Rotavirus infection

Epidemiology and dynamics of development

The causative agent of the disease is RNA viruses belonging to the genus Rotavirus (family Reoviridae). This pathogen is one of the main culprits of infectious gastroenteritis in pediatric practice.

The infection can affect people of different ages, but it is of greatest epidemiological significance for children in the first 3 years of life. The peak incidence traditionally occurs in the age group from 1 to 3 years. The epidemic process is characterized by a pronounced autumn-winter seasonality.

The pathogenetic orientation of the virus consists in the development of acute enteritis. The disease is characterized by rapid dynamics:

• Incubation period is extremely short — from 15 hours to 3–5 days (averaging 1–3 days).
• Onset is always acute.
• Full deployment of all clinical symptoms occurs within the first day of the disease.

Clinical features

A specific feature of rotavirus infection is the combined lesion of the gastrointestinal tract and the respiratory system. Such a picture is observed in the overwhelming majority of patients (60–70%). It is important to note that catarrhal syndrome often precedes diarrheal syndrome.

Respiratory (catarrhal) syndrome Manifests as nasal congestion and mild coughing. Oropharyngeal examination reveals moderate hyperemia, as well as characteristic granularity of the mucous membrane of the fauces, arches, and soft palate.

Intoxication syndrome Accompanied by fever, with values ranging from subfebrile to febrile. Usually, body temperature stays within 38.5–39 °C. The temperature curve, as a rule, normalizes by the 3rd–4th day of the disease. Abdominal pain syndrome is not pronounced — pain is rare and moderate in character.

Gastroenteritic syndrome and dehydration

GI tract involvement in rotavirus infection has clear clinical markers.

1. Vomiting. This is one of the most characteristic signs, noted in the majority of patients. Vomiting occurs simultaneously with diarrhea or even precedes it. It is often repetitive (multiple) and secondary in nature, but successfully resolves within 1–2 days.
2. Stool characteristics. Stool becomes liquid, watery, foamy, and pale. It is fundamentally important that pathological impurities (such as blood or pus) are completely absent. Only a minor admixture of mucus is permitted.
3. Frequency of bowel movements. Averages 4–5 times a day, but in young children can reach 15–20 times.
4. Duration of diarrhea. Directly depends on the patient's age. In older children, the syndrome resolves in 3–7 days, whereas in infants it takes a protracted course and can last up to 10–14 days.

The main criterion for the severity of the patient's condition is the degree of exicosis (dehydration). It is what determines the severity of the course, which varies from mild (grade I) to severe (grade III). The development of grade I–II exicosis is typical for rotavirus infection, while grade III is quite rare.

Class and exam questions

What else to study on this topic

• Differential diagnosis with dysentery and salmonellosis
• Degrees of exicosis (I, II, III) and their clinical manifestations
• Differentiation from yersiniosis, escherichiosis, and campylobacteriosis
• Laboratory methods for rotavirus verification

Other topics from the section «Chapter 12. Infectious and parasitic diseases»

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