Rotaviruses contain double-stranded RNA, resemble a
wheel, have icosahedral symmetry, and are “double-shelled” (with inner
and outer capsid).
Rotavirus particles have been found in the duodenal
mucosa of children with acute gastroenteritis and in diarrheal stool
specimens.
In developed countries rotavirus is the most common
pathogen of childhood diarrhea.
Rotavirus-induced diarrhea is an
endemic problem throughout the world, the organisms being identified
in half the children in developing countries.
In temperate countries rotavirus diarrhea usually has a
seasonal winter peak, but in tropical countries high rates are
observed throughout the year.
Nosocomial infections are common, and shedding of
rotavirus has been found in some (usually asymptomatic) newborns in
communal obstetric nurseries within 3 to 4 days of birth.
Antibodies to the rotavirus in colostrums and breast
milk protect against infection.
The highest incidence of symptomatic infection is in
children aged 7 to 24 months.
Most children have rotavirus antibodies by end of the
third year, and nearly all infections in adults are subclinical.
Rotavirus is spread by faecal-oral transmission,
typically by person-to-person or by contact with a contaminated
object.
Contaminated water may be an important mode of
transmission in developing countries.
After an incubation period of 2 to 3 days there is an
abrupt onset of watery diarrhea, followed by dehydration and vomiting
and fever distinguish rotavirus diarrhea from diarrhea caused by
enterotoxigenic E. coli or Vibrio cholerae.
Visit:
Escherichia coli Infection
;
Cholera
The upper respiratory tract may also be affected.
In some countries, children have a
self-limited illness that lasts for a few days. But coincidental
infection with pathogenic enterobacteria may extend the duration.
Severe life-threatening dehydration may be an important
cause of mortality among children under 2 years of age.
Although Rota
virus infection is not associated to specific dermatologic clinical
pictures, recently, different clinical manifestations have been
reported in association with this infection. They include exanthema,
Gianotti-Crosti syndrome, and Acute Infantile Hemorrhagic Edema. The
condition can be diagnosed microbiologically with stool cultures. The
prognosis is excellent in healthy, immunocompetent individuals.
Treatment of rotavirus diarrhea consists of prompt
intravenous or oral rehydration.
Animal studies have shows that resistance to rotavirus
diarrhea depends primarily on local antibody to rotavirus in the lumen
of the small intestine.
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