Rotavirus In Babies: Causes, Symptoms And Prevention

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Rotavirus infection in babies can lead to severe symptoms that deteriorate the baby’s overall health. A baby may even suffer complications like a complete loss of appetite, poor growth, and dehydration. But how can an infant catch the rotavirus?

Is there a way to prevent the infection? MomJunction tells you all about rotavirus in babies, how it affects them, and how parents can take measures to protect their infant from this deadly virus.

What Is Rotavirus?

Rotavirus is a virus that infects the inner lining of the small intestine. There are several species of rotavirus. The most common one to affect humans is the species A rotavirus or rotavirus A (1). This virus mainly attacks the cells lined up along the inner wall of the intestine. It interferes with the functions of intestinal cells, thus damaging them and making it impossible for the small intestine to absorb nutrients from the food (2). Rotavirus is nearly found on all continents of the world.

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How Common Is The Rotavirus Infection In Babies?

According to the World Health Organization, rotavirus is the leading cause of diarrheal disease among children (3). The virus is the most common cause of acute gastroenteritis among infants and toddlers (4). The most affected are infants below the age of 11 months (5). The highest mortality rate due to the virus is in African, Asian, and Latin American countries.

According to the statistics revealed in 2013, about 215,000 children under the age of five across the world succumb to a rotavirus infection every year, with most occurring in developing countries.

Rotavirus was also responsible for 250,000 emergency room visits among children below the age of five in the US (6). Mortality rate due to rotavirus in the US was between 20-60 per year, but since the introduction of the vaccine, the numbers have declined.

[ Read: Personal Hygiene For Babies ]

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How Does A Baby Catch The Rotavirus?

Rotavirus is highly contagious and mostly transmits through the fecal-oral route. The virus can spread through the following two ways (7) (8):

  1. An infant can get the virus by consuming contaminated food and water that may contain fecal particles of a person infected with rotavirus. Food and water become a cause when not sterilized before consumption. Babies older than six months can eat solid food thus making them vulnerable to rotavirus. Rotavirus can survive in water for several weeks.
  1. Rotavirus can spread when the baby comes in contact with contaminated surfaces such as toys, doorknobs, and other hard surfaces. If someone in the family has rotavirus and does not wash hands after using the toilet, then they can pass the virus to the baby by touching the baby’s things. The virus is transferred when the baby touches the contaminated object and puts the hand in their mouth.

Rotavirus may less occasionally spread through sneeze and cough (9). Older infants and toddlers may repeatedly self-infect if they do not wash their hands after using the toilet. Rotavirus is shed in stools even when the infection and symptoms end. Some situations make the child more prone to the virus.

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Risk Factors Of Rotavirus Infection

The following situations increase the risk of a baby catching the rotavirus:

  1. Aged less than three years: Those below the age of five years are worst affected by rotavirus, but the disease is more severe among those below the age of three years. Infants below 11 months display the most severe symptoms.
  1. Winter to spring season: Rotavirus mostly spreads during winters and can spread through the spring season, usually from December to June.
  1. Overcrowded settings: Babies and toddlers who spend a lot of time in daycare and playgroups are more susceptible to rotavirus. Rotavirus can spread quickly within a group.

An infant can get rotavirus from multiple sources and at many places. Should your infant get it, you should be able to identify the infection via symptoms.

[ Read: Causes Of Diarrhea In Babies ]

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What Are The Symptoms Of Rotavirus Infection In Babies?

It takes two to three days for the following symptoms of rotavirus to emerge (10):

  1. Watery diarrhea is the hallmark symptom of a rotavirus infection and lasts for three to eight days. The watery stool has a strong foul smell and is often green or brown.
  2. Vomiting and nausea occur with diarrhea for three to eight days. The vomit will be watery and frequent. The baby will have constant nausea.
  3. Loss of appetite is a very common symptom.
  4. Severe abdominal pain
  5. Fever, which may go away after a couple of days even if diarrhea and vomiting persist.
  6. Fatigue and lethargy with constant drowsiness.

Vomiting and diarrhea are together the biggest threat for a baby in rotavirus infection. These conditions alone are responsible for complications due to the infection.

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What Are The Complications Of Rotavirus Infection In Babies?

Dehydration is a single significant complication of rotavirus infection. The baby loses a lot of water due to vomiting and watery diarrhea. Dehydration can affect nearly every organ in the body, and in extreme cases may even cause death. It is crucial to spot the symptoms of dehydration to tackle it soon:

  • Dry mouth and throat
  • Decreased urination; while you may a change a lot of diapers due to diarrhea, there will not be much urination
  • Sunken eyes
  • Soft spot on top of the head (fontanelle) feels sunken
  • Few or no tears while crying
  • Pale skin
  • Extreme lethargy and constant drowsiness
  • Older toddlers who can stand and walk will feel dizzy when they stand up

Dehydration is a medical emergency, so take your baby to the doctor right away.

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How Is Rotavirus In Babies Diagnosed?

A stool test is the primary method of diagnosing rotavirus. The doctor will collect a stool sample and send it for lab analysis to check the presence of the virus. A blood test also helps determine the infection by checking antibodies against the virus in the blood.

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How Is Rotavirus Treated?

There is no medicine to treat the rotavirus infection (11). However, it is possible to manage the symptoms to help the baby feel better.

[ Read: How To Relieve Stomach Pain In Babies ]

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How To Manage Rotavirus Infection In Babies?

The management of rotavirus involves the following medical and home care methods:

  1. Provide adequate fluids: If the baby is less than six months old, then breastfeed them more often. An exclusively breastfed infant gets all their fluids from breast milk. Infants older than six months can have water.

Give older infants and toddlers foods like vegetable and meat broth, which provide nutrition. However, if the baby has no problem eating solid food, then do not restrict it. Solid food intake may even help control watery diarrhea to some extent.

Never give infants and toddlers soda, fruit juice, or a sports drink since they contain a lot of sugar and other compounds that may worsen diarrhea.

  1. Rehydration through ORS: An oral rehydration solution or ORS contains the right mix of electrolytes (sugar and salts) to replace those lost through diarrhea. ORS is safe and can be given to babies below six months when breast milk alone is not enough to tackle dehydration.

Multiply the baby’s weight in kilograms by 75 to get the quantity of ORS (in milliliters) that you must give once every four hours, in small sips, using spoon or cup (12). If your baby’s pediatrician suggests a different quantity of ORS, then follow the instructions of the doctor.

  1. Lots of rest: Your little one may feel better after having ORS and liquids. But the baby must continue with bed rest till they are entirely free of the infection.
  1. Intravenous fluids and nasogastric feeding: Extreme cases of dehydration can require hospitalization and intravenous administration of electrolytes. The baby may even need nasogastric feeding (feeding through a nasal tube) if they get unconscious and are unable to eat/drink from the mouth.

The symptoms of rotavirus infection cause extreme pain and discomfort to the baby, which makes parents wonder how long the disease lasts.

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How Long Does Rotavirus Infection Last In Babies?

Rotavirus infection usually lasts no more than eight days (13). Most cases typically resolve in a few days. Since the infection causes several complex symptoms, the course of the disease could extend. Dehydration, which is one of the major complications, can lead to more problems than the virus itself. It is for these reasons prevention of rotavirus in babies is critically important.

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How To Prevent Rotavirus Infection In Babies?

The following steps and methods help protect an infant from the rotavirus:

  1. Vaccination for rotavirus is widely available. In most countries, it is a part of the compulsory vaccine roster for infants and toddlers. Your healthcare provider is quite likely to guide you about it during a routine visit.
  1. Always give your toddler clean water and cooked food. If you do not have access to readily purified water, then you should use a purifier or boil the water for safety. Filter any debris using a filter paper and transfer the water into a clean vessel placed on a stove. Bring the water to a rolling boil and let it boil for a minute. Turn off the heat and let the water cool down naturally (14).
  2. Cook food before giving it to your baby. Boiling vegetables and meat in a pressure cooker is the best way to kill any virus, including the rotavirus.
  3. Good hygiene constitutes multiple good habits, with the most important being the regular washing of hands with soap after using the toilet. Wash your hands before holding or feeding the baby.

If a member in the family has rotavirus infection, ask them to stay away from the baby. If the baby has a rotavirus infection, then use gloves while changing diapers and wash your hands thoroughly. It helps prevent the spread of the virus and reinfection.

Hygienic sanitation facilities are essential to prevent the contamination of food and water with feces. Most countries and communities have measures to prevent drinking water contamination. If you live at a place where sanitation and sewage are not in check, then you will have to be extra careful and follow personal hygiene and care to prevent infection.

Vaccination is still the single most important method of prevention since it provides herd immunity. When the entire population in a community is vaccinated, then the virus is nearly eliminated since the pathogen cannot find a suitable host.

Keep reading if you have more questions about rotavirus in babies.

[ Read: Signs Of Dehydration In Babies ]

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What Vaccine Should Your Baby Have Against Rotavirus?

RotaTeq (RV5) and Rotarix (RV1) (Rotavac and Rtasure in India) are the two vaccines that your local doctor/government provides. Babies get three doses of RotaTeq at the age of two, four, and six months. If your doctor chooses Rotarix, then the baby gets two doses at the age of two and four months (15). Rotavirus vaccine is an oral vaccine and can be given along with any other vaccine they are due to get.

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Are There Any Side Effects Of The Rotavirus Vaccine?

Rotavirus may have a few mild side effects or no side effects at all in some infants. An infant may display temporary signs such as irritability, mild diarrhea, and vomiting. Intussusception (collapse of the small intestine) was once a common side effect of the older version of the rotavirus vaccine, although the modern rotavirus vaccines seldom cause the condition (16).

The risk of intussusception can be one among 20,000-100,000 vaccinated infants. Check for complications within one week of dosage and report to the doctor. In any case, the vaccine is safe and the best tool to prevent the child from getting infected.

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Who Should Not Have The Rotavirus Vaccine?

Infants with the following condition may not be given the rotavirus vaccine:

  • Infants who display a severe allergic reaction to the first dose of the vaccine are not given the subsequent doses.
  • Babies with immunodeficiency or any other condition that affects the immune system, such as HIV/AIDS and cancer.
  • Infants undergoing cancer treatment and those getting treated with medicines containing steroids.
  • Infants who already have intussusception or have a history of suffering from it.

Babies who are ill, have diarrhea or vomiting due to other reasons should recover before getting the rotavirus vaccine.

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Can Babies Get Rotavirus Infection Even After Immunization?

Probably, but the risk is low. Vaccines are made to prevent most cases of disease and not all. There is always some risk of getting the disease even after vaccination. But babies who get the vaccine have an immensely lower chance of developing severe diarrhea and vomiting that leads to dehydration.

The US Centers for Disease Control and Prevention states that the vaccine completely protects 7-8 children out of 10. Even if babies get the infection, 90% of them do not develop severe fever, diarrhea, and vomiting. Since the benefits of rotavirus vaccine outweigh the risks, it is essential you vaccinate your baby against the virus.

[ Read: Signs Of Intussusception In Infants ]

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Can A Baby Get Rotavirus Infection More Than Once?

Yes. A baby can get infected by rotavirus more than once, and the risk may be higher if they are not vaccinated. Natural infection through the virus allows the body to make its antibodies, but even those do not always provide 100% protection. So it is best to take preventive measures and get the child vaccinated to minimize the risk of infection and reinfection.

Rotavirus infection is among the most deadly childhood diseases. Thankfully, the availability of a vaccine makes it less of an epidemic illness. A few drops of rotavirus vaccine is all that it takes to keep your baby and toddler protected against rotavirus for a lifetime.

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Which rotavirus vaccine did your baby have? Share us your experience with us in the comment section below.

References:

1. S.E. Crawford et al., Rotavirus infection; National Center for Biotechnology Information
2. Image of the Month: Repairing rotavirus-damaged intestinal cells; Baylor College of Medicine
3. Rotavirus; World Health Organization
4. E.J. Elliott, Acute gastroenteritis in children; National Center for Biotechnology Information
5. Human Rotavirus; Stanford University
6. Rotavirus; National Foundation for Infectious Diseases
7. What Is Rotavirus?; Stanford Medicine
8. Rotavirus: Transmission; US Centers for Disease Control and Prevention
9. Rotavirus; University of Oxford
10. Rotavirus: Symptoms; US Centers for Disease Control and Prevention
11. Rotavirus: Treatment; US Centers for Disease Control and Prevention
12. Integrated Management of Childhood Illness; World Health Organization
13. Rotavirus Infection in Children; University of California
14. How to Boil or Disinfect Water; Government of Michigan
15. Rotavirus VIS; US Centers for Disease Control and Prevention
16. Rotavirus Vaccination: What Everyone Should Know; US Centers for Disease Control and Prevention

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