Rotavirus

Rotavirus infection is the leading cause of severe gastroenteritis in young children globally. It often occurs in epidemics, affecting mainly children under two years of age although older age groups can also be affected. It is possible to be infected more than once but repeat infections are usually less severe.

In the NT, 90% of the known rotavirus cases are in children under the age of five years. Very young children are the ones most at risk of severe disease and may need to be admitted to hospital.

How it is spread

Spread occurs when hands, objects (such as toys), food or water contaminated by tiny amounts of faeces or vomit from infected people are put into the mouth of an uninfected person. Spread can occur quickly in families, childcare centres and other places where young children who are not toilet trained are gathered together.

Symptoms

Rotavirus infection can range from being a mild to a very severe illness. The main symptoms are fever, vomiting and watery diarrhoea which can lead to dehydration and rapid weight loss.

Symptoms start suddenly, between one to three days after being infected and usually last four to six days.

Infectious period

People unwell with rotavirus infection can pass the virus onto others and can continue to for several days after the diarrhoea has stopped. Most people are no longer infectious after eight days.

Management

Anyone with vomiting or diarrhoea should drink extra fluids to avoid dehydration.

It is recommended that parents give oral glucose/electrolyte solution to babies and young children with gastroenteritis. This can be bought at pharmacies. If children refuse this solution, diluted fruit juice may be given (one part juice to four parts water).

Babies should continue to be offered their normal milk feeds plus extra fluids in between feeds.

Babies with symptoms and young children who refuse fluids or who are very unwell should see a doctor as hospital admission may be required to manage dehydration.

Medicines to prevent vomiting or diarrhoea should not be given, especially to children, except when prescribed by a doctor.

Prevention

Rotavirus vaccine is 70% effective in preventing any rotavirus gastroenteritis and 85-100% effective in preventing severe rotavirus gastroenteritis. Rotarix® is the vaccine used in the NT, given as an oral vaccine (by the mouth) at six weeks and again at four months of age. It is important that babies receive both doses on time as the doses cannot be given after a certain age.

There is another vaccine used elsewhere in Australia that requires 3 doses. Rotavirus vaccine is still recommended for children who have already had rotavirus infection as having the disease only provides partial protection. Similarly, a child vaccinated against rotavirus may still become infected but the symptoms will be milder.

Side effects following Rotarix® vaccination are rare. Investigations have shown there is a slightly increased risk of intussusception (a bowel condition) following vaccination.

Intussusception is rare and the risks of rotavirus infection outweigh the risks of an adverse event from vaccination. Babies who have had an episode of intussusception or who are born with a bowel condition e.g. Meckel’s diverticulum should not receive the vaccine.

Following vaccination, the virus can be found in the faeces of a baby for a week or even longer.

It is not known if contact with the vaccinederived virus could result in another person becoming infected.

The spread of rotavirus infection can be reduced by:

• thorough hand washing especially after using the toilet, changing nappies or handling soiled items and before handling food and drinks
• not letting the runny poo escape from a nappy (disposable nappies with elastic around the legs may work better for this), careful nappy disposal and cleaning of nappy change areas
• never change nappies on tables or counters where food is prepared or eaten
• clean books, toys, equipment, furnishings, floors and toilets regularly (including toilet door handles) using a chlorine based solution.

Anyone with diarrhoea should not:

• prepare or handle food for others
• attend work, school or childcare for at least 24 hours after the diarrhoea has ceased
• swim, wade or paddle in public pools.

Exclusively breastfeeding in the first six months of life has been shown to reduce the risk of rotavirus infection.

Information for health professionals

To find out more go to the NT Health website.

Contact

For more information contact your nearest Centre for Disease Control.