Rotavirus infection is one of the most common on the planet. It is she who most often causes children's diarrhea, and not grandma's pancakes or green apples, as most parents think. There is no such person in the world who would never have encountered a rotavirus infection. That is why it is important to know exactly the "enemy in the face" and be able to resist him.
What it is?
Rotavirus infection is one of the acute intestinal infectious diseases. Quite often you can find the name of this ailment, familiar in everyday life - "intestinal flu" or "stomach flu". It should be noted that the rotavirus, which causes an unpleasant illness, has nothing to do with the influenza virus. Rotavirus has a different structure, different properties, a different principle of action.
If the influenza virus is capable of reproducing only on the mucous membranes of the respiratory organs, then the rotavirus lives and multiplies well in the small intestine. Therefore, rotavirus infection, although it belongs to the number of viral ailments, has nothing to do with influenza and ARVI, since it is not respiratory, it does not affect the respiratory system.
The causative agents of infection are rotaviruses. They got their name not from the fact that they enter the body through the mouth, although this is an absolute truth, but from their form. Under the microscope, viruses of this family resemble a wheel with a rim and hub. Therefore, the Latin word "rota", translated as "wheel", and formed the root of the name of the pathogen.
There are 9 types of rotavirus. They are designated by Latin letters from A to I. Ten out of ten children usually have the most common type A rotavirus. Type B and type C viruses are also dangerous to humans from the point of view of possible infection. Other viruses are found in animals. The rotavirus itself is a tough and resilient "fighter". It has a triple strong protein coat, thanks to which the virus is able to survive in the human stomach, withstand the attack of the acidic environment of gastric juice, in order to eventually reach its destination - the walls of the small intestine.
Even the most caring mother cannot fully protect her child from rotavirus infection. 97% of children have had this disease at least once by the age of three. The route of transmission of the virus is fecal-oral. More often than not, anyway. In other words, rotavirus leaves the body, in which it parasitizes, with feces, for a long time it can exist in soil, water, especially in spring or sea water, and wait in the wings when it manages to penetrate through the mouth into the gastrointestinal tract of a new "carrier ".
A child can become infected through water, food, through contact with toys, household items, if they were touched by a person who is sick with rotavirus, or a person who accidentally brought particles of the virus on his hands. About 3-4% of cases of rotavirus infection are fatal. Here you should say something: death does not occur from the rotavirus itself, but from the complications that it causes, in particular, from dehydration that occurs with prolonged severe diarrhea.
If an adult with this ailment spends only a few days in the toilet with diarrhea, then children often have a more severe infection, because their immune defenses are weak due to age and immaturity of the body. The younger the child, the more dangerous rotavirus infection is for him. In about half of rotavirus infections, young children require hospitalization. Most often, children aged 1.5 to 5 years die from the disease. At the same time, medical statistics indicate that boys are more likely to be hospitalized than girls. It is difficult to say with what it is connected, but the fact remains.
Rotavirus is so contagious that it can cause not only sporadic outbreaks of the disease, but entire epidemics. No pandemic has been reported. Most often, children attending kindergarten and school are drawn into the circle of patients. It is in children's collectives that the infectious agent spreads the fastest. Doctors also noticed a certain seasonality of the disease - rotavirus infection in Russia is most often recorded in the cold season. The rise in incidence begins in November, peaks in January-February, and begins to subside by the end of April.
How does the infection take place?
The feces of a person with rotavirus contain tens of trillions of viral particles. No more than a hundred of these particles are needed to infect another person, so one disease can infect many thousands of people. This is the reason for the extremely high infectiousness of rotavirus. The virus can penetrate into the organism of the "carrier" in different ways - most often through the mouth, but in some cases it was possible to register an aerogenic infection, that is, through close contact with a sick person.
Rotavirus infection is a so-called “dirty hand disease”. It is impossible to hide from her. Where there are children who try everything on the "gut", there will always be cases of infection with it.
Rotavirus is not affected by standard sanitization measures. After the virus enters the child's body, it may take about 1-5 days until the first symptoms appear. This is the average standard time, which is considered to be the incubation period.
The viruses target the villi of the small intestine. They are attacked by rotaviruses, destroying the structure of cells. There the virus replicates, whole "factories" are created that produce new virus particles. When they accumulate in excess, the villi of the small intestine are unable to absorb nutrients and take part in digestion, and symptoms of intestinal upset appear.
Diarrhea is caused by the death of the villi, as well as the fact that viruses produce special proteins that interfere with the normal absorption of water and contribute to the accumulation of lactase.
After the first symptoms appear, an acute period begins, it usually lasts 3-5 days, in severe cases - more than a week.
Then the process of restoration of the body begins - it lasts about 5-6 days. A child after an illness caused by rotavirus is contagious for about a week. Even if the baby feels well, all the symptoms of the disease have receded, with its feces, particles of rotavirus continue to be released, and this is unsafe for others.
Most often, children from six months to 5 years old are infected with it. Newborns rarely suffer from this infection, because in the first months after birth, they are protected by innate maternal immunity - a set of antibodies that are transmitted by a woman to a fetus with blood during pregnancy, as well as antibodies that a baby receives when breastfeeding.
Causes
Do not think that rotavirus infection threatens children who grow up in inadequate sanitary conditions. Even in families where order and cleanliness are given the utmost attention, children get sick of it. Washing fruits and vegetables, observing the rules of personal hygiene - all this does not at all affect the likelihood of contracting a viral infection. This is due to the high pathogenicity of the virus, its widespread distribution.
Most often, the virus gets into drinking water, and not only into spring water, but also into tap water; existing purification systems cannot guarantee the complete harmlessness of water. Often, a baby gets rotavirus with milk and dairy products.
The most common cause of infection is contact with other children, one or more of whom may be carriers of the infection.
Symptoms and Signs
Rotavirus infection manifests itself sharply, acutely, its very beginning practically does not raise doubts about what is happening. The first signs are intestinal disorders. Most often, rotavirus in a child's body declares itself with diarrhea. The child simultaneously with liquid stools develops multiple vomiting, a high temperature rises (38-39 degrees).
The child complains of weakness, malaise, that the stomach hurts. The urine becomes cloudy due to intoxication of the body. Flatulence increases, the baby loses appetite, the skin becomes pale, and an unpleasant odor may appear from the mouth.
By the consistency and color of the stool, you can understand that we are talking about rotavirus infection, because with it, feces have their own characteristics. At the very beginning, the stool has a foamy consistency and a yellow-green color. It can contain mucus impurities, feces have a pungent and unpleasant odor. On the second or third day after the onset of the acute phase of the disease, the feces become clay-like, gray-yellow. Light-colored feces have an uneven consistency.
The urine becomes dark on the 2nd day, visually flocculent impurities can be observed in it, the liquid secreted by the kidneys begins to smell unpleasant. A day after the onset of the disease, most children begin to have a sore throat, a cough, and a slight runny nose. It is for this, most likely, that the disease is called "intestinal flu."
By the way, rotavirus always "walks" somewhere near the flu virus. Most often, outbreaks of intestinal infectious disease occur either on the eve of an epidemic of influenza and SARS or in its midst.
The course of the disease may be different, besides, each child, due to the state of health, may have individual reactions, for example, a small rash may appear if the child is prone to allergies or atopy.
Signs of dehydration - dehydration are considered alarming symptoms in rotavirus infection. You can guess that it has begun by the characteristic change in facial features - it looks haggard, the lines are pointed, blue circles appear under the eyes, the eyes look somewhat sunken. The amount of urine decreases, the child may never pee in 5-6 hours. The baby has a dry tongue, lips dry, he is thirsty.
It is dehydration with rotavirus that leads to death, and therefore parents should try their best to prevent such an outcome, and if dehydration cannot be avoided, immediately call an ambulance.
The most classic picture of infection is rotavirus gastroenteritis and enteritis. Signs of secondary lactase deficiency may appear. After recovery, such children should be careful to introduce milk and dairy products into the menu, since a relapse is possible.
According to the severity of symptoms, the infection is divided into mild, moderate and severe:
- the mild form is less painful, with an average frequency of loose stools can reach 10 times a day;
- in severe form, diarrhea forces the child to empty the intestines about 15-20 times a day, while vomiting is frequent, profuse, even from drinking water. Physical activity decreases, in a one-year-old child, body weight can quickly decrease.
Effects
In most children, rotavirus infection is successfully treated at home and has no consequences. However, a doctor's consultation is mandatory already because it is rather difficult for parents on their own to understand what form the ailment has and how dangerous it can be.
Improper treatment, non-compliance with clinical recommendations, refusal to be admitted to a hospital, if the form of the disease is severe - all this can cause serious complications.
Rotavirus infection is dangerous because it can cause acute heart failure, kidney failure. The immunity weakened by the virus creates excellent prerequisites for the attachment of a secondary, mainly bacterial infection. If the child has had problems with the digestive system, rotavirus infection can exacerbate chronic diseases.
Diagnostics - how to distinguish from poisoning?
Common food poisoning, which can be confused with rotavirus, only at first glance looks like this viral disease. If you look closely, these two states are easy to distinguish from each other.
Food poisoning is a predominantly bacterial process. Poisoning often proceeds with vomiting, but without diarrhea and fever. It is also often manifested by diarrhea without fever or with its rise to subfebrile values (about 37.0 degrees).
High fever is the main hallmark of rotavirus infection. In addition, in case of poisoning, the feces will resemble gruel in consistency, and in case of a viral disease, it will be watery. Be sure to tell your doctor about these symptoms so that it is easier for him to make a correct diagnosis. It should be noted that the doctor, when examining the child, can only question the diagnosis of "rotavirus infection".
Accurately confirming the presence of rotavirus is possible only on the basis of laboratory tests, which primarily include the study of feces for the presence of its particles in them. A blood test is also carried out for the detection of specific antibodies to rotaviruses, as well as other laboratory methods.
At home, parents can do a rapid rotavirus test. These tests are commercially available. The child's feces are used as the test material.
Treatment
Parents' desire to treat their child at home under their own vigilant control is easy to understand. However, regarding rotavirus infection, moms and dads should be fully aware of what is happening. Only mild forms of the disease can be cured at home, with moderate to severe and severe forms of the disease, hospitalization and treatment in a hospital are indicated.
Treatment must be timely, which means that the earlier the mother and father of a sick child call a doctor, the more favorable the prognosis will be and the less likely complications. You should not wait several days to make sure that diarrhea and vomiting are long-term. On the first day, you should seek medical help and begin the prescribed treatment.
Since the disease is of viral origin, it is almost impossible to fight against the rotavirus itself, like most other viruses known to mankind. Only the baby's own immunity can cope with them, but it takes several days for it to become active. therefore the essence of therapy is reduced to symptomatic treatment, which should prevent the occurrence of dehydration, seizures, changes in the cardiovascular and excretory systems. Diarrhea if you follow a diet, special food passes in two to three days, but the recovery period will require a more attentive attitude.
Diarrhea, as already mentioned, can cause dehydration, and it is precisely on its prevention that all efforts of parents should be directed from the very first hours of the onset of the acute stage of the disease.
It is the intensive rehydration therapy aimed at replenishing the body's water-salt balance that is the basis of treatment.
With a mild form, it is carried out at home, with moderate and severe forms, the lack of fluid in the body is replenished by intravenous infusion in a hospital setting.
Also you should not refuse hospitalization even if the child has severe vomiting, and he cannot drink at all and "hold" liquid - he is immediately sick. It is also better for such a baby to start injecting saline intravenously as soon as possible.
At the first symptoms of rotavirus infection, parents should provide the child with rest, measured bed rest. Reducing physical activity can help you get through the tough early days with high fever without increasing your risk of complications.
Adequate drinking regime should be ensured from the very first minutes. The drinking regimen means that the baby must take a large amount of liquid. The more intense the diarrhea and gag reflex, the more fluids he needs to give.
Carbonated drinks, juices, milk are not suitable to prevent dehydration. You should give only drinking clean water, homemade sour fruit drink, unsweetened dried fruit compote.
An important condition is the temperature of the liquid. Drinks should not be hot or cold. Only drinks at room temperature can be absorbed faster in the intestines and absorbed by the body. If the child is young and refuses to drink, parents can use a syringe without a needle to infuse liquid with a drip method. In this case, you need to direct the syringe at an acute angle along the inner surface of the cheek, so the baby will not choke and will not be able to spit out everything that the parents poured back.
If, despite persuasion and tricks, the child cannot be drunk, the parents should call an ambulance, as dehydration is easier to prevent than to cure later. The remaining symptoms of rotavirus infection are relieved as they are received. Temperature - antipyretic drugs, runny nose - vasoconstrictor drops. What drugs can be prescribed to a child with rotavirus infection, we will describe below.
Drugs
A child who has been struck by an acute intestinal infection will definitely need medications that will help relieve unpleasant symptoms and reduce the duration of the illness. These primarily include means for oral rehydration (to replenish the water-salt balance)... Such funds should always be at hand, as part of a home first aid kit. These are "Regidron", "Humana Electrolyte" and others. They are packaged in convenient sachets that can be easily diluted in warm water and given the mixture to drink the child.
Because rotavirus infection occurs suddenly, the medicine you need may not be in your medicine cabinet. There is nothing wrong with this, since the saline solution, which is best for feeding a child with vomiting and severe diarrhea, can be prepared on your own using simple ingredients that are available in any kitchen. By the way, such a recipe was approved by the WHO, and it can undoubtedly be used in practice. You will need a liter of warm water, two tablespoons of sugar, a spoonful of salt and a spoonful of soda. Everything mixes well and is given to the child to drink as often as possible.
Sorbent preparations are in second place in terms of importance for recovery. These include "Activated Coal", "Enterosgel", "Enterol", "Smecta". They will help to quickly remove decay products from the body and reduce intoxication. The use of antiviral drugs seems logical, because the disease is viral. However, in practice, things do not look so rosy.
The standards of care for rotavirus infection do not imply the prescription of antiviral drugs, since none of them show the slightest tolerable efficacy against rotavirus.
Of course, a doctor summoned to your home will most likely recommend Anaferon, Cycloferon or Kagocel. It's just that the pediatrician knows perfectly well that the viral infection will go away on its own, but anxious parents definitely need to "treat" their child with something, because if the doctor confines himself to recommendations to drink more fluids, mom and dad may think that he simply does not want or does not know how to treat their child ... Therefore, drugs are prescribed, many of which are generally homeopathic (Anaferon, for example). It means that such drugs will not cause any harm to the child's body. But, alas, they will not be useful either.
Antivirals are expensive, so it's worth weighing your family budget. The conscience of the parents can be completely calm - there is no need for such drugs. Their effectiveness has not been proven. Quite often, parents repeat monstrous mistakes when trying to prescribe medication to the child on their own.
Moms and dads, who know very well that antidiarrheal drugs help against diarrhea, may think that a dose of Enterofuril or Furazolidone will help the baby recover sooner. These drugs can only harm you with rotavirus infection. Fighting diarrhea as such is not worth it. It is necessary for virus particles to leave the body. He is a kind of defense mechanism.
Forcibly stopping diarrhea with rotavirus means retaining viral particles inside the intestine, thereby prolonging the period of illness. Some parents so diligently feed the child with antidiarrheal drugs that after such treatment the child suffers from constipation for a long time.
It is considered a gross mistake to prescribe antibiotics to a child during a rotavirus infection. Antibacterial agents do not have any effect on the virus, do not help relieve symptoms, do not alleviate the child's condition, and additionally aggressively affect the microflora of his intestines. Thus, the baby also acquires dysbiosis.
Sometimes parents may run into a doctor who advises taking antibiotics for rotavirus "just in case" to "avoid complications." It is better not to have any business with such doctors who seek not to provide assistance, but primarily to insure themselves. Antibiotics for rotavirus infection are prohibited! This is a rule that has no exceptions and is not negotiable.
Antipyretic drugs can be used, but you should avoid "Aspirin" and any drugs based on acetylsalicylic acid, it can cause a child's life-threatening Ray syndrome.
It is better to give preference to paracetamol-based drugs. They can be used rectally in suppositories, in tablets and syrups for small children.
At the recovery stage, vitamins and probiotics are often prescribed, which allow the intestines to be populated with normal beneficial microflora.
How to provide first aid to a child?
If vomiting and diarrhea are intense, in addition to drinking plenty of fluids, parents should remember to take precautions when providing first aid. As already mentioned, the child should be put to bed. If the son or daughter is small, you should put the child on its side so that during a sudden attack of vomiting, the baby does not choke on vomit. You can't feed the baby. The exception is babies who are breastfed. Breast milk is not prohibited.
Do not rush to dispose of the diaper with stool samples or the contents of the pot into the sewer, since it will be easier for a visiting doctor to diagnose if he sees and appreciates the nature, color and consistency of stool.
Nutrition
From the moment the symptoms of infection appear, it is better to abstain from meals at all. If the child asks very much, he can be given low-fat puree, porridge-spread. But only in very small quantities. A therapeutic diet implies a complete rejection of spicy foods, fatty foods, sweets, juices and dairy products. Citrus fruits (orange, lemon, tangerines), as well as carbonated drinks are prohibited.
As the vomiting subsides, you can gradually and carefully introduce foods into the child's diet. The best place to start is with low-fat vegetable broth and homemade croutons made from white bread. Then add porridge (without milk and butter), banana, vegetable purees. You can eat soups, steamed cutlets from lean meat or fish.
The recommendation to restrict the child's food does not mean that parents should start using therapeutic fasting. But on the first day, it is really better to abstain from food. When the baby feels better, he will certainly want to eat himself, and here the main thing is not to start feeding him according to his usual diet right away, otherwise a relapse cannot be avoided.
Prevention
Preventive measures to prevent rotavirus infection are taken at the state level. Water is chlorinated, in children's institutions they adhere to a certain sanitary regime. Washing hands and paying attention to the cleanliness of food, especially fruits and vegetables, as well as mother's advice not to drag toys and fingers in the street in the mouth are all non-specific preventive measures.
If your child is sick, do not contribute to the further spread of rotavirus. At high temperatures, the baby should be in bed. When the fever subsides, the patient can walk, the child can be bathed, but you should not visit playgrounds, places where other children walk and play, in order to exclude their infection with an aggressive and insidious rotavirus.
Vaccination is the only specific measure to protect the child. We will explain more about this vaccine below.
Rotavirus vaccine
The rotavirus vaccine exists, but most parents don't even know it. The fact is that in Russia it is not yet included in the National Calendar of Preventive Vaccinations. This vaccine is available at paid clinics and private health centers. It is recommended to do it when a trip to the sea is planned, especially to places where there is an unfavorable epidemiological situation for rotavirus infection.
Recently, the Ministry of Health has thought about expanding the calendar of vaccinations, which are mandatory. The rotavirus vaccine is planned to be made mandatory for all children soon. This vaccination is already approved as a universal childhood vaccination in many countries around the world. According to experts, the risk of getting sick in a vaccinated child is reduced by about 80%, and the number of deaths as a result of complications from a rotavirus infection is reduced by more than 40%.
It should be understood that vaccination against rotavirus infection does not so much reduce the incidence as it provides an easier course of the disease. By the way, after suffering an ailment to rotavirus, one's own immunity is also developed, but it is weak, it cannot be considered lifelong: after a few months it weakens, but does not completely disappear, and therefore each subsequent infection with a rotavirus infection will proceed more easily than the previous one.
There are two types of vaccines - Rotarix and RotTek. Both are drops, that is, the child will not have to endure a sore corner, the drug in liquid form is dripped into his mouth. The vaccines contain a live, real rotavirus, which has been artificially weakened in laboratory conditions. It is not capable of causing disease, but it is able to activate immune processes - specific antibodies to a certain type of rotavirus will begin to be produced.
You should not be afraid of allergies to this vaccine. An inadequate response of the body to vaccine components is extremely rare, such cases are rather isolated. Experts are confident that the benefits of vaccination will be especially great for a certain age group of children. It is recommended to vaccinate children from one and a half months to six months. Older children don't make much sense to get vaccinated because they are more likely to have rotavirus.
No special preparation for vaccination is required. The only prerequisite is the absence at the time of vaccination of diseases, malaise, and poor health. For such babies, the timing of vaccination can be postponed.
Experts emphasize that careful attention to the planning of children's recreation and timely vaccination will help reduce the incidence of rotavirus infection. So, Rospotrebnadzor regularly monitors the regions where outbreaks of the disease are observed and warns everyone who is going to these regions on business or on vacation.
In recent years, the largest number of outbreaks has been recorded in the resort areas of Bulgaria, Crimea, Sochi. A vacation at sea can be spoiled by unpleasant symptoms of rotavirus infection, which is transmitted with sea water in the midst of the holiday tourist season.
It is quite difficult to cure a child while on vacation with him. Therefore, experts recommend that a child of any age, especially babies up to one year old, be vaccinated about 2-3 weeks before departure.
What is rotavirus and what are its symptoms - Dr. Komarovsky will answer all questions in the next video.
