WHAT IS ROTAVIRUS?
Rotavirus infections are very common causes of gastroenteritis in all countries. In fact rotavirus infections are the most common causes of infectious diarrhoea (gastroenteritis) in young children worldwide. The people most at risk for rotavirus infections are young children especially those under 2 years old. Almost all people worldwide have a rotavirus infection before they are 5 years old. Rotavirus also affects older children and adults, but usually less severely, as they have some protection from having had the infection before. Strangely enough newborn infants seem more resistant to the disease than their slightly older peers. They may shed the virus without being symptomatic. This phenomenon occurs in both breastfed and formula-fed babies; therefore, it is not explained by the protective effect of breastfeeding.
Rotavirus infections are easily spread in places where children who are not toilet trained are gathered together, e.g. childcare centers. In Australia 20-40% of all admissions of young children to hospital with diarrhoea are due to rotavirus infections. World wide, rotavirus infections cause an estimated 600,000 deaths per year in developing countries, and a third of children admitted to hospital worldwide for diarrhoea have a rotavirus infection.
HOW ROTAVIRUS IS SPREAD
Rotaviruses are in the poo (faeces) of a person while they have diarrhoea and for several weeks after the diarrhoea stops (sometimes up to 2 months or longer). Rotaviruses spread most when the person has diarrhoea because the runny faeces can ‘leak’ more easily (out of a nappy for example) and get onto many hands and surfaces. When the faeces is hard again the virus cannot ‘escape’ as easily, but it is still infectious (the virus can still be passed on to others). The viruses can get onto surfaces (such as a bench or nappy change table) where it is picked up by the hands of other people, and it can also get into food and water. Strict hygiene practices including very careful hand washing, cleaning of chairs, tables and toys are needed all of the time, not only when a child has diarrhoea.
HOW LONG DOES IT TAKE TO DEVELOP?
The vomiting and diarrhoea takes about 24 to 72 hours (one to 3 days) to develop after contact with the virus.
SYMPTOMS OF ROTAVIRUS INFECTION
The onset is usually sudden, with vomiting, watery diarrhoea, fever and usually a runny nose and cough. It can be mild, but some children, especially those under 2 years, require hospital treatment for dehydration. The diarrhoea usually lasts from 2 to 5 days. Some children will have diarrhoea that lasts longer after a rotavirus infection, due to intolerance to one of the sugars in food (usually lactose). Intolerance means they are not able to break down (digest) the sugar fully because of the effect of the virus on the gut. This can last for a few weeks. During this period it is best to use a soy rather than a cows milk formula for your child.
Important Note
If a child is vomiting, has diarrhoea and is refusing fluids, the child needs to be assessed urgently by a doctor to check if the child needs treatment for dehydration. Remember the younger/ smaller the child, the faster dehydration will take effect
WHAT YOU CAN DO
The most important thing is for the child to have extra drinks. It is often recommended that parents keep some ‘Oral Rehydration Solution’ (ORS – “pedialyte”, “gastrolyte” & “pharolyte” sachets are all available locally. “Gatorade” or “Pocari Sweat” can be used for older children and adults) at home so that they can start using the best treatment for gastro as soon as possible. If the child has diarrhoea and is not drinking, see a doctor as soon as possible to check for dehydration and to decide if the child needs other treatment. Almost all children will recover with oral treatment (by mouth).
PROTECTING CHILDREN FROM ROTAVIRUS
The main ways to protect children from rotavirus infections are careful hygiene such as:
- hand washing especially after using the toilet.
- careful nappy disposal, cleaning of nappy change areas, disposal of tissues used for runny noses etc.
- Washing surfaces, toys and other things that are shared with other children e.g. at childcare and at home, with detergents and disinfectants
- keeping children who are unwell at home (keeping them out of childcare or school for example). Children should not go to school or childcare while they have diarrhoea.
Note: In 1998 a vaccine to protect children from rotavirus infections started to be used, but this was stopped in October 1999 because a health problem called intussusception (bowel blockage) was happening more often in very young children who had the vaccine.
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Kim Patra is a qualified Registered Nurse and Midwife that has been living and working in Bali for almost twenty years. She now runs her own private practice and medical referral service from her Kuta office. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at info@chcbali.com”.
