Rotavirus Disease and Diarrhoea

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Rotavirus is the most common cause of severe diarrhoea in young children. It accounts for more than a third of all hospitalizations of children less than 5 years. It occurs year round with peaks between the dry months (December - March). Children are infected by age 2 to 3 years and re-infections are common.  

Cause

Rotavirus: 5 types of rotavirus are known to cause >90% of all cases worldwide

Symptoms

• Fever 
• Vomiting 
• Profuse watery diarrhoea
• Thirst 

Signs

• Sunken eyes 
• Diminished skin turgor 
• Altered consciousness, depending on the degree of dehydration

Investigations

Detection of rotavirus antigen in stool by an enzyme immunoassay (EIA)

TreatmentTreatment Objectives

• Correction of fluid and electrolyte deficits
• Replacement of on-going fluid losses 
• Adequate nutrition to prevent malnutrition

Non-pharmacological treatment

• Home-based fluids e.g. breast milk, porridges, coconut drink
• Nutrition: feed as can be tolerated during the episode, give an extra meal per day for 2 weeks after the episode

Pharmacological treatment 

ORS and Zinc supplementation

(See section on ‘Diarrhoea’)

Referral Criteria

• Poor response to rehydration process (passing more stools than drinking) 
• Poor drinking
• Blood in stool
• Poor feeding
• Altered consciousness/convulsions
• Diarrhoea and vomiting continuing for > 3 days

Note: Two (2) doses of Rotavirus vaccine, given at 6 - 10 weeks, is effective in preventing rotavirus diarrhoea. The 2nd dose should be given by 16 weeks, and not  later than 24 weeks. Rotavirus vaccine is now currently given as part of routine immunization in Ghana. (See section on ‘Immunisation’).