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Section 3. Summaries of Infectious Diseases

Rotavirus Infections

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS

Infection begins with acute onset of fever and vomiting followed 24 to 48 hours later by watery diarrhea. Symptoms generally persist for 3 to 8 days. In moderate to severe cases, dehydration, electrolyte abnormalities, and acidosis may occur. In immunocompromised children, including children with human immunodeficiency virus infection, persistent infection and diarrhea can develop.


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ETIOLOGY

Rotaviruses are segmented, double-stranded RNA viruses belonging to the family Reoviridae, with at least 7 distinct antigenic groups (A through G). Group A viruses are the major causes of rotavirus diarrhea worldwide. Serotyping is based on the 2 surface proteins, VP7 glycoprotein (G) and VP4 protease-cleaved hemagglutinin (P); G types 1 through 4 and 9 and P types 1A and 1B are most common in the United States.


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EPIDEMIOLOGY

Most human infections result from direct or indirect contact with infected people. Rotavirus is present in high titer in stools of infected patients with diarrhea. Rotavirus can be detected in stool before onset of diarrhea and may persist for as long as 21 days after the onset of symptoms in immunocompetent hosts. Transmission is presumed to be by the fecal-oral route. Rotavirus can be found on toys and hard surfaces in child care centers, indicating that fomites may serve as a mechanism of transmission. Respiratory transmission likely plays a minor role in disease transmission. Spread within families and institutions is common. Rotavirus is the most common cause of health care-associated diarrhea in children and is an important cause of acute gastroenteritis in children attending child care. Rarely, common-source outbreaks from contaminated water or food have been reported.

Human rotavirus infections are ubiquitous. Virtually all children in the United States are infected by . . . [Go to Full Text]


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