Status of rotavirus infection
The main virus that causes pediatric enteritis in the fall and winter is rotavirus, and rotavirus enteritis occurs mainly in infants and young children, who are most likely to be infected from 6 months to about 2 years of age after birth. 90% of young children are infected before the age of 2. It is often caused by group A rotavirus, and because its peak incidence is in the fall, it is called “infantile autumn diarrhea”, and rotavirus infection causes diarrhea in approximately 1.5 billion infants and children worldwide each year, most of which occur in developing countries.
The virus is highly resistant and spreads mainly through the fecal and oral routes. The virus invades the epithelium of the small intestine and multiplies in the human small intestinal villous cells, causing shortening and loss of intestinal mucosal cell villi, which affects digestion and absorption functions. At the same time, the activity of intestinal mucosal disaccharidase decreases, affecting the hydrolysis of lactose in the intestinal lumen and impairing its absorption, resulting in an increase in intestinal osmotic pressure and the entry of large amounts of water and electrolytes into the intestinal lumen, resulting in diarrhea.
Symptoms of rotavirus infection
Infants and children who are infected with rotavirus can develop the disease in 1~2 days. At first, it is often accompanied by cold symptoms, such as fever, cough, red throat, runny nose, depression and loss of appetite. Then diarrhea appears, 5-6 times a day, or 10-20 times a day. The stool is egg-flake soup-like or watery, with a sour odor, and is lighter in color because it contains less bile. The child is often accompanied by vomiting and abdominal pain. Due to the large loss of water and salt brought about by diarrhea, it can cause dehydration and acidosis in sick children.
Even if the symptoms are mild, vomiting may occur for 1 to 2 days and diarrhea for about 1 week, but sequelae are less likely to occur.
Medication guidance
Treatment principles.
Oral rehydration salts: Many parents are very alarmed when they see their children vomiting and diarrhea, and often ask the doctor to give them fluids. In fact, most children with diarrhea do not need to be treated with fluids, but only need to use “oral rehydration salts” to prevent dehydration due to diarrhea. Oral rehydration salts are the most economical, convenient and scientific way of oral rehydration. Its formula is 3,5g of sodium chloride, 2,5g of sodium bicarbonate, 1,5g of potassium chloride, 20g of glucose, and 1000ml of boiled water, to be taken in divided doses. Oral rehydration solution is suitable for mild, moderate dehydration, or severe dehydration maintained by oral rehydration solution after intravenous rehydration.
Montmorillonite Bulk is an antidiarrheal agent to protect the mucous membrane of the whole digestive tract. This medicine comes in a bag and the main ingredient is double octahedral montmorillonite. Double octahedral montmorillonite is a kind of GI mucosal protector that can adsorb pathogens and strengthen the intestinal mucosal barrier. It can bind to mucosal glycoproteins and improve the defense function of the mucosal barrier against attack factors, and has good effect on rotavirus enteritis. The drug has the aromatic flavor of vanillin and is easy to take, so children are happy to accept it.
In particular, parents should be reminded that for pediatric viral diarrhea, there is absolutely no need for oral or intravenous antibiotics, and the abuse of antibiotics can only increase adverse reactions and is not beneficial to the disease. Lactobacillus active agent and bifidobacterium preparations can be taken orally to promote digestion and absorption of food, inhibit pathogenic bacteria causing intestinal diseases and protect the intestinal tract.
Home care advice
Hydration is most important, observe the situation before deciding to feed
More hydration: To prevent dehydration, it is important to hydrate more often. This is the most important thing for home care. If your child’s appetite is poor, you do not need to eliminate it, just hydrate more often. If you feed too much at one time, he or she will vomit, so feed in small amounts.
Eating for vomiting babies: Start eating again after the vomiting symptoms disappear and the appetite is somewhat restored. After observing the improvement of the bowel movement, you can decide what to feed. When the color of the stool gradually changes from white to yellow, you can rest assured.
Increase the number of feedings: If the diarrhea is still severe with breast milk, shorten the duration of each feeding and increase the number of feedings. When the diarrhea improves and the child wants to drink, feed him/her. In the case of milk, if the diarrhea is still severe, feed the child in small amounts or use lactose-free milk. When the diarrhea improves, feed the child the usual amount.
Addition of complementary foods: For children who have started complementary foods, if the diarrhea is still severe, switch to breast milk or cow’s milk, lactose-free milk, apple puree, vegetable soup, etc. When the situation improves, observe the bowel movements before deciding on a diet of soft, easily digestible foods such as congee and tofu.
Change diapers regularly: Diarrhea can easily cause diaper rash. To prevent diaper rash, change diapers more often or rinse with warm water to keep them clean. In order not to cause infection, remember to wash your hands after diaper changes. Avoid bathing if you have severe diarrhea or vomiting.
Record the number of diarrhea and vomiting: Record the number of diarrhea, vomiting, and bowel movements to understand how much water and food is absorbed in the diet and for reference at the next visit.
Prevention of rotavirus enteritis
An effective way to prevent rotavirus infection is to administer a live oral rotavirus vaccine. Live oral rotavirus vaccine is of great interest to WHO, which has included live oral rotavirus vaccine as one of the priority targets in global vaccine planning and diarrheal disease control planning to promote its use in developing countries and recommended its inclusion in national immunization programs. Live rotavirus vaccine is effective and breastfeeding has been observed to not interfere with the effects of oral vaccine, but protection may be type dependent.
Other preventive measures include.
1. Maintain good personal food and environmental hygiene.
2. Wash hands before handling food or eating and after using the toilet.
Parents should wear gloves when cleaning up vomit, feces and diapers, and should wash hands thoroughly again.
4.Clean and disinfect contaminated objects and surfaces
5. School-age children who have vomiting or diarrhea should seek rest and stay out of school as soon as possible.