Rotavirus overview

Abstract

Rotaviral gastroenteritis is a serious public health problem in both developed and developing countries. The disease is ubiquitous, affecting nearly all children by the age of 5 years. It is the most common cause of hospitalizations for gastroenteritis among children in the United States (30%-70% depending on the season) and is associated with direct and indirect costs of approximately $1 billion per year. Symptoms of rotaviral gastroenteritis are nonspecific (ie, diarrhea, vomiting, and fever), with disease severity varying considerably. Diagnostic confirmation of rotaviral gastroenteritis requires laboratory tests (most commonly enzyme immunoassay or latex agglutination); however, because specific diagnosis is costly and does not affect treatment, laboratory tests are generally not performed. Because no antiviral therapies are currently available, treatment of rotavirus infection is supportive and primarily aimed at the replacement of fluid and electrolyte losses. Based on the observations that improved sanitation does not decrease disease prevalence and that hospitalizations remain high despite the availability and use of oral rehydrating solutions, the primary public health intervention for rotavirus infection is vaccination. Current vaccines (ie, RotaTeq, Merck and Company; Rotarix, GlaxoSmithKline) are effective for reducing rotaviral gastroenteritis (particularly severe disease), emergency department visits, and hospitalizations. Rotavirus vaccination is now included as part of the routine vaccination schedule for all infants in the United States.