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
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
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
G12 P 6
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