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What is Rotovirus?


rotavirus

The rotavirus is a nonenveloped RNA virus that belongs to the Reoviridae family. According to the World Health Organization (WHO), rotaviruses are the most common cause of severe diarrhea among children worldwide.1

Most cases of rotavirus occur in children ages three to 35 months; however older children and adults can still develop the infection.2 Virtually all children become infected with rotavirus in the first five years of life. Infants younger than three months of age may not develop diarrhea symptoms when they are infected with rotavirus because they have maternal antibodies transferred from their mother to protect them in the first few months of life, including through breastfeeding.3

Rotavirus is very contagious. The virus spreads when individuals come into contact with an infected person’s body fluids or feces, or items that have been in contact with the feces of an infected person.4  The incubation period for rotavirus disease is approximately two days. Primary symptoms include vomiting and watery diarrhea for three to eight days. Fever, abdominal pain, and loss of appetite occur frequently.5

The virus can live for hours on hands and for days on hard surfaces. It is also very resistant to most disinfectants. In non-tropical climates like the U.S., rotavirus infections are more likely to occur in the colder winter months than in the summer.6

Laboratory testing is required to confirm a diagnosis of rotavirus because clinical symptoms of the illness are similar to those caused by other pathogens.7

It is possible to have rotavirus infection more than once since neither the vaccine or natural infection confers full immunity to all strains of the virus.8 Symptoms on re-exposure to the disease are usually less severe because each additional exposure strengthens immunity.9

Ensuring adequate hydration of a child with rotavirus infection is important to prevent dehydration – the most frequent complication of the illness. Symptoms of dehydration include crying without tears, dry mouth, decreased urine output, excessive sleepiness or irritability, and dizziness.10 If dehydration occurs, it may be necessary for the child to be hospitalized for treatment with intravenous (IV) fluids. Severe dehydration can lead to shock, convulsions, and even death.11

In 2013, rotavirus illness was estimated to cause 215,000 deaths globally, and most deaths occurred in developing countries.12 This death rate has significantly decreased from the estimated 528,000 rotavirus-associated deaths that occurred in 2000.13

Strains of rotavirus can infect both humans or animals, such as cows, sheep and monkeys, but animal rotaviruses differ from human ones, and rarely cause infection in humans.14 Worldwide, over 60 different strains of rotavirus have been identified.15 Additionally, certain strains found in the RotaTeq vaccine have reassorted to become vaccine-derived strains capable of causing gastrointestinal illness. This reassortment has been found to occur in one to three percent of rotavirus cases that have been sequenced.16

The virus is made up of three shells that contain 11 gene segments. There are two proteins on the outermost shell that confirm the serotype of the virus – VP4, or the P-protein, and VP7, or the G-protein.17

There are six G- and P-protein combination viruses that are most commonly found in the U.S. -  P[4] G2, P[6] G9, P[8] G3, P[8]G1, P[8] G4, and P[8] G9; however, in recent years, P[8]G12[26] has emerged as a cause of serious rotavirus infection in the U.S. and abroad.18

IMPORTANT NOTE: NVIC encourages you to become fully informed about rotavirus and rotavirus vaccines by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

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References

1 World Health Organization (WHO). Rotavirus.  In: Immunizations, Vaccines and Biologicals. Oct. 2020.

2 Mayo Clinic. Rotavirus. In: Symptoms and causes. Mar. 12, 2019.

3 Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). Rotavirus  In: Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Centers for Disease Control (CDC) 2015; Pg. 314-315. Updated November 2020. Accessed Apr. 4, 2021.

4 Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). Rotavirus  In: Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Centers for Disease Control (CDC) 2015; Pg. 313. Updated November 2020. Accessed Apr. 4, 2021.

5 U.S. Centers for Disease Control and Prevention. Symptoms. In: Rotavirus. Mar. 26, 2021.

6 Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). Rotavirus  In: Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Centers for Disease Control (CDC) 2015; Pg. 313. Updated November 2020. Accessed Apr. 4, 2021.

7 Cortese MM, Parashar UD. Prevention of Rotavirus Gastroenteritis Among Infants and Children Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Feb. 6, 2009; 58(RR02):1-25.

8 U.S. Centers for Disease Control and Prevention. Clinical Information. In: Rotavirus. Mar. 26, 2021.

9 Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). Rotavirus  In: Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Centers for Disease Control (CDC) 2015; Pg. 311-312. Updated November 2020. Accessed Apr. 4, 2021.

10 U.S. Centers for Disease Control and Prevention. Treatment. In: Rotavirus. Mar. 26, 2021.

11 National Foundation for Infectious Diseases. What is Rotavirus? In: Frequently Asked Questions About Rotavirus. No Date. Accessed Apr. 4, 2021.

12 World Health Organization (WHO). Rotavirus. In: Vaccines, Blood, and Biologics. Oct. 2020.

13 Almalki SSR. Circulating rotavirus G and P strains post rotavirus vaccination in Eastern Mediterranean Region. Saudi Med J. Aug. 2018 ;39(8):755-766.

14 Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). Rotavirus. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Centers for Disease Control 2015.

15 Almalki SSR. Circulating rotavirus G and P strains post rotavirus vaccination in Eastern Mediterranean Region Saudi Med J. 2018 Aug; 39(8):755-766.

16 Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). Chapter 13: Rotavirus - Background In: Manual for the Surveillance of Vaccine-Preventable Diseases. Centers for Disease Control (CDC) May 18, 2019.

17 Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). Rotavirus  In: Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Centers for Disease Control (CDC) 2015; Pg. 311. Updated November 2020. Accessed Apr. 4, 2021.

18 Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). Chapter 13: Rotavirus - Background In: Manual for the Surveillance of Vaccine-Preventable Diseases. Centers for Disease Control (CDC) May 18, 2019.


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