▶️ Rotavirus is a highly contagious virus that causes inflammation of the stomach and intestines, leading to severe diarrhea and vomiting, especially in infants and young children.

– Rotavirus infection can result in dehydration, which can be life-threatening if not treated promptly. Let's take a question-answer approach to learn more about rotavirus. Buckle up!

What are the causes of rotavirus?

– Rotavirus is present in the stool of an infected person and can spread to others through the fecal-oral route, which means that the virus enters the mouth of a susceptible person after contact with contaminated hands, objects, food or water.

– Rotavirus can also spread through respiratory droplets when an infected person coughs or sneezes. Rotavirus can survive for a long time on surfaces that are not disinfected. A person can get rotavirus more than once, but the first infection is usually the most severe.

🔅 Incubation: The incubation period for rotavirus is the time between exposure to the virus and the onset of symptoms. It is typically about two days, but can range from one to four days.

What are the signs and symptoms of rotavirus?

– The most common symptoms of rotavirus infection are severe watery diarrhea, vomiting, fever and abdominal pain. These symptoms usually last for three to eight days, but can vary depending on the age and immune status of the person. Infants and young children are more likely to develop dehydration, which can cause dry mouth, decreased urination, sunken eyes, lethargy, irritability and crying without tears. Dehydration can lead to complications such as electrolyte imbalance, acidosis, shock and death.

Who does it affect?

– Rotavirus infection can affect people of any age, but it is most common and severe in children under five years old. Children who are not breastfed, have malnutrition, have underlying medical conditions or have weakened immune systems are at higher risk of severe disease and complications. Adults who get rotavirus infection usually have milder symptoms or no symptoms at all.

What are the prevention and treatment tips for rotavirus?

– The best way to prevent rotavirus infection is to get vaccinated. There are two oral vaccines available for infants: Rotarix® and RotaTeq®.

– These vaccines are safe and effective in preventing severe rotavirus disease and hospitalization. They are given in two or three doses, starting from six weeks of age.

🔅 The vaccines do not protect against all strains of rotavirus, so it is still possible to get infected after vaccination, but the symptoms are usually less severe.

– Other preventive measures include practicing good hygiene, such as washing hands frequently with soap and water, especially after using the toilet or changing diapers; disinfecting surfaces and objects that may be contaminated; avoiding contact with sick people; and drinking safe water and eating cooked food.

– There is no specific treatment for rotavirus infection. The main goal of treatment is to prevent or treat dehydration by giving oral rehydration solutions (ORS), which are fluids that contain water, salts and sugars. ORS can be bought over-the-counter or made at home by mixing six level teaspoons of sugar and half a level teaspoon of salt with one liter of clean water.

– ORS should be given frequently and in small amounts to avoid vomiting. In some cases, intravenous fluids may be needed to treat severe dehydration in a hospital setting.

– Antibiotics and antiviral drugs are not effective against rotavirus infection. Antidiarrheal drugs are not recommended for children with rotavirus infection, as they may worsen the condition or cause side effects.

Where it's most rampant?

– Rotavirus infection is a global problem that affects millions of children every year. It is more prevalent in low- and middle-income countries, where access to safe water, sanitation and health care is limited. According to the World Health Organization (WHO), rotavirus causes about 215,000 deaths among children under five years old every year worldwide, mostly in Africa and Asia.

What conditions trigger its occurrence?

– Rotavirus infection occurs throughout the year, but it has a seasonal pattern in some regions. In temperate climates, such as the United States and Europe, rotavirus infection peaks during winter and spring months. In tropical climates, such as Africa and Asia, rotavirus infection occurs more evenly throughout the year or peaks during the rainy season.

– Rotavirus infection can also occur in outbreaks in settings where many people live or gather together, such as child care centers, schools, hospitals and nursing homes.

Who are the specialists involved in its treatment?

– Rotavirus infection is usually diagnosed and treated by primary care providers, such as pediatricians or family doctors. In some cases, specialists such as gastroenterologists (doctors who specialize in digestive diseases) or infectious disease specialists (doctors who specialize in infections) may be consulted for diagnosis or management of complications.

▶️ THE ROTAVIRUS VACCINE(S)

– The rotavirus vaccine is a live oral vaccine that protects infants and young children from severe gastroenteritis caused by rotavirus infection.

– Rotavirus is a highly contagious virus that can cause watery diarrhea, vomiting, fever, and dehydration. It is the leading cause of death from diarrhea in children under five years old worldwide.

▶️ THE MANUFACTURING PROCESS

– The manufacturing process of rotavirus vaccines involves several steps, such as:

• Growing the reassortant viruses in cell cultures derived from monkey kidneys (Vero cells) or African green monkey kidneys (MA104 cells).

• Harvesting the virus-containing fluids from the cell cultures and purifying them by filtration and centrifugation.

• Inactivating any residual cellular DNA or proteins by treatment with enzymes or chemicals.

• Formulating the purified virus particles with stabilizers, such as sugars or amino acids, to protect them from degradation or aggregation.

• Filling the vaccine solution into single-dose tubes or syringes and sealing them under sterile conditions.

• Testing the vaccine for safety, potency, purity, and identity before releasing it for distribution.

– The rotavirus vaccine can cause side effects, but they are usually mild and do not last long. Common side effects include: restlessness, irritability, and mild diarrhea. Rare side effects include: allergic reaction (anaphylaxis), which can cause difficulty breathing, swelling, rash, or shock; and intestinal blockage (intussusception), which can cause abdominal pain, vomiting, bloody stools, or lethargy.

– These side effects are very rare (about 1 in 1 million for anaphylaxis and between 1 and 6 in 100,000 for intussusception) and can be treated promptly if detected early.

How effective is the rotavirus vaccine?

– The efficacy of rotavirus vaccine is the measure of how well the vaccine protects against rotavirus infection, which is a common cause of severe diarrhea and vomiting in infants and young children.

– The efficacy of rotavirus vaccine can vary depending on the type of vaccine, the setting, and the strain of rotavirus.

There are two types of rotavirus vaccine currently licensed for infants in the United States: RotaTeq® and Rotarix®. Both vaccines are given by putting drops in the infant’s mouth.

– RotaTeq® is given in three doses at 2 months, 4 months, and 6 months of age, whilst Rotarix® is given in two doses at 2 months and 4 months of age. The first dose of either vaccine should be given before a child is 15 weeks of age. Children should receive all doses of rotavirus vaccine before they turn 8 months old.

– Both rotavirus vaccines were tested in large clinical trials that involved thousands of infants and were found to be safe and effective. About 9 out of 10 children who get the vaccine will be protected from severe rotavirus illness (fever, vomiting, diarrhea, and changes in behavior), while about seven to eight out of 10 children will be completely protected from rotavirus illness.

– The vaccine efficacy can last up to 2 years of age.

The efficacy of rotavirus vaccine can also depend on the setting where the vaccine is used. In resource-limited settings, where access to safe water, sanitation and health care is limited, rotavirus vaccination can have important cost implications and save lives. However, the efficacy of rotavirus vaccine may be lower in these settings due to factors such as malnutrition, co-infections, maternal antibodies, or genetic diversity of rotavirus strains. The efficacy of rotavirus vaccine can also vary by the strain of rotavirus that causes the infection.

– Rotavirus strains are classified by their outer proteins, called G and P types. The most common G types are G1, G2, G3, G4, and G9, while the most common P types are P[4], P[6], and P[8]. Both rotavirus vaccines are made from human-bovine reassortant rotaviruses, which contain genes from both human and bovine (cow) strains of rotavirus. These reassortant viruses can stimulate the immune system to produce antibodies against different G and P types of rotavirus.

– Studies have shown that both rotavirus vaccines can provide cross-protection against non-vaccine G types, such as G8 and G12. However, the efficacy may vary depending on the prevalence and diversity of these strains in different regions. For example, a study in Niger found that Rotarix® had lower efficacy against G8 strains than against other strains. Therefore, it is important to monitor the circulating rotavirus strains and evaluate the strain-specific efficacy of rotavirus vaccines over time.