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 Rotavirus

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AlleyRose
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PostSubject: Rotavirus   Fri Apr 04, 2014 9:01 pm

By the time they are five years old, most kids will have been exposed to the gastro-causing rotavirus.



Key points

  • Caused by an infection with rotavirus.

  • Signs and symptoms include low-grade fever and vomiting, leading to diarrhoea.

  • The diarrhoea lasts about 4-8 days.

  • Most commonly spread through poor hand hygiene.

  • Untreated dehydration in children with rotavirus can become fatal.




Rotavirus is a common form of gastroenteritis, an inflammation of the gastrointestinal tract (gut) that causes vomiting and diarrhoea. It particularly affects children aged under two years.
It's thought that by the age of five years virtually all children will have been exposed to rotavirus at least once.
Adults with rotavirus often don't have symptoms, but they can be a source of infection to other people.



Signs and symptoms
Following a two-day incubation period after becoming infected, the illness begins with low-grade fever and vomiting. This leads onto diarrhoea, lasting four to eight days.
Course and duration
The condition generally runs its course in about seven days. If loose explosive fluid bowel motions continue after this time, despite the child being well again, this can indicate that there is a secondary lactose intolerance, related to the original infection, which can be managed by your doctor.



Spread of infection
The infection is largely spread when people don't wash their hands properly. The organism can then be passed from the bowel of an infected person, onto their hands and left on a surface where it can be picked up by another person, entering their body through their mouth.
Droplets from the mouth of an infected person may also spread the infection.
It's also worth remembering rotavirus can survive for some time in water.

Infectious period
Children should be excluded from school or day care until they have been clear of symptoms for at least 24 hours.



Complications
Dehydration is the most serious complication of rotavirus infection, and if left untreated dehydration can be fatal. If dehydration is severe, hospitalisation and intravenous fluid replacement are needed.

Treatment

  • Breast feeding should be continued as tolerated.

  • Otherwise, vomiting children may be able to tolerate small frequent amounts of clear fluid, such as broth.

  • Commercially available oral rehydration fluids are the best form of fluid replacement in children with watery diarrhoea. These contain the correct amounts of essential electrolytes and glucose to replace what your child has lost, plus they provide a source of energy. Volumes of 10-20mls per kg per hour in small frequent doses should be offered. If the child refuses fluids or continues to vomit, they should be reviewed immediately by your practitioner.

  • Homemade replacement solutions run the risk of being too concentrated and making the diarrhoea worse. If you do use fruit juice or soft drinks for rehydration, they must be diluted.

  • It's worth remembering that plain water does not replace lost electrolytes and in large amounts can be harmful.



Prevention
Rotavirus vaccination has been part of the Australian free vaccination program since 2007 and is the main way to prevent this infection. Since vaccination commenced the rate of admissions of children to hospital with rotavirus gastroenteritis has fallen considerably.
Other general strategies to stop the spread of the virus include:

  • hand washing, especially after nappy changing and using the toilet

  • not changing nappies on surfaces used to prepare food

  • excluding infected children from swimming or playing in a communal pool for two weeks after the infection (some authorities recommend this last step)




Medical intervention
The smaller the child, the earlier you should seek medical advice if you suspect your child has rotavirus.
Early assessment becomes more urgent when a small child refuses fluids or breast milk and is continuing to vomit and have diarrhoea.
Children can die if they lose 10 per cent or more of their body weight through severe dehydration. In a small baby, this may only represent 500ml or 0.5 kg in weight.
Many other conditions can present with vomiting and loose bowel motions especially in infants and young children. So if your child is not improving in the expected time with treatment or seems worse, they should be seen by your doctor.
http://www.abc.net.au/health/library/stories/2012/03/21/3425085.htm#b
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