August 27, 2013

Rotavirus – Still a Lot to Learn

By Julie Suchanek, MBA, MT (ASCP)
Metropolitan Medical Laboratory, PLC

Dr. Roger Glass, of the National Institute of Health, stated in August 2013 that, “Despite all the attention society has placed on ensuring access to clean food and water, sewage control, and hand washing, gastrointestinal illnesses remain one of the most common afflictions of humankind. We still have a lot to learn.”

One of these common gastrointestinal illnesses is Rotavirus. Rotavirus is common in infants and young children, with most children in the United States acquiring the infection by five years of age. However, adults and older children can also become infected. In this country, rotavirus infections can also cause diarrhea in adults who care for children, in adults who are traveling and in older adults. Once a person has been exposed to rotavirus, symptoms appear in about two days.

Transmission

Rotavirus spreads easily among young children, who can spread the virus before and after they become sick. Family members and others in close contact with someone who has the virus can become infected. The virus enters the body orally (via the mouth) through contaminated hands, objects (such as toys), food, and water.

In temperate climates, rotavirus disease is more common during fall and winter. Annual epidemic peaks usually begin in the Southwest United States during November and December, and then spread to the Northeast by April and May. The reason for this seasonal pattern is not known.

Symptoms

Symptoms usually begin with fever and vomiting, and progress to watery diarrhea, and abdominal pain. The diarrhea may last from three to eight days, and may lead to dehydration (loss of fluids), electrolyte imbalance and metabolic acidosis – all potentially harmful for infants and small children. Symptoms of dehydration include:
• a decrease in urination
• no or few tears when a child cries
• a dry mouth and throat
• a feeling of dizziness when standing up
• overly sleepy and/or irritable
• sunken eyes

Severe dehydration may lead to other serious problems that may require hospitalization in order to rehydrate through intravenous fluids.

Children may develop rotavirus disease more than once, because there are many different types of rotavirus. Generally, a person’s first infection causes the most severe symptoms.

Testing for Rotavirus

The clinical features and stool characteristics of rotavirus diarrhea are nonspecific. Because similar illness may be caused by other pathogens, lab testing is necessary to identify the specific cause of illness. The lab test most commonly ordered to diagnose rotavirus is a “rapid antigen detection” of rotavirus in a stool specimen. Other lab tests may be ordered to rule out other pathogens.

Treatment

Severe dehydration can be serious. If you or someone you are caring for may be severely dehydrated, contact your doctor. The best way to protect against dehydration is to drink plenty of liquids, including oral rehydration solutions which contain electrolytes such as sodium, potassium, and chloride. These pre-mixed solutions are commonly available in food and drug stores, and should be used according to your doctor’s recommendations.

Prevention

Because rotavirus spreads easily, hand washing and cleanliness are important. Rotavirus vaccines are very effective (85 to 98 percent) in preventing severe rotavirus disease in infants. The Centers for Disease Control and Prevention (CDC) recommends routine vaccination of infants with either of these two available vaccines:
• RotaTeq® – given in three doses (ages two months, four months, and six months)
• Rotarix® – given in two doses (ages two months and four months)

For more information, see www.cdc.gov/rotavirus.

Metropolitan Medical Laboratory, PLC is one of the largest accredited laboratories in the states of Illinois and Iowa, and has provided this community with quality laboratory services for 99 years. Visit www.metromedlab.com, or visit one of our two largest locations:
• 520 7th St, Moline, (309) 762-8555 Hours: 6 a.m.-6 p.m. Monday-Friday; 6 a.m.-noon Saturday
• 828 E. Locust, Davenport, (563) 324-0471 Hours: 6 a.m.-6 p.m. Monday-Friday; 6 a.m.-noon Saturday & Sunday
Tell your doctor, “I want my lab tests to go to Metro.”