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Viral gastroenteritis caused by Rotavirus — Clinical Guidelines

Overview

Rotavirus gastroenteritis primarily affects infants and young children under five years old, causing significant morbidity and mortality, particularly in developing countries. Despite vaccination efforts, it remains a global health concern, leading to approximately 200,000 child deaths annually worldwide 1.

Diagnosis

Clinical presentation includes severe diarrhea, vomiting, fever, and dehydration 1 2.

Stool samples can confirm rotavirus infection through antigen detection or RT-PCR 1.

Laboratory tests may reveal electrolyte imbalances and signs of systemic infection 2.

Management

First-line treatment: Oral rehydration therapy (ORT) to prevent and treat dehydration 4.

Adjunctive treatments: Intravenous fluids for severe dehydration 2.

Monitoring: Close observation for complications such as disseminated intravascular coagulation (DIC) in severe cases 5.

Special Populations

Pediatrics: Primary target group; vaccination is highly recommended 1 3.

Adults: Rare but can present critically with multi-organ failure requiring intensive care management 2.

Comorbidities: No specific guidance provided; management focuses on supportive care and addressing complications 2 5.

Key Recommendations

Administer rotavirus vaccines (RotaTeq or Rotarix) according to the recommended schedule (2, 4, and 6 months for RV5; 2 and 4 months for RV1) to prevent severe gastroenteritis 3 (Evidence: Strong).

Prioritize oral rehydration therapy for treatment of dehydration in rotavirus gastroenteritis 4 (Evidence: Strong).

Vigilantly monitor and manage severe cases in adults and children for potential complications like DIC and multi-organ failure 2 5 (Evidence: Moderate).

References

1 Sharma AD, Magdaleno JSL, Singh H, Orduz AFC, Cavallo L, Chawla M. Immunoinformatics-driven design of a multi-epitope vaccine targeting neonatal rotavirus with focus on outer capsid proteins VP4 and VP7 and non structural proteins NSP2 and NSP5. Scientific reports 2025. link 2 Edwards N, Abasszade JH, Nan K, Abrahams T, La PBD, Tinson AJ. Severe Adult Rotavirus Gastroenteritis: A Rare Case with Multi-Organ Failure and Critical Management. The American journal of case reports 2023. link 3 Hibbs BF, Miller ER, Shimabukuro T. Notes from the field: rotavirus vaccine administration errors--United States, 2006-2013. MMWR. Morbidity and mortality weekly report 2014. link 4 Madden V. An end to rotavirus misery. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2006. link 5 Limbos MA, Lieberman JM. Disseminated intravascular coagulation associated with rotavirus gastroenteritis: report of two cases. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 1996. link

Viral gastroenteritis caused by Rotavirus