Some time ago, I always wondered why the autumn diarrhea storm did not come this year. At that time, norovirus infection caused more gastroenteritis, and are more children after preschool (about 7 years old), which is clearly different from rotavirus infection, and the course of the disease is also very short, usually 2-3 days to relieve. At the time, a colleague lamented whether the gradual rollout of the oral rotavirus vaccine was to blame. As we entered December, I discovered that we were wrong about the fall diarrhea, and the winter outbreak came with a vengeance, far exceeding previous years (subjective feeling, not CDC data). It is rotavirus gastroenteritis, called fall diarrhea because the disease tends to be high in the fall, but it doesn’t just occur in the fall; winter is also a high incidence time period, even more than fall. This is the case with rotavirus infections this year. If your child suddenly has frequent vomiting during the recent “cold”, vomiting with or without fever (usually a moderate fever lasting about 1 day), and if you think about your child’s recent food history and feel that he or she has no history of unclean food, the first thing you should think about is If the child soon has diarrhea, vomiting gradually stops, but the diarrhea becomes more and more obvious, and the stool becomes more and more dilute, close to watery or egg-flake, then the possibility of rotavirus enteritis is greater. At this time you need to immediately collect your child’s stool in a clean glass container or plastic wrap and immediately send them to the hospital for routine stool and rotavirus testing. The results are usually available in 10+ minutes. If the rotavirus is positive and a small number of white blood cells are seen in the stool routine or the stool routine cell count is completely normal, the diagnosis of rotavirus is basically established when combined with the child’s symptoms, and the local morbidity situation. The baby has rotavirus enteritis, but do not need to panic, this disease and common viral infections, can be self-healing, as long as given reasonable supportive treatment, does not require antiviral, let alone antibiotics to “anti-inflammatory”, as the body antibody production, the virus will be cleared, the disease will be cured. The natural course of the disease is usually about 1 week (diarrhea may last longer than 2 weeks in cases of secondary lactose intolerance or inappropriate treatment of feeding). The supportive treatment mentioned here is mainly rehydration, which can be oral rehydration or intravenous rehydration. For the first day of illness, some babies tend to vomit significantly, drink water and vomit, drink 50ml in and even vomit 60ml out. At this time, if the baby has not started diarrhea, you can fast briefly for 4-6 hours or take small amounts of oral rehydration salts III several times, each time and 10-20ml, through the above method baby still obviously vomit, or soon appear obvious diarrhea, baby’s mental state becomes, urine volume obviously reduced, oral rehydration solution failed, this time need to take intravenous infusion, which is what we say to play a hanging bottle. Don’t think that playing the suspension is bad, after the failure of oral rehydration, intravenous rehydration is necessary and is an effective means to reduce small problems turning into big ones. Because rotavirus enteritis if there is moderate to severe dehydration and not corrected in time, the next will be acidosis, electrolyte disorders, shock, multi-system damage and other serious complications that endanger the baby’s life! Let’s not forget that diarrheal disease (rotavirus enteritis is among the important diarrheal diseases) remains the second leading cause of death in children under five years of age, according to World Health Organization statistics from 2013. A total of 760,000 children die from diarrheal diseases each year. Diarrhea can last for several days, causing dehydration and salt deficiency, which are essential for the body. Most of the people who die from diarrhea actually die from severe dehydration and loss of body fluids. Of course I know what you most want to know must be when to take your baby to the hospital for infusion treatment instead of oral rehydration at the parents. In general, for a normally healthy baby (no malnutrition, etc.), moderate and above dehydration often requires prompt intravenous rehydration, by which time the body has lost about 5-10% of its body weight in water (for a baby of about 1 year old, about 10 kg, 500 ml of water or more is lost). The child can experience thirst (not always), irritability, lack of skin elasticity, sunken eyes, sunken fontanelle, reduced tears when crying, and a significant decrease in urine output. Of course, these indicators are inherently subjective, and it is sometimes difficult for parents to make accurate judgments. It is very important to get medical help in time. Oral rehydration can be used for children with mild to moderate dehydration. Oral rehydration is best done with Oral Rehydration Salt III (not I or II), and in the absence of oral rehydration salt, rice soup with a small amount of salt can be used temporarily (because the amount of salt added is too subjective and not recommended). The principle of oral rehydration is to lose as much as possible and to replenish a small amount many times, that is, if the baby has diarrhea once, it is necessary to replenish a little. During diarrhea must continue to feed, there are many parents think that the baby diarrhea because of the food is not digested, so do not eat it will not pull again? The fact is that for rotavirus enteritis, even if you don’t give your baby anything to eat, the baby will pull just the same, and will lose all the water inside and outside the cells, so that the baby will quickly become dehydrated and cause danger. The food structure still needs to be properly adjusted, for example, high-fat and high-sugar foods should not be eaten because they will lead to an increase in intestinal osmotic pressure and aggravate diarrhea, and spicy foods, of course, should not be eaten. Breastfed babies should also continue to breastfeed, but since rotavirus enteritis can be secondary to lactose intolerance, lactase can be added before breast milk, and regular formula feeding can be adjusted to de-lactose formula. Another overlooked treatment is zinc supplementation, which, according to WHO, can reduce the duration of diarrhea by 25% and the amount of stool by 30%. It is recommended to supplement all children with diarrhea with 20 mg of zinc per day for 10 days, and infants 2 years old and younger with 10 mg per day for 10 days. Some studies have shown that montmorillonite as an adsorbent can also reduce the duration of the disease and speed up the elimination of viruses, and that probiotic supplementation is beneficial for the recovery of intestinal function. For babies who do not have the disease, how to prevent it must be the most important thing you want to know. In fact, you must know the means of prevention: not to go to the crowd (rotavirus can be transmitted not only through the fecal mouth, but also through the respiratory tract in the form of aerosols); hand washing with soap (a simple and effective way to cut off the fecal mouth route); the first six months of exclusive breastfeeding babies (breast milk gets the antibody protection that even high-end milk powder can not simulate); good personal hygiene habits and food hygiene ( Everyone on earth knows this); rotavirus vaccination (the protection rate is not 100%). One of the reasons why many parents say that their babies get rotavirus vaccine is because there are many types of rotavirus, and the current rotavirus vaccine is only effective for group A rotavirus infection. If your baby has been vaccinated against rotavirus, even if he or she is sick, the symptoms will be significantly less severe. In addition to the risk of dehydration and electrolyte disturbance mentioned above, rotavirus infection of the digestive tract can also cause harm to other systems of the body without severe dehydration, and can attack the nerves, respiratory, heart, liver, gallbladder, blood, etc. It can attack the nervous, respiratory, cardiac, hepatobiliary, blood and other systems. The good news is that I have encountered this situation only a few times since I started practicing medicine! Of course, it could be that nothing is old enough!