Rotavirus is a highly contagious virus that commonly causes severe watery diarrhoea and vomiting, particularly in infants and young children. Although most children recover within a few days, some may experience severe dehydration requiring hospital treatment. In very rare cases, rotavirus can be life-threatening. Globally, rotaviruses are the leading cause of severe diarrhoea in young children although the number of deaths has dropped since a vaccine became available.
Symptoms of rotavirus typically begin up to three days after exposure and usually clear up within a week. However, symptoms can last up to two to three weeks.
The most common symptoms include:
Additional symptoms can include loss of appetite and dehydration, which can be particularly dangerous for very young children. Signs of dehydration include decreased urination, dry mouth and throat, dizziness when standing, crying with few or no tears, and unusual sleepiness.
Rotavirus can lead to significant health risks, particularly due to the potential for severe dehydration, which dangerous for young children. Severe dehydration is treated with intravenous fluids. In some instances, if treatment is delayed, it can result in death. In poorer countries around 2.5 per cent of children who present to health facilities will die.
If a young child has had diarrhoea for more than 24 hours or their faeces is black and/or has blood in it you should take them to a doctor immediately.
Rotavirus is primarily transmitted through contact with the faeces of infected individuals. The virus can easily spread in families, hospitals, and childcare centres. Transmission occurs when virus particles enter the mouth via unwashed hands, by touching contaminated objects or surfaces, or by eating contaminated food. People are most contagious when they have symptoms and during the first three days after recovery. They can also spread the virus before they develop symptoms. Rotavirus infections often follow a seasonal pattern, peaking in the winter and spring in countries with temperate climates.
Rotavirus is prevalent globally and, unlike bacterial diarrhoea, it is not linked to poor sanitation and hygiene. It is thought every child will have had it by their fifth birthday.
There is no specific medicine to treat rotavirus infection, but your doctor may recommend medicine to treat the symptoms. Antibiotics are not effective against viruses such as rotavirus. The main treatment focuses on managing symptoms and preventing dehydration through oral rehydration therapy, which involves drinking a beverage containing water, sugar, and electrolytes. If dehydration is severe, hospitalisation for intravenous fluids may be required.
The most effective way to prevent rotavirus disease is through vaccination. The rotavirus vaccine is part of routine immunisation programmes. In the UK, babies receive two doses of the vaccine at 8 and 12 weeks old. Additionally, practising good hygiene, such as frequent handwashing, is important in reducing the spread of the virus, alongside keeping children and young babies away from school and nursery when they are sick. While the vaccine doesn’t provide complete protection from infection, vaccinated children are less likely to become seriously unwell.
There is also a very small risk – one in 20,000 to one in 100,000 – of a serious problem where the bowel becomes blocked (intussusception) in the week after being vaccinated.
Rotavirus was first discovered in 1973 by an Australian team led by Ruth Bishop, who identified the wheel-shaped virus from intestinal biopsies of children with gastroenteritis. By 1980, rotavirus was recognised as the most common cause of severe gastroenteritis in infants and young children in the United States. In the prevaccine era, the was responsible for up to 500,000 deaths among children annually worldwide.
In 1998 the first rotavirus vaccine, RotaShield,was licenced in the United States but was withdrawn over the risk of blocked bowel. In 2005 two new vaccines were introduced and, alongside two additional vaccines, they are now used in more than 100 countries worldwide. Together they have contributed to marked decreases in hospitalisations and deaths from diarrhoea.
The rotavirus vaccine was introduced into the routine UK vaccination schedule in 2013. A study in the Journal of Infectious Diseases in 2016 found that the number of young children being admitted to hospital for acute gastroenteritis fell by 26 per cent the year after the introduction of the vaccine.
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