Rotavirus, Infants and Children

Rotaviruses can cause acute stomach and bowel upset (gastroenteritis) in all ages. Older children and adults have either no symptoms or minimal symptoms. However, in infants and young children rotavirus is the most common infectious cause of vomiting and diarrhea. In infants and young children the infection can be very serious and even cause death from severe dehydration (loss of body fluids).

The virus is spread from person to person by the fecal-oral route. This means that hands contaminated with human waste touch your or another person's food or mouth. Person-to-person transfer via contaminated hands is the most common way rotaviruses are spread to other groups of people.

SYMPTOMS

  • Rotavirus infection typically causes vomiting, watery diarrhea and low-grade fever.

  • Symptoms usually begin with vomiting and low grade fever over 2 to 3 days. Diarrhea then typically occurs and lasts for 4 to 5 days.

  • Recovery is usually complete. Severe diarrhea without fluid and electrolyte replacement may result in harm. It may even result in death.

TREATMENT

There is no drug treatment for rotavirus infection. Children typically get better when enough oral fluid is actively provided. Anti-diarrheal medicines are not usually suggested or prescribed.

Oral Rehydration Solutions (ORS)

Infants and children lose nourishment, electrolytes and water with their diarrhea. This loss can be dangerous. Therefore, children need to receive the right amount of replacement electrolytes (salts) and sugar. Sugar is needed for two reasons. It gives calories. And, most importantly, it helps transport sodium (an electrolyte) across the bowel wall into the blood stream. Many oral rehydration products on the market will help with this and are very similar to each other. Ask your pharmacist about the ORS you wish to buy.

Replace any new fluid losses from diarrhea and vomiting with ORS or clear fluids as follows:

Treating infants:

An ORS or similar solution will not provide enough calories for small infants. They MUST still receive formula or breast milk. When an infant vomits or has diarrhea, a guideline is to give 2 to 4 ounces of ORS for each episode in addition to trying some regular formula or breast milk feedings.

Treating children:

Children may not agree to drink a flavored ORS. When this occurs, parents may use sport drinks or sugar containing sodas for rehydration. This is not ideal but it is better than fruit juices. Toddlers and small children should get additional caloric and nutritional needs from an age-appropriate diet. Foods should include complex carbohydrates, meats, yogurts, fruits and vegetables. When a child vomits or has diarrhea, 4 to 8 ounces of ORS or a sport drink can be given to replace lost nutrients.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your infant or child has decreased urination.

  • Your infant or child has a dry mouth, tongue or lips.

  • You notice decreased tears or sunken eyes.

  • The infant or child has dry skin.

  • Your infant or child is increasingly fussy or floppy.

  • Your infant or child is pale or has poor color.

  • There is blood in the vomit or stool.

  • Your infant's or child's abdomen becomes distended or very tender.

  • There is persistent vomiting or severe diarrhea.

  • Your child has an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • Your baby is older than 3 months with a rectal temperature of 102° F (38.9° C) or higher.

  • Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.

It is very important that you participate in your infant's or child's return to normal health. Any delay in seeking treatment may result in serious injury or even death.

Vaccination to prevent rotavirus infection in infants is recommended. The vaccine is taken by mouth, and is very safe and effective. If not yet given or advised, ask your health care provider about vaccinating your infant.