What is rotavirus enteritis? What are the dangers of it? How is it diagnosed, treated and prevented?
Rotavirus enteritis, also known as fall diarrhea, is caused by rotavirus infection, which is highly contagious and can easily infect infants and children under 3 years of age who have not been vaccinated against rotavirus. Because there are multiple strains of rotavirus, most children are infected with rotavirus several times during their first year of life, and after several infections the child gains resistance to rotavirus infection. In some cases, infection can also occur through contact with contaminated water or food and surfaces of utensils through small amounts of rotavirus-containing secretions from the respiratory tract.
Signs and symptoms: It takes about 2 days for symptoms to appear after rotavirus infection. The symptoms are mainly fever, vomiting and loose stools, but abdominal pain may also occur. Infected children develop large amounts of watery stools that can last for several days (3-8 days). The danger of rotavirus infection is dehydration, and although cases of severe dehydration causing death in children are rare, it is important for both the doctor and the child’s family to recognize the signs and symptoms of dehydration and how to treat the child. The symptoms of dehydration are as follows: tiredness and weakness, thirst, dry skin, cold limbs, no tears when crying, sunken eyes and fontanelle (the part of the head that feels soft to the touch at the top center), and reduced urine output. In addition, extraintestinal organ damage such as myocardial and liver function caused by rotavirus infection is also more common.
Diagnosis: Detection of rotavirus antigen in stool is a sensitive method for diagnosing rotavirus enteritis…. However, during the fall and winter diarrhea epidemic seasons, typical cases can be diagnosed based on clinical features even if they are not equipped to do fecal rotavirus testing.
Treatment: There is no specific treatment for fall diarrhea. For people with a healthy immune system, intestinal rotavirus infection is a self-limiting disease with a natural course of 5-8 days. The principles of treatment are prevention of dehydration, correction of dehydration acidosis, continuation of diet, and rational use of medication. Only about 2.5% of children with rotavirus diarrhea require hospitalization for intravenous fluids.
Microecological preparations such as Rejuvenation, Pepcid, and Mammazine along with oral montelukast to prevent dehydration along with oral rehydration salts is the most common treatment for rotavirus enteritis, which is reliable and can shorten the course of the disease. We use intravenous fluids + virazole drip for children with rotavirus diarrhea, and oral simethicone also has some effect. In children with severe autumn diarrhea complicated by dehydration, the degree of dehydration and the nature of dehydration should be judged based on blood cell pressure, blood electrolytes and urine specific gravity, combined with clinical symptoms, before designing a rehydration plan. Our experience is that in cases of hypotonic dehydration, more electrolytes (sodium, potassium, etc.) and appropriate calcium supplementation should be provided. Parents should be reminded that rotavirus diarrhea is often accompanied by lactase deficiency in the late stages, so artificially fed children can be switched to lactose-free milk powder, and zinc and folic acid should be supplemented appropriately in the late stages of diarrhea. By the way, parents are reminded that rotavirus diarrhea can be fed as soon as vomiting stops, and protein absorption is generally not affected during diarrhea, so it is recommended to eat less and more meals, and avoid eating fiber-containing vegetables and fats.
During the autumn diarrhea epidemic, infants and children hospitalized for acute respiratory infections should be treated with caution with antimicrobials. If after 3-5 days of antimicrobial use there is still a low fever and cough, followed by vomiting and diarrhea, in this case it is difficult to distinguish whether the diarrhea is caused by antibiotic use or rotavirus infection. Our experience is that immediate discontinuation of antibacterial agents and switching to intravenous drip of virazole and oral treatment with zinc preparations and mometas often gives better results, and the child not only stops vomiting and diarrhea, but the cough is also reduced.
Vaccination: Vaccination of infants and children against rotavirus is the most effective measure to prevent autumn diarrhea. The live oral rotavirus vaccine produced in China has long been available and is recommended for use two times, once each at 2 and 4 months of age.