Rotavirus
Overview
What is rotavirus?
Rotavirus is a gastrointestinal (stomach and intestines) infection that happens in young children. It causes diarrhea and vomiting. Kids tend to get rotavirus during the late winter to early spring.
There are two vaccines for rotavirus. The first got approved by the United States government in 2006, with the second following in 2008. The majority of children who get vaccinated never get rotavirus. For those who do, the vaccines almost always reduce the severity of illness.
Who gets rotavirus?
People of all ages can get rotavirus. But, it mostly happens to children under age one. It’s very contagious — before the rotavirus vaccines, most children got rotavirus by age five. Since the vaccines, the number of children who get the disease has dropped. The rotavirus vaccines — Rotarix® or Rotateq® — are part of a child’s scheduled immunizations.
Who’s at risk for rotavirus?
Typically, children in daycare or other programs with large numbers of children are at higher risk. Children between the ages of three months and three years who don’t get vaccinated tend to get the most severe disease. Some children can’t get the vaccine because of a history of allergic reactions to the vaccine ingredients or other health reasons determined by a healthcare provider.
Can adults get rotavirus?
Adults can also get rotavirus. They tend to get less sick than young children. Adults at risk for rotavirus include those who:
- Are older.
- Care for children who have rotavirus.
- Have compromised immune systems (such as having HIV).
How does rotavirus spread?
Rotavirus spreads through contact with stool (poop). For example, you might change a soiled diaper of a baby with rotavirus. If you don’t wash your hands afterward, you could get virus particles in your mouth. It’s important for family members to wash hands well to prevent the virus from spreading.
How common is rotavirus?
Before the vaccines, rotavirus was the number one cause of severe diarrhea in babies and young children in the United States. Nearly all children got rotavirus before age five. Rotavirus led to 55,000 to 70,000 hospitalizations each year.
The vaccines have significantly improved children’s health and hospitalization rates. The Centers for Disease Control and Prevention (CDC) has studied the impact. It estimates that every year, the vaccines prevent 40,000 to 50,000 hospitalizations among babies and young children.
Symptoms and Causes
What causes rotavirus?
Rotavirus is a virus, one that spreads through hand-to-mouth contact. It shows up in an infected child’s poop a few days before symptoms start. And it can remain in bowel movements for up to 10 days after symptoms stop.
What are the symptoms of rotavirus?
Your child may have:
- Vomiting and watery diarrhea, which can last anywhere from three to eight days.
- Fever (usually above 101 degrees Fahrenheit).
- Loss of appetite.
Babies and young children may also get dehydrated from vomiting and diarrhea. Contact your healthcare provider right away if your child has symptoms of dehydration:
- Not peeing as frequently (fewer wet diapers than usual).
- Cool, dry skin.
- Dizziness when standing.
- Dry mouth and throat.
- Few or no tears when crying.
- Lethargy — sleeping more and playing less or acting unusually fussy.
- Sunken eyes or sunken soft spot on the top of the head.
Why is dehydration serious for babies?
Dehydration means your baby doesn’t have enough water and salts to function properly. Babies under one year old can dehydrate easily.
Many times, children who are dehydrated need IV fluids to rehydrate. If dehydration gets severe, a child could start convulsing (experiencing sudden, erratic body movements) or go into shock. It could be life-threatening.
How long do rotavirus symptoms last?
Symptoms of rotavirus usually last from three to eight days. Most children are contagious for around 12 days total. That’s because infection starts a few days before symptoms do.
Diagnosis and Tests
How is rotavirus diagnosed?
If your child has signs of rotavirus, contact your healthcare provider. Providers can often diagnose rotavirus based on symptoms and a physical examination. In some cases, they may take a stool (poop) sample to test it for rotavirus. But, this step usually isn’t needed.
If you do need to take a stool sample, your provider will give you a sterile (germ-free) container. You collect some of your child’s stool in the container. A lab analyzes the stool for rotavirus.
Management and Treatment
Is there a medicine for rotavirus?
Rotavirus is caused by a virus, not bacteria. So antibiotics won’t help your child feel better. The virus gets better on its own after about a week. The main treatment is to keep your child hydrated.
Can rotavirus be treated at home?
Contact your child’s healthcare provider if you notice rotavirus symptoms. They may recommend you:
- Give your child smaller, more frequent feedings instead of larger meals.
- Make sure your child gets enough fluids.
- Use an electrolyte replacement such as Pedialyte®. Electrolytes help keep body systems in balance, but you can lose them through vomiting and diarrhea. Replacements can fix that. Just make sure to follow the instructions on the label carefully.
- Give your child some acetaminophen (Tylenol®) to lower the fever. Make sure not to give your child aspirin.
- Wash your hands after changing diapers or touching stool.
- Make sure your child rests.
- Recommend your child stay at home instead of going to daycare/school.
- Follow up with your healthcare provider as necessary.
Will my child need rotavirus treatment in the hospital?
Most children recover from rotavirus at home. But if your child becomes very dehydrated, they may need treatment in a hospital. In the hospital, the care team may:
- Test your child’s blood or stool.
- Give your child IV fluids.
- Help slowly increase your child’s food intake.
Prevention
How can I prevent rotavirus?
The best way to prevent rotavirus and protect the health of your family is with one of the rotavirus vaccines.
About 70% of children who get vaccinated don’t get rotavirus. For those who still get infected, the symptoms are much milder. Put another way, 90% of vaccinated children either get protected from severe rotavirus or avoid the disease altogether.
Talk to your healthcare provider about which rotavirus vaccine your child should get. The vaccines are not given as shots. Instead, the provider puts drops in your baby’s mouth over a series of visits, based on age. Options and vaccination schedules include:
- RotaTeq® is given in three doses: at two months, four months and six months.
- Rotarix® is given in two doses: at two months and four months.
Is the rotavirus vaccine safe?
Both rotavirus vaccines have been extensively tested in thousands of babies. Both vaccines are considered safe and effective. They protect many children from getting rotavirus. And even if a child does get the virus, the illness will be less severe if they got the vaccination.
There are very few side effects from the vaccine. If your child does experience side effects, such as temporary diarrhea or vomiting, the reactions usually go away on their own. If your child has a medical condition, talk to your healthcare provider about your child’s vaccination schedule.
What else can I do to protect against rotavirus?
The vaccine is your best defense against the disease. It’s also crucial to practice good hand-washing. Wash your hands frequently with soap and water, for at least 30 seconds:
- After using the bathroom.
- After changing a diaper or helping a child use the bathroom.
- Before preparing food.
Outlook / Prognosis
What’s the outlook for children with rotavirus?
Most children recover from rotavirus without long-term health effects. Symptoms last about a week.
If your child becomes dehydrated, it could lead to serious complications and even death. Call your healthcare provider right away if your child shows symptoms of rotavirus. Your provider can help you prevent dehydration.
Also make sure to follow your child’s immunization schedule. The rotavirus vaccine is the best way to protect your child’s health.
Can my child get rotavirus again?
Children can get re-infected. However, a second infection tends to be mild.
Living With
When can my child return to school or daycare?
Your school or daycare will probably let you know how long to keep your child home. Usually, the requirement is that children have no symptoms for at least 24 hours before returning to these settings.
What else should I ask my healthcare provider?
If your child has rotavirus, ask your provider about:
Medicine:
- Which over-the-counter medications do you recommend to reduce fever? Are there any I shouldn’t use?
- How long should I give my child the medication?
- What time of day is best for the medication?
- How should I store the medication?
Food, drink and follow-up care:
- What symptoms require immediate attention?
- Are certain foods or liquids more helpful? Are there any my child should avoid?
- Should I keep my child home from school or daycare?
- Are there activities my child shouldn’t do?
- When will my child start to feel better?
- When should I bring my child back for a follow-up visit?
When should I call a healthcare provider about rotavirus?
Call your child’s provider if you notice an increase in vomiting or diarrhea. Also contact your provider if you see signs of dehydration, which may happen because of vomiting and diarrhea:
- No wet diapers for more than eight hours.
- Pale skin.
- Dry lips.
- Sunken eyes.
Children can dehydrate very quickly. This change can lead to serious complications and even death. Call your healthcare provider right away if you notice signs of dehydration.
A note from Cleveland Clinic
Rotavirus is a gastrointestinal (stomach and intestine) infection. It can happen to anyone, but most often affects children. Call your healthcare provider if your child has diarrhea and fever, both common rotavirus symptoms. The provider will recommend plenty of fluids and rest, as well as medicine to reduce fever. If there’s a risk of dehydration, your provider may recommend bringing your child to the hospital for IV fluids. Most children recover from rotavirus with no long-term health effects. Rotavirus vaccines — either Rotarix® or Rotateq® — can keep your child and family healthy.
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