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Rotavirus in Children
Rotavirus infections occur seasonally, with infections most common in Autumn through Spring, reaching a peak in the winter. Although it is possible to get a rotavirus infection more than once, subsequent infections are usually more mild and not as severe as the first episode.
Children usually develop symptoms about 1 to 3 days after having contact with someone who is also infected. Transmission is usually by the fecaloral route, but it may also be spread through respiratory secretions. Rotavirus is present in the stool of children with diarrhea and can be passed by having direct contact with the stool. It can also be transmitted by indirect contact, such as can occur after an infected child touches a toy, or if someone doesnt wash their hands after changing a diaper.
Although there are tests available to check for rotavirus by detecting rotavirus antigens in the stool, they are not routinely performed. Since there is no treatment and most children recover on their own, there is usually no reason to confirm that a case of acute diarrhea is caused by the rotavirus. Testing for rotavirus is often performed in children with complicated cases or prolonged diarrhea. In these cases, detecting a rotavirus infection can help to rule out other more serious infections caused by parasites or bacteria.
Diarrhea usually lasts about 37 days in most children with a rotavirus infection, but some episodes may last as long as two weeks. Although there is no cure or medication for rotavirus infections, treatment with extra fluids is recommended and can prevent dehydration.
Fluids that are good for children with diarrhea and vomiting include unflavored or flavored oral rehydration solutions, such as Pedialyte, Infalyte or Kaoelectrolyte, some of which are also available as popsicles. These fluids have the right amount of water, sugar and salt that your child needs. Other choices, such as soft drinks, juices or KoolAid have too much sugar and can make the diarrhea worse. Also do not give just plain water, tea, or chicken broth.
The main problem from having diarrhea, with or without vomiting, is that it can lead your child to getting dehydrated. The first sign of dehydration is that your child will urinate less frequently your child should be urinating every six to eight hours. Other signs include a dry mouth, not having tears when crying, sunken eyes, and decreased activity or increased irritability. If your child has persistent diarrhea and vomiting, but is still urinating regularly and has a moist mouth then there is little danger that he is getting dehydrated.
Children with dehydration who arent tolerating oral fluids may need to be seen by their physician or in the emergency room to begin intravenous IV fluids.
If your child has diarrhea and is not vomiting or has only vomited a few times, then you can continue his usual diet including breastfeeding or formula, but do give 24 ounces of extra fluid every time that he has a large watery diarrhea. Although your child will not be able to digest everything that he eats as well as he normally would, by eating a regular diet your child will continue to get the nutrition he needs to get well. Withholding or limiting your childs diet during uncomplicated cases of gastroenteritis may actually make the diarrhea last longer.
If your child does not want to eat the first day then you can try the typical BRAT diet bananas, rice, applesauce and toast with lots of fluids and then advance his diet as he will tolerate it.
If your child has had prolonged diarrhea, then he may rarely develop a temporary lactase deficiency and may not be able to tolerate dairy products. You can try a soy formula or soy milk for a few weeks if your childs diarrhea becomes worse after drinking dairy products, although this isnt usually necessary.
While a vaccine to prevent rotavirus infections was previously available Rotashield, it was removed from the market because its use was associated with an increased incidence of intussusception.
Avoid giving just Pedialyte for more than 1224 hours.
Avoid medications: Medicines for diarrhea and vomiting have not been shown to improve symptoms in children and can make them worse.
Call your pediatrician if your child is becoming dehydrated decreased urination, dry mouth, not having tears when crying, sunken eyes, and decreased activity or increased irritability, if your child is vomiting blood, if the diarrhea is not improved in two weeks or if there is blood or pus in the diarrhea. Also call if your child is vomiting and has a high fever, severe headache or stomachache. Iannellis new book