from the initial exposure and include severe watery diarrhea, vomiting, nausea, and fever, with the gastroenteritis lasting from three to ten days. Dehydration may result if fluids are not adequately replenished. Symptoms of severe dehydration include dry mouth, dry skin, sunken eyes, no tears when crying, lethargy, irritability, and reduced or no wet diapers for over three hours. A physician should be notified if symptoms of severe dehydration are observed. Because the virus is highly contagious, epidemic outbreaks may be seen in childcare centers.

Treatment and Therapy

Clinical diagnosis is made from the detection of the virus antigen in a stool sample. Detection of rotavirus is also possible with an electron microscope or tissue culture. Treatment involves drinking plenty of fluids to prevent dehydration. Antidiarrheal medication should not be given to children unless prescribed by a doctor. Hospitalization may be required for intravenous (IV) fluid rehydration if severe dehydration occurs. Immunity develops after repeated infections, with subsequent infections exhibiting less severe symptoms. The virus may survive on hard surfaces for years. Diligent handwashing and disinfection of surfaces with a diluted bleach solution or 70 percent alcohol may help slow the spread of the virus.

Perspective and Prospects

Rotavirus was discovered in 1973 from intestinal biopsies of children diagnosed with winter vomiting disease. The name is derived from the Latin word rota, which means “wheel.” In February 2006, the US Food and Drug Administration (FDA) approved a live, oral vaccine for use in children. In 2018, the World Health Organization (WHO) recommended that the vaccine be made a routine part of national immunization programs around the world. Despite this, children in some countries do not have access to the vaccination. Into the mid-2020s, the vaccine landscape continued to expand. Two additional oral vaccines—Rotavac® and Rotasiil®—were WHO-prequalified, increasing immunization options for low-resource settings. Vaccination programs worldwide led to major declines in rotavirus hospitalizations and deaths. In the US, hospitalizations have dropped by over 80 percent compared to pre-vaccine years.

Bibliography

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Aronson, Susan S., and Timothy R. Shope, editors. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide. Elk Grove Village, Ill.: American Academy of Pediatrics, 2005.

“Current and Upcoming Rotavirus Vaccines.” Johns Hopkins Bloomberg School of Public Health, publichealth.jhu.edu/sites/default/files/2024-02/rota-brief2-productlandscape2022ax.pdf. Accessed 15 Aug. 2025.

"Rotavirus." History of Vaccines, 18 Apr. 2022, historyofvaccines.org/diseases/rotavirus. Accessed 15 Aug. 2025.

“Rotavirus: Symptoms & Causes.” Mayo Clinic, 28 Apr. 2021, www.mayoclinic.org/diseases-conditions/rotavirus/symptoms-causes/syc-20351300. Accessed 15 Aug. 2025.

“Rotavirus - Immunization, Vaccines and Biologicals.” World Health Organization, 16 July 2021, www.who.int/teams/immunization-vaccines-and-biologicals/diseases/rotavirus. Accessed 15 Aug. 2025.

"Rotavirus Vaccine, Live (Oral Route)." Mayo Clinic, 1 July 2025, www.mayoclinic.org/drugs-supplements/rotavirus-vaccine-live-oral-route/description/drg-20071625. Accessed 15 Aug. 2025.

Heymann, David L., editor. Control of Communicable Diseases Manual. 19th ed,. American Public Health Association, 2008.

Matson, David O. “Rotaviruses.” In Principles and Practice of Pediatric Infectious Diseases, edited by Sarah S. Long, Larry K. Pickering, and Charles G. Prober. 3rd ed., Churchill Livingstone/Elsevier, 2008.