Rotavirus gastroenteritis Dr Rob Hicks Diarrhoea and vomiting are among the symptoms in children under five.

In this article

What is rotavirus gastroenteritis? Symptoms

Causes and risk factors Treatment and recovery

This viral infection is the most common cause of diarrhoea in children under the age of five.

Rotavirus causes diarrhoea, vomiting, abdominal pain, fever and dehydration.

Some children have only a few mild symptoms, while others are affected more severely.

Diarrhoea can occur up to 20 times a day and for many days on end. Not only is this unpleasant for the child, but also for parents faced with the distressed child, along with continued changing and cleaning of the child’s clothes.

As a consequence of the diarrhoea, skin problems often arise around the nappy area.

Dehydration is the major concern with rotavirus infection, as liquid is lost from the body through diarrhoea and vomiting, and may not be easily replaced.

Signs of dehydration in children include:

• Dry mouth.
• Fewer wet nappies or, in older children, not passing water for six to eight hours.
• Irritable behaviour.
• Few or no tears when crying.
• Sunken or flatter than usual fontanelles (the soft spots on top of a baby's head).
• Dry and wrinkled skin.
• Being less alert and active than usual.
• Appearing weak.
• Fast pulse and breathing

Around one in 38 children under the age of five needs hospital treatment for rotavirus gastroenteritis.

Each year in the UK, around 14 children under five die as a result of rotavirus.

Elsewhere in the world, especially in developing countries where poverty and malnourishment are additional factors, rotavirus gastroenteritis may be responsible for as many as half a million child deaths every year.

Rotavirus gastroenteritis is caused by a virus, called rotavirus, which multiplies in the gut of those with the infection. Gastroenteritis is the medical term for an illness causing diarrhoea and/or vomiting.

Rotavirus is spread through airborne liquid droplets. It can survive for weeks in water and for up to four hours on human skin. It can also survive on surfaces, toys and clothing.

The virus passes into the body through the mouth and nose when liquid droplets are breathed in or when fingers contaminated with the virus enter the mouth.

Rotavirus is highly contagious and most children have had the infection by the time they reach five years old. Children under the age of two are most likely to catch the infection.

The number of rotavirus infections peaks during winter and spring

The number of rotavirus infections peaks during winter and spring.

Immunity develops after the initial infection, so future infections tend to be less severe. Immunity lasts a long time, which means adults tend not to be affected so badly, if at all.

There's no specific treatment for rotavirus gastroenteritis.

Ensuring the child takes in enough liquid is essential. Rehydration treatments can be obtained from the pharmacist.

If someone with the infection wants to eat, soups, bread, potatoes and pasta are usually better tolerated. Breastfed and bottle-fed babies and children can continue to be fed as normal.

Paracetamol or ibuprofen suitable for the child's age can be given to treat fever. Anti-diarrhoea medicines shouldn't be given to children or babies.

Some children need hospital treatment for dehydration with intravenous fluids.

Good hygiene is essential to prevent the virus being spread. This includes:

• Washing hands after using the toilet, handling soiled clothing and linen, changing nappies and cleaning up afterwards.
• Ensuring good hygiene before preparing and eating food.
• Avoiding sharing eating or drinking utensils, towels or face cloths.
• Cleaning toilet flush handles and seats, and door handles.
• Keeping soiled items away from the rest of the household washing, and using as hot a wash as possible for soiled clothing and linen.

Effective vaccines to protect against rotavirus gastroenteritis are available but aren't yet included in the national childhood immunisation scheme in the UK.

Children with rotavirus gastroenteritis should be kept away from other children until 48 hours after the symptoms have resolved, as the virus can still be spread during this time.

This article was last medically reviewed by Dr Trisha Macnair in August 2009.