[Rotavirus infections]

Abstract

Rotaviruses are genetically highly variable, non-enveloped viruses with a double-stranded, segmented ribonucleic acid genome. They are a major cause of gastroenteritis worldwide. In children aged less than 5 years, they are the most frequent agent of severe acute diarrheal illnesses. In less developed countries, rotavirus diseases are one of the most frequent causes of death in infants and little children. Typically, symptomatic rotavirus diseases in infants (<5 years) and the elderly (>70 years) arise with sudden onset of watery diarrhoea with high risk of dehydration, accompanied by vomiting and, in several cases, unspecific respiratory symptoms such as cold and sore throat. In adults aged less than 70 years, illnesses due to rotavirus appear generally mild or as travel diarrhoea. Although rotavirus infections are considered to by systemic, extraintestinal manifestations such as rotavirus central nervous system diseases are relatively rare. Rotaviruses are transmitted primarily from person-to-person by the faecal-oral route. Treatment of rotavirus diarrhoea is usually symptomatic and comprises a sufficient fluid and electrolyte substitution. Although nitazoxanide and some other drugs show high efficacy against rotavirus in vitro and in vivo, there is currently no recommended specific antiviral therapy. For prophylaxis, special attention should be paid to adequate hygienic rules. Because of the high stability of rotaviruses to changing environmental conditions, disinfection should be performed applying disinfectants with proven activity against rotaviruses. In Germany, two efficient and secure live vaccines against rotaviruses have been approved. Their application, however, is not generally recommended.