Rotavirus, from the family Reoviridae, is an eleven sequence, non- enveloped double stranded, two layered protein capsid (3). Discovered in 1973 in Australia by a woman named Ruth Bishop (2). It measures around 70nm and can be seen with an electron microscope (4). It is a RNA virus that has seven antigenic groups, three of which infect humans (1). These three groups (Groups A, B, and C) can account for 1/3 of all diarrhea- associated hospitalizations in the United States (4). Some have said it costs 264 million in medical costs and over 1 billion in societal costs worldwide (7). This disease has even been linked with aseptic meningitis, hepatic abscesses, SIDS, and even could be the cause of intussusception (10).
So what exactly is rotavirus and how is it spread? It is a wheel like virus (named for it's shape: rota means "wheel" in Latin (8)) that infects humans via the fecal- oral passage way (1). It is also transmitted "person-to-person" by contaminated hands or food (3). It has also been called gastroenteritis (3). It has also been seen in the respiratory tract (8). It is also highly contagious and found a lot in daycare settings. It mainly infects children under 5 but adults and older children can be infected. Many parents of infected children catch the disease after their children have started to show symptoms. Rotavirus is characterized by vomiting, diarrhea, abdominal pain, and fever (8). Usually after contracting the virus symptoms start to appear 18- 36 later, starting with diarrhea then with the onset of vomiting and fever but it can appear in any order (2). Some children have also been known to show no symptoms at all (3). Some have only shown cold- like symptoms such as runny noses and coughs (3). Frequent vomiting and diarrhea can be associated with rotavirus (every 5-10 minutes) (5). The symptoms can last anywhere from four to six days but has been known to last longer (6). It is more severe in children under age 5. Adults can become infected but it is not as severe as seen in children. Group A infects mainly children while Group B can infect both adults and children, and then Group C is a rare form that infects children (3). Epidemics of the disease occur from November to April every year (8). It also seems to start in the southwestern United States and then makes it way northeast (7).
So how is the disease diagnosed? There are numerous tests that can be used to detect the presence of rotavirus. A rectal swab can be obtained and then tested. The enzyme- linked immunosorbent assay (ELISA) is used to test for the presence of the disease. This test may take awhile so for faster detection a latex agglutination test may be performed (1). Also used are the polyacrylamide gel electrophoresis tests (8). It is important for fast detection so fluids can be administered. This is "major cause of death from dehydration" in many third world countries so a fast diagnosis is important.
What can be done to treat this disease? There is no specific treatment for this virus. It is important to keep the infected people hydrated to prevent dehydration from loss of fluids (8). Usually a diet of low salt content and high glucose content are recommended. (1). Antibiotics have no effect on the virus and therefore are not used (1). It has been said that four out of five children under the age of five will contact rotavirus. Then one in seven infected will visit the E.R. Another one in seventy-eight will need to be hospitalized and unfortunately one in 200,000 will die from complications associated with rotavirus (7). It is extremely important to get a fast diagnosis and to treat the infected with rehydration therapy. Re-infection can occur but less severe (8).
Are there any vaccinations available to combat this disease? On August 31, 1998 a live vaccine was introduced called Rotashield (RRV-TV or tetravalent rotavirus vaccine) (3). This vaccine was given to infants then after only about 10 months it was pulled off the market. On July 15, 1999 the CDC recommended the vaccine be stopped. Then on October 22,1999 the Advisory Committee on Immunization Practices voted to stop the vaccine all together (5). Fifteen to twenty-three cases of intussusception in children had been reported (1,3). This is when the bowels of the intestines fold into themselves and cause an obstruction. This can be deadly in some cases (3). It was never proved if the vaccine actually causes intussusception but it was still taken off the market and no vaccine has since been available. It is important to prevent the spread of this disease. Infected children should stay out of daycare until doctors okay their release. The disease can still be spread after the symptoms of diarrhea have stopped (7). The disease is stable in the environment so inanimate objects can be contaminated (8). Washing hands with just soap will not kill the virus either (7). The virus will become "inactivated" or denatured by chlorine. Although frequent hand washing is recommended especially in daycare settings or places where infected persons come in contact with others (6).
Overall it is important to be informed and understand the severity of this disease. If treatment is provided in a fast manner then this virus will not have lasting effects. It has been linked with close to 800,000 to 1 million deaths worldwide (4,3). That is just the child mortality rate. (3). The virus has been said to cause over 3 million people, in just the United States, to become infected annually. With numbers like that hopefully a safe vaccine will be created to help combat this nasty virus called rotavirus.
Reference:
1. Clash, Kimberly. "Rotavirus". (* ). URL: http://www.hopkins-heic.org/infectious_diseases/rotavirus.htm accessed on 05/05/02.
2. Glass, Dr. Roger. " Rotavirus In Depth". ( *) URL: http://www.childrensvaccine.org/html/v_rota_id.htm accessed on 05/05/02
3. U.S. Food and Drug Administration. " Bad Bug Book: Rotavirus". 02/13/02. URL: http://vm.cfsan.fda.gov/~mow/chap33.html accessed on 05/05/02.
4. Parashar, Bresee, Gentsch, and Glass. "Rotavirus". 06/26/02. URL: http://www.cdc.gov/ncidod/EID/vol4no4/parashar.htm#fig%201 accessed on 05/01/02.
5. Reddy, Dr. Vinay. "Rotavirus". 04/13/01. URL: http://www.drreddy.com/shots/rotavirus.html accessed on 05/01/02.
6. Centers For Disease Control. "What You Should Know About…Rotavirus Diarrhea in The Child Care Setting". 01/97. URL: http://www.cdc.gov/ncidod/hip/abc/facts34.htm accessed on 04/29/02
7. State of Georgia. "Rotavirus and Intussusception Factsheet". (*). URL : http://www.ph.dhr.state.ga.us/epi/news/resources/rotavirusfaq.shtml accessed on 04/29/02.
8. National Center for Infectious Diseases, The Respiratory and Enteric Viruses Branch. " Rotavirus". 08/20/01. URL: http://www.cdc.gov/ncidod/dvrd/revb/gastro/rotavirus.htm accessed on 04/29/01.
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