ROTA VIRUS DISEASE

Rota virus is the most common cause of severe diarrhea in infants and children

Responsible for 27,000 diarrheal deaths each year worldwide

Symptoms

• Incubation period 1 – 3 days
• Acute watery diarrhea – self-limiting, usually 2 – 7 days, possibly longer
• Fever - first few days - can be high
• Vomiting - first few days
• G1 symptoms may last upto 2 – 3 weeks

Compared to other common causes of diarrhea – more severe with greater risk of dehydration & hospitalization

Rotavirus Strains

• 7 different serogroups (A-G)
• Only A-C cause human disease
• Only A cause severe disease in children
• Serotyping based on 2

            structural proteins (GVP7 & PVP4)

            – 11 possible “G” serotypes (1, 2, 3, 4, 9)

            – 11 possible “P” serotypes (4, 8)

• Strains vary: By region and Over time
• 5 serotypes (G₁P₈, G₂P₄, G₃P₈, G₄P₈, G₉P₈) cause 90% of all human infections.
• G₁P₈ most prevalent globally.
• No relation between strain and severity

Deaths due to rotavirus annually *

India : 122,270  World : 527,000 (4,75,000 – 5,80,000)

• 29% of all deaths due to diarrhea globally.
• 20% of all deaths in children <5 years of age from India are due to diarrhea.
• 39.2% of all diarrhea-related hospital admissions among children aged <5 years in India (range from 35% in Mumbai to 53% in Trichy).
• 23% of deaths due to rotavirus in world.

OPD visits >25 million

Hospitalization >2 million

*Umesh Parashar, et al Global Mortality Associated with Rotavirus among Children

Reinfection is common but symptoms will be less significant.

Transmission is Feco-oral, person-person, fomites. Clean water, hygiene unlikely to have substantial effect on virus transmission.

• First infection usually does not lead to permanent immunity
• Reinfection can occur at any age
• Subsequent infections generally less severe

Most Common Types of Rotavirus Strains Found by the IRSN

International authorities (WHO, Institutes for Medicine, GAVI) highlight need for rotavirus vaccines

• Disease not prevented by good sanitation & hygiene
• Despite potential for ORS, IV fluids often needed for severe disease

Glass R et al. Lancet 2006;368:323-332