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Rotavirus infection in children: signs, symptoms, treatment


When detecting a rotavirus infection that is transmitted through contaminated food or through household contact, the term “dirty hands disease” is used in medical slang. It should be noted that the standard of living, civilization of society, careful hygiene measures and living conditions do not play a special role in shaping the risk of morbidity, that is, an intestinal infection at least once in a lifetime, every child is sick, regardless of care and social status.

What is a rotavirus infection?

Rotavirus infection for children Rotavirus infection (intestinal flu, rotavirus gastroenteritis) is an infectious pathology of the digestive tract, accompanied by symptoms of general intoxication and dehydration (dehydration) of the body. This disease is typical for all age groups, however, children from six months to 3 years are more often infected.

According to statistics, in recent years, the incidence of rotavirus infection among young children has increased significantly (up to 60%). According to experts, the reason for this phenomenon lies not only in the increase in the absolute number of diseases associated with the deterioration of sanitation and hygiene, but also in expanding the possibilities of laboratory diagnostics.

Every year, 440,000 children are victims of rotavirus infection, dying of diarrhea around the world. The most vulnerable are babies from one to three years. This is explained by the fact that at this age there are no antibodies to rotavirus in the child’s body. Up to a year, maternal antibodies are passed to children along with breast milk. At the same time, babies who are on artificial feeding, the chances of getting sick are quite high.

Clinical forms of the disease:

  1. Gastroenteric (gastrointestinal).
  2. Enteric (intestinal).

Causes of rotavirus infection

The causative agent of intestinal infection is rotavirus from the reovirus family. Its name (rota in Latin means wheel) RNA-containing virus was due to its similarity with a small bicycle wheel with a wide hub, sleeve, clearly defined rim and knitting needles. The diameter of the virus particles can vary in the range of 65-75 nm. According to antigenic properties, rotaviruses are subdivided into 9 serological types. Contagious for humans is 1-4, as well as type 8 and 9 of the virus.

The pathogen has an outer and inner protein shell (capsid). Virions, deprived of external capsid, which are often isolated from the feces of sick people, do not possess infectious activity. The rotavirus genome is represented as a double-stranded RNA consisting of 11 fragments.

For several months, the virus is able to maintain its viability at environmental facilities, it tolerates the effects of ether and acids, is relatively resistant to disinfectants, and quickly dies when heated.

Rotavirus infection is most common in the winter-spring period. At the same time, sporadic outbreaks of the disease can be recorded throughout the year.

Mechanism of development of the disease

The source of the disease is a person with an acute form of a manifest infection, or a virus carrier that secretes a pathogen into the external environment along with feces. The highest concentration of virions in feces is recorded in the first 3-5 days of the disease. This period is considered the most dangerous in epidemiological terms. Often, the source of infection in young children are their own mothers infected with rotavirus. At an older age, infection occurs in children's groups.

After penetration into the body, the pathogen of the intestinal infection is introduced into the epithelial cells of the mucous membrane of the digestive tract, most often in the epithelial layer of the small intestine. Having rooted inside the cell, rotavirus contributes to the damage and rejection of its villi. This, in turn, leads to desquamation of mature cells of the intestinal epithelium and their replacement by functionally unformed morphological structures that are not able to synthesize digestive enzymes and carry out the processes of digestion and absorption. Thus, the causative agent of rotavirus infection does not cause inflammation of the gastrointestinal tract, but becomes a cause of impaired digestive function. Due to insufficient production of digestive enzymes (maltase, lactase and invertase), unsplit sugars accumulate in the intestine. This condition leads to an excess flow of water and electrolytes into the lumen of the small intestine and the development of secretory diarrhea (watery diarrhea, which causes dehydration).

Mechanism of transmission:

  • Fecal-oral;
  • Food;
  • Water;
  • Contact and household.
  • Airborne (in rare cases).

Symptoms of rotavirus infection in children

Rotavirus infection is a cyclical disease. The duration of the incubation period is 1-4 days (usually 12 hours or a day). Usually, the disease begins acutely, with an increase in body temperature to 39-40 C. A severe rumbling and abdominal pain, copious fetid watery stools (up to 20 times a day) and repeated or repeated vomiting, starting from the very first hours of the disease, even if a hungry stomach or after consuming just over 50 ml of liquid. After the meal, undigested food pieces are found in the vomit. Often the amount of vomit exceeds the amount of food and water received by the child. To reduce body temperature with rotavirus infection is quite difficult and it can stay at around 39 ° C for 5-6 days. In infants with the development of the disease there is a strong rumbling in the abdomen, rapid weight loss, lethargy and drowsiness.

As the pathological process progresses, due to the loss of a large amount of fluid, exsicosis develops (dehydration of the body). The clinical manifestations of this condition depend on the severity of the disease. For light and moderate flow characteristic paleness of the skin, weakness and thirst (I-II degree of dehydration). In severe forms of rotavirus infection, diuresis decreases, acrocyanosis develops, the voice becomes hoarse, involuntary contraction of the muscles of the limbs is possible (dehydration of the III degree).

Exicosis occurs in 70-75% of hospitalized children, but in 95% of cases it occurs in mild to moderate degrees, and only in 5% of cases severe dehydration of the body with decompensated metabolic acidosis is observed.

The development of dehydration is indicated by the following signs: constant thirst, retraction of the eyes and large spring, dry skin, sclera and mucous membranes. The skin becomes an earthy gray tint, lips become bright and dry, reduces skin turgor, decreases the amount of urine. The most dangerous condition is the stage of dehydration, in which thirst is replaced by a complete rejection of drinking.

In some cases, the disease can occur in subacute form. In this situation, the child becomes sluggish and capricious, his appetite decreases, fatigue increases, general weakness develops, headache, discomfort and rumbling occur in the abdomen, and moderate catarrhal phenomena are observed (tickle in the gol, hyperemia of the pharynx, nasal congestion, mild cough and swollen lymph nodes). This condition can last 3-4 days. Often, pediatricians mistakenly consider signs of a subacute rotavirus infection for acute respiratory infections or acute respiratory viral infections.

The most characteristic difference in diarrhea caused by rotavirus from dysentery or salmonellosis is the absence of mucus, greens and blood impurities in the stool, as well as the absence of tenesmus (the painful false urge to defecate). In very young children, feces may discolour without changing their consistency. On average, the duration of diarrhea is 5-6 days. In the first 2-3 days the stool is watery, and then becomes clay-like, characteristic gray-yellow color. Catarrhal phenomena pass in 3-4 days. As a rule, after the body produces antibodies against the virus, the disease ends in self-healing.

If blood impurities are detected in the fecal masses, this signals the accession of a bacterial infection (escherichiosis, shigellosis, campylobacteriosis). Such children have more pronounced symptoms of general intoxication. With regard to catarrhal signs of rotavirus infection, many experts also consider them as a consequence of the layering of a secondary bacterial infection.

Specific immunity to rotavirus, caused by secretory and humoral antibodies, is formed in early childhood, after an illness. It should be noted that the immunity is unstable, and with a low level of antibodies in adulthood, a relapse of the disease is possible.

Complications of rotavirus infection

  • Hemodynamic disorders;
  • Acute renal failure;
  • Infectious toxic kidney;
  • Gasser syndrome;
  • Hemorrhagic gastroenteritis;
  • Necrotizing enterocolitis.

Diagnostic features of rotavirus infection in children

  1. This disease is characterized by autumn-winter seasonality, high contagiousness (contagiousness), epidemic or sporadic outbreaks. Rotavirus infection mainly affects young children (from one to three years).
  2. Distinctive signs: acute onset, feverish state, vomiting and diarrhea of ​​secretory character.
  3. From the first day of the disease, a typical combination of respiratory and gastroenteritis scrologic syndrome is observed.
  4. Absence in mucus, blood and greens.
  5. The absence of "finds" when conducting a conventional bacteriological examination of the intestinal group of microorganisms.

Laboratory diagnosis of rotavirus infection

  1. Virological examination of feces (electronic or immunoelectron microscopy of the biomaterial for the detection of rotavirus or viral antigen) and isolation of the virus in cell cultures.
  2. Serological examination (detection of rotavirus antigen by ELISA, PH, RSK, RNGA, latex-agglutination).

If a mixed infection is suspected and dubious serological and virological results are obtained, a retroanoscopy with aspiration biopsy of the large intestinal mucosa can be used as an additional diagnostic technique (this study is performed in severe cases).

What diseases can be confused?

Rotavirus infection should be differentiated from dysentery, gastrointestinal forms of salmonellosis, cholera, yersiniosis, and protozoal intestinal invasions.

Treatment of rotavirus infection

The main goal of anti-ratavirus therapy is to fight against intoxication and dehydration of the body, as well as disorders of the cardiovascular and excretory system associated with the disease. Hospitalization is carried out according to clinical indications. With a mild to moderate rotavirus infection, a child’s treatment can take place at home. Before embarking on the effective elimination of symptoms, it is necessary to establish the degree of dehydration of the organism. When I-II degree of dehydration, the patient is administered oral dehydration therapy, which involves the use of drugs that restore the water-salt composition of the blood (rehydron, gluxonal, etc.). For 13 days, the child is regularly given small doses of the solution until the stools are fully normalized.

With the development of III degree of dehydration, the use of combined oral and parenteral rehydration therapy is recommended. For intravenous administration (jet or drip) apply acesol, quartosol, trisol. In severe cases, the child is prescribed rheosorbilact, polyglukin, hemodez, and other macrodextrants.

In the acute period, astringent and adsorbing substances (carbolene, polyphepanum, smecta, enterosgel, etc.) are used to accelerate the normalization of stool and the removal of the virus from the body. These drugs should also be given to the child for three days, in accordance with the instructions.

Due to the fact that many children suffering from rotavirus gastroenteritis, intestinal dysbiosis develops, in complex therapy it is recommended to use biological preparations containing lactobacilli (lactobacterin, acylact, etc.). In the course of their metabolism, they are capable of producing substances with antibiotic activity and replacing lactase.

To increase the concentration of antibodies to pathogens of intestinal infections, anti-rotavirus immunoglobulin or complex immunoglobulin preparations for enteral use are indicated. These funds significantly reduce the time of intoxication and diarrhea.

Immunoglobulin preparations may be used only with the permission of the attending physician!

After a decrease in body temperature and cessation of vomiting and diarrhea for 10 days, the child should be given enzyme preparations that help normalize digestion and optimal digestion of food. Most often appointed pancreatin, festal, mezim-forte, creon, etc.

What drugs can not be used in the treatment of rotavirus infection in children?

Antidiarrheal drugs . Rotavirus "leaves" the body along with feces. Therefore, treatment should be directed not at eliminating the symptoms of diarrhea, but at alleviating the condition of the child and reducing the number of urges to defecate.

Antibiotics . Antibacterial drugs are not able to affect the viral particles, and their use leads to the development of dysbiosis and deterioration of the digestion process.

Diet for treating rotavirus infection

In the treatment of intestinal infections, provoking the development of fermentopathy, special attention is paid to diet. Since the development of the pathological process disrupts the activity of a number of digestive enzymes, in particular, lactase, in the acute period of the disease, whole milk and dairy products should be excluded from the diet of the child and the carbohydrate-rich food intake (sweet fruits, fruit juices, pastries, legumes) should be excluded. culture). Also in the acute period of the disease it is not allowed to feed children with meat, broths, meat products, fatty and fried dishes. Food for a sick child is often given in small portions. The list of permitted products includes mucous porridges, vegetable purees and soups, white crackers and baked apples.

Breastfeeding in the presence of an intestinal infection is not stopped, because the mother's milk contains antibodies that neutralize rotavirus and immunoglobulins that facilitate the course of the disease.

It is very important in the treatment of rotavirus infection to observe the correct drinking regimen. With abundant vomiting and severe diarrhea, the children's body requires constant replenishment of the lost fluid. Drink slowly, in small sips, with intervals of 5-10 minutes. After each attack of vomiting, a baby should be given 50 ml of liquid, at a later age - 100-200 ml. With a significant dehydration, the drinking regimen should be prescribed by the attending physician.

As a drink, mineral water without gas, tea or water with lemon, cranberry juice, chamomile decoction, as well as special salt solutions are used.

Prevention of rotavirus infection in children

  • Use only boiled water for drinking;
  • Thorough washing hands before eating;
  • Pre-wash fruits and vegetables with a brush;
  • Sufficient heat treatment of food.

| 15 June 2015 | | 1,073 | Infectious diseases
Leave your feedback

Patricia Brown: I knew it!!!! Vaccines are bad for kids so take that doctors who always make kids cry!! This is also why sooooooo many kids hate their doctor!●

Mia Ramos: My little sister Sienna had constant diarrhea and watery diarrhea and she's only 8 years old we think she's sick but we still don't know what to do if you know tell us what's happening and why its happening

Jagraj Singh: My daughter was having loose stools and vomiting for five to six days. We rushed her to hospital and Dr. diagnosed her with Cholera. Antimicrobials were given to her. She got symptomatic relief but not permanent relief. One day I shared my problem with one of my friend. He told me about Planet Ayurveda. We visited there and met Dr. Vikram Chauhan. Dr. said that her digestive system is weak and gave us Digestion support capsules. Now my son is absolutely fine and his symptoms are resolving very fast.