Rotavirus infection is a highly contagious disease that particularly affects children under the age of five. Rotaviruses cause diarrhea, which can be very mild or cause severe complications. Rotavirus infections are reportable in Germany.
What is a rotavirus infection?
A rotavirus infection is caused by the so-called rotaviruses. The name “Rota” comes from the appearance of the viruses, because they are round like a wheel (lat. rota= the wheel). Rotavirus infection belongs to the gastrointestinal diseases. The viruses can cause severe diarrhea with high fluid loss. Especially in infants and small children this can lead to dangerous conditions. In third world countries, rotavirus infections are often fatal. Of the 100 million children who fall ill each year in these countries, at least 600,000 probably die. However, rotavirus infections can also affect adults. Infection often occurs via infected children. The disease is particularly dangerous for the elderly, and rotavirus infections are much feared in retirement homes. Just as in children, the disease can cause complications and take a fatal course in the elderly and debilitated due to high fluid loss.
Causes
Rotavirus infection is caused by highly infectious viruses. Even a small amount of these rotaviruses is enough to cause illness. Once they have infected a body, they settle in the folds of the mucosa of the small intestine and multiply there. A short time later, diarrhea begins. The viruses are excreted again through the intestines by infected persons. There are billions of viruses in each stool of infected patients. The pathogens are so highly contagious because they can survive for a very long time without a host. They hang from toilets, sinks and doorknobs, toys and dishes, and also on the hands of infected persons and are passed on in this way. This is known as smear infection. The pathogen can also be transmitted via drinking water and food or via the water in swimming pools. If the disease has broken out in an institution, such as a kindergarten or retirement home, it is extremely difficult to prevent infection among people. There are also different types of rotaviruses; five different types occur in Europe. Once you are sick with a rotavirus infection, you are only immune for a short time and only against this one type that has infected you.
Symptoms, complaints, and signs
Rotavirus infection is the most common diarrheal disease seen in children worldwide. Rotavirus is especially dangerous for babies and young children. In Germany, however, there are hardly any deaths in connection with the disease. The highly contagious virus spreads especially in the winter months. After an infection, about three days pass until the typical symptoms appear. In addition to severe diarrhea and vomiting, fever also occurs. In adults, the disease is comparatively harmless. The infection initially manifests itself as mild and watery diarrhea. However, the symptoms worsen visibly. Severe stomach pain is accompanied by nausea and vomiting. In children, this is often accompanied by high fever. Patients lack appetite and regurgitate ingested food. Especially in young children, there is a rapid loss of fluids. A lot of fluid is lost, especially due to the high fever. Some of those affected also complain of symptoms reminiscent of influenza. Thus, the rotavirus infection may be accompanied by cough or aching limbs. The symptoms subside after about five days. The virus remains highly contagious until about ten days after infection and is excreted in the stool.
Diagnosis and course
Rotavirus infection can have a very different course. Weakened individuals, the elderly, or young children often show more severe symptoms than older children or young adults. The illness usually begins with diarrhea that quickly becomes watery. This is accompanied by nausea, vomiting, cramping abdominal pain and fever. Some patients experience difficulty breathing. If sufferers lose too much fluid through the watery diarrhea, there is an acute risk of dehydration.The first signs of such an extreme lack of fluid in the body are headaches, great thirst, dry mouth and parched mucous membranes. Patients have no or very little need to pass urine. In addition, some confusion may occur. A diagnosis of rotavirus infection will not be suspected by the nature of the symptoms alone, as they are similar to those of a harmless intestinal infection. However, if typically a large number of people fall ill at the same time and the courses are more severe, a suspicion of rotavirus infection will quickly arise. However, only a stool examination in the laboratory provides ultimate certainty.
Complications
Rotavirus infection is often associated with high fever. If the body temperature rises to more than 41° Celsius, this can result in life-threatening complications. For example, there are often circulatory problems and finally circulatory collapse, which must be treated in hospital in any case. The lack of fluids as a result of diarrhea and vomiting can lead to dehydration and thus to physical and mental deficits. In children, the elderly and the sick, there is a danger to life. In infants, diarrhea associated with rotavirus infection must be treated immediately by a physician because fluid loss quickly leads to dehydration. Treatment of rotavirus infection can also cause complications. Infusion carries the risk of an allergic reaction or allergic shock. Injuries can occur when access is established, which can become infected and, in the worst case, cause sepsis. If the access slips, the infusion can leak into the surrounding tissue, possibly causing severe soft tissue damage. Edema or thrombosis also cannot be ruled out. Last, the prescribed painkillers and antipyretic preparations can cause a number of side effects and interactions, as well as allergic reactions.
When should you see a doctor?
Rotavirus infection must always be treated by a doctor. Various complications can occur with this disease, which in the worst case can reduce the life expectancy of the affected person. For this reason, treatment by a doctor is essential and should be carried out immediately at the first signs of infection. A doctor should be consulted if the child suddenly suffers from very severe diarrhea. This also results in vomiting and a very high fever. In most cases, affected children also suffer from severe pain in the stomach and nausea. The child also finds it very difficult to take in food. If these symptoms occur, a doctor must be consulted. In most cases, rotavirus infection can be examined and treated by a pediatrician or by a general practitioner. If diagnosed early, there are no complications and the course of the disease is usually positive. In case of acute symptoms, it is also possible to go directly to the hospital.
Treatment and therapy
A specific treatment of rotavirus infection is not possible. To date, there is no drug with which one could kill the rotaviruses. Thus, treatment consists of alleviating the symptoms. It is especially important to compensate for the lack of fluids in the body. Smaller children and older weakened people are usually admitted as inpatients. They are given fluids via an infusion. For normally healthy adults, frequent drinking is often sufficient. Unless they are affected by very severe nausea and vomiting, so that they cannot keep drunk water with them. Then an infusion will also provide hydration. The infusions contain mineral salts important for the body, which were excreted by the diarrhea and are now missing. If the illness is milder, no further measures are necessary. Infants may continue to be breastfed, toddlers and adults should drink plenty of water or even herbal teas. Sugary drinks should be avoided during a rotavirus infection. Abdominal pain can be relieved by gentle massage and by applying a hot water bottle.
Prevention
Pronounced hygiene measures are the best way to help prevent rotavirus infection. Frequent hand washing, especially after using the toilet and before eating, is important. In addition, bathrooms and toilets should be adequately cleaned. A vaccine has now also been developed that can be used in infants as young as six weeks.
Aftercare
Rotavirus infection weakens not only the gastrointestinal tract but the entire organism. Targeted aftercare can sustainably support the regeneration of the body. Ideally, it should be discussed with the patient’s family physician or internist. The cooperation of the patient is of decisive importance. The greatest possible rest is just as important in aftercare as a certain dietary discipline. The weakened body can recover particularly well with sufficient sleep. Stress, both private and professional, should also be avoided as much as possible during aftercare. In addition, drink enough to support the gastrointestinal tract, circulation and metabolism. Here, carbonic acid, acid (for example in orange juice), coffee and, of course, alcohol should ideally be avoided. The diet should not put additional strain on the intestines, which are weakened by the disease. Fatty and flatulent foods are best eliminated from the aftercare phase. Probiotics and yogurt are often useful because they help rebuild the intestinal flora that may have been disturbed by the disease. Fruits and vegetables, if they do not cause gas or irritation, are also helpful. They replace vitamins, minerals and trace elements that have been flushed from the body by the diarrhea of rotavirus infection. Physical activity such as a walk can boost circulation weakened by lack of fluids, but should be done in doses, especially at first.
What you can do yourself
Rotavirus infection can be alleviated in its symptoms by self-help, but needs the treatment of the doctor if pregnant women, seniors or young children, or loss of fluid leads to severe circulatory problems. Self-help in everyday life with rotavirus infection essentially means to relieve the symptoms, since the disease is usually over after two days anyway in a normal course. Diarrhea and vomiting are amenable to self-help by consistently replenishing the fluid loss they cause. Still water and unsweetened herbal teas are ideal drinks in this context. In addition, for abdominal cramps, a hot water bottle or a hot cloth on the abdomen can provide relief. Remedies against diarrhea are not ideal, since diarrhea is a measure of the body to flush the infectious germs out of the intestine as quickly as possible. Gentle foods such as mashed potatoes are foods that are most likely to be tolerated after possible food abstinence. Self-care in a family’s daily routine also means protecting other family members, as rotavirus is a highly contagious germ. Here, disinfecting the shared toilet after going to the toilet is highly recommended. Hand washing around the toilet is Plicht when infected with rotavirus, because the risk of infection in this disease is very high and hygiene is thus very important.
