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Rotavirus gastroenteritis

rotavirus; gastro; gastroenteritis; diarrhoea; vomit; dehydrate; hygiene; dehydration; rota; virus; diarrhea ; immunisation; immunization; rotateq; rotarix; teq ;

Rotavirus infections are the most common causes of infectious diarrhoea (gastroenteritis) in young children worldwide. In Australia Rotavirus immunisation is available free to babies up to 6 months old.

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Rotavirus infections are the most common causes of infectious diarrhoea (gastroenteritis) in young children worldwide. In Australia the number of young children getting rotavirus infections is now less than several years ago because the immunisation of babies is very effective.

In Australia Rotavirus immunisation is available free to babies up to 6 months old.

  • The first dose needs to be given with the other immunisations that babies have when they are 6 weeks old. One or two more doses need to be given depending on which vaccine is being used.
  • The vaccine is given by mouth (orally).

Have a look at our topic 'Gastroenteritis' to find out what to do when a child is vomiting and has diarrhoea.

Rotavirus infections

  • Rotavirus infections are very common causes of gastroenteritis in all countries.
  • Children can be infected with Rotavirus several times during their lives, and almost every child in Australia will have at least one infection by the time they are 3 years old.
  • Before the immunisation program was started for babies, in Australia about 10,000 children under 5 years old were admitted to hospital each year due to Rotavirus infections, about 22,000 went to a hospital emergency department and 115,000 went to see a doctor. 
  • Rotavirus also affects older children and adults.
    • Parents and older children often get ill when their child has a Rotavirus infection. If they get infected, the illness is usually less severe, as they have some protection from having had the infection before. 
    • Even if the illness is not so severe as for very young children, they should stay home from school or work, both because they are unwell and because they can pass the infection to others. 
      SA Health Exclusion from childcare, preschool, school and work
  • Rotavirus infections tend to be more common in late autumn and early winter in temperate areas.
  • They are easily spread in places where children who are not toilet trained are gathered together, eg childcare centres, hospitals. Many young children who are admitted to hospital for other reasons (such as asthma) catch Rotavirus in hospitals.
  • World wide, Rotavirus infections cause an estimated 600,000 deaths per year in developing countries, and a third of children admitted to hospital worldwide for diarrhoea have a Rotavirus infection.

How rotavirus is spread

  • Rotaviruses are in the poo (faeces) of a person while they have diarrhoea (runny, watery poo) and for several weeks after the diarrhoea stops (sometimes up to 2 months or longer).
  • Rotaviruses spread most when the person has diarrhoea because the runny poo can 'escape' more easily (out of a nappy for example) and get onto many hands and surfaces. When the poo is hard again the virus cannot 'escape' as easily, but it is still infectious (the virus can still be passed on to others).
  • The viruses can get onto surfaces (such as a bench or nappy change table) where it is picked up by the hands of other people, and it can also get into food and water.
  • Strict hygiene practices including very careful hand washing, cleaning of chairs, tables and toys are needed all of the time, not only when a child has diarrhoea.
  • At the beginning of an illness with Rotavirus a child may have a cough and runny nose and the infection may be spread by coughing or sneezing.

How long does it take to develop?

  • The vomiting and diarrhoea takes about 24 to 72 hours (one to 3 days) to develop after contact with the virus.

Symptoms of rotavirus infection

  • The onset is usually sudden, with vomiting, watery diarrhoea, fever and usually a runny nose and cough.
  • It can be mild, but some children, especially those under 2 years, require hospital treatment for dehydration.
  • The diarrhoea usually lasts from 2 to 5 days.
  • Some children will have diarrhoea that lasts longer after a Rotavirus infection, due to intolerance to one of the sugars in food (usually lactose). Intolerance means they are not able to break down (digest) the sugar fully because of the effect of the virus on the gut. This can last for a few weeks.

What you can do

  • The most important thing is for the child to have extra drinks.
    • See the topic 'Gastroenteritis' for the drinks that are most helpful.
    • Almost all children will only need oral treatment (by mouth).
  • It is recommended that parents give 'Oral Rehydration Solution' (ORS) to babies and young children with gastro. It can be useful to have some at home so that you can start using the best treatment for gastro as soon as possible.
    • ORS can be bought at pharmacies.
    • The salts and fluids in ORS are different in different countries because in many countries children are likely to have other health problems such as poor nutrition.
  • If the child has diarrhoea and is not drinking, see a doctor as soon as possible to check for dehydration and to decide if the child needs other treatment or to go to hospital. 
  • If a baby is vomiting and/or has diarrhoea or a child is very unwell (eg high fever, drowsy, not interested in anything) see the doctor as soon as possible.

Protecting children from Rotavirus

  • The main ways to protect children from Rotavirus infections are
    • careful hygiene such as hand washing especially after using the toilet, not letting the runny poo escape from a nappy (disposable nappies with elastic around the legs may work better for this), careful nappy disposal, cleaning of nappy change areas, disposal of tissues used for runny noses etc, and even more hand washing
    • washing surfaces, toys and other things that are shared with other children eg at childcare and at home, with detergents and disinfectants. This should be done all the time, not only when a child is obviously unwell. 
    • washing hands well after going to the toilet and before handling food and drinks
    • keeping children who are unwell at home (keeping them out of childcare or school for example). Children should not go to school or childcare while they have diarrhoea. For adults, staying home from work is best too. SA Health Exclusion from childcare, preschool, school and work  
    • immunisation.

Immunisation

Immunisation is currently recommended for children up to 6 months old.

  • The first dose is given at the same time as the baby's other 6 week old immunisations. It is important that the immunisation is given close to this age.
  • In South Australia 2 more doses are given - at 4 and 6 months - at the same time as other immunisations.
  • It is given by mouth (orally).

Immunisation is very good at preventing severe diarrhoea and vomiting caused by rotavirus.

  • If immunised children get a Rotavirus infection, they usually have a milder form of the disease.
  • Immunisation does not protect them from other causes of gastro.
  • Babies who have been given the immunisation are slightly more likely to have diarrhoea or vomiting in the week after immunisation - but serious side effects are rare.
  • If a child has already had a Rotavirus infection, immunisation is still usually recommended in most cases, as one infection only gives partial protection.
  • It is safe for babies to be immunised if they live in a household where there is a pregnant woman.

The Rotavirus vaccines have undergone some of the largest and most stringent testing in clinical trials ever seen for any vaccine and have been shown to be very safe, however recent investigations have shown that there is a slightly increased risk of intussusception, a bowel condition, associated with rotavirus vaccination. The Australian Technical Advisory Group on Immunisation (ATAGI) and Therapeutic Goods Administration (TGA) have reviewed recent evidence and found that the benefits of rotavirus vaccination outweigh the risks associated with it. ATAGI recommends the continued use of the rotavirus vaccine for infants under the National Immunisation Program. It is important for parents to be aware of the risks associated with rotavirus vaccination.

For more information have a look at  Rotavirus vaccine and intussusception information for Parents and Guardians.

References

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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