What is rotavirus and how does it affect children?

Rotavirus is a common virus that causes gastroenteritis, affecting infants and young children particularly hard. This virus is a leading cause of severe watery diarrhea and vomiting in this age group. Before vaccines were available, most children in the United States would contract rotavirus before reaching age five [2]. The infection can be serious as it may lead to severe dehydration, sometimes requiring hospitalization.

Rotavirus spreads extremely easily among infants and young children, often transmitting within households, childcare centers, and hospitals [3]. The virus spreads through stool; infected children can transmit it to others via unwashed hands touching the mouth, touching contaminated surfaces and then putting fingers in the mouth, or even through consuming contaminated food. Children are most susceptible to rotavirus infection during the winter and spring months [3].

Symptoms of Rotavirus

Symptoms of rotavirus typically begin about two days after exposure to the virus [3]. Common symptoms include:

• Severe watery diarrhea [3]
• Vomiting [3]
• Fever [3]
• Abdominal pain [3]

Vomiting and diarrhea can last between 3 to 8 days [3]. It is crucial to monitor for signs of dehydration, especially in infants and young children, as it can be dangerous. Signs of dehydration include decreased urination, dry mouth and throat, feeling dizzy when standing, crying with few or no tears, and unusual sleepiness or fussiness [3].

Preventing Rotavirus

The best way to protect your child from rotavirus is through vaccination. Doctors recommend two or more doses of the rotavirus vaccine for infants [1]. The available vaccines are safe and effective, and they are given orally as drops [1]. Vaccination helps protect your child from severe illness and significantly reduces the risk of hospitalization due to rotavirus [1].

Your child should receive the first dose of the rotavirus vaccine before 15 weeks of age, and all doses should be completed before 8 months of age [1]. The vaccine can be safely administered during the same doctor visit as other vaccines, such as DTaP (diphtheria, tetanus, and acellular pertussis), Hib (Haemophilus influenzae type b), polio, hepatitis B, and pneumococcal conjugate vaccines [1].

Who Should Receive the Vaccine and Who Should Delay It?

Most infants should receive the rotavirus vaccine to protect against the disease [1]. However, there are certain situations where the vaccine might not be given or might need to be delayed. You should consult your child’s healthcare provider if the child has:

• A severe (life-threatening) allergic reaction to a previous dose of rotavirus vaccine or to any of its components [1].
• Severe Combined Immunodeficiency (SCID), a condition where the child's immune system cannot fight off infections [1].
• A history of a type of bowel obstruction called intussusception [1].
• A weakened immune system due to HIV/AIDS, other immune-affecting diseases, treatment with medications such as steroids, cancer, or cancer treatment with X-rays or drugs [1].

Infants suffering from a moderate or severe illness, including moderate or severe diarrhea or vomiting, should wait until they recover before receiving the vaccine [1]. Infants with a mild illness can receive the vaccine [1].

What to Do if Your Child Gets Rotavirus

There is no specific medication to treat rotavirus infection; antibiotics do not help because they treat bacteria, not viruses [3]. Treatment focuses on relieving symptoms and preventing dehydration. The most important step is ensuring your child drinks plenty of fluids [3]. Your doctor may recommend over-the-counter oral rehydration solutions [3]. In cases of severe dehydration, children may need hospitalization to receive intravenous (IV) fluids [2].

If you suspect your child is severely dehydrated, you should contact a doctor immediately [3]. Signs of severe dehydration include noticeably decreased urination, severe dry mouth, absence of tears when crying, unusual lethargy, or difficulty waking up. For more information on this topic, you can visit Rotavirus: Protecting Children from Severe Diarrhea and Vomiting with Vaccination (Arabic).

When Should You Seek Emergency Medical Care?

Although the rotavirus vaccine is safe and effective, there are rare but potentially serious side effects, such as intussusception. Intussusception is a rare type of bowel obstruction that occurs when the intestine folds into itself [1]. This small risk occurs within one week after the first or second dose of the rotavirus vaccine [1].

You should contact a doctor immediately or go to the hospital if you notice signs of stomach pain accompanied by severe crying, if the child is pulling their legs toward their chest, vomiting multiple times, or if there is blood in the stool [1]. These symptoms may indicate intussusception, and in such cases, you must inform the doctors about the date your child received the rotavirus vaccine [1].

Medical references

• Rotavirus Vaccination
• Rotavirus Infections
• About Rotavirus