Rotavirus is the principal cause of severe life threatening diarrhea in children worldwide. It accounts for 20-70% of hospitalizations in children. In India, incidence of Rotavirus diarrhea varies from 5% to 70%. Similar incidence of disease in developing as well as developed countries suggests that the disease cannot be controlled by merely improving water quality, sanitation or hygiene.
The virus is transmitted by the fecal-oral route and a small infectious dose facilitates spread from person to person via direct contact or possibly via airborne droplets. Amount of virus required to cause infection is very small. During the episode of Rota virus diarrhea large concentration of virus is excreted through stool. Both these factors contribute to the highly contagious nature of disease.
Rota virus symptoms can occur after an incubation period of 24 to 48 hours. Symptoms range from vomiting and mild watery diarrhea of short duration to severe gastroenteritis with life threatening dehydration secondary to gastrointestinal fluid loss. Severe dehydration can lead to death if not adequately managed. Vomiting appears first followed by diarrhea and dehydration along with fever and abdominal pain. Both vomiting and fever may last for up to 9 days while diarrhea usually persists for 21 days depending upon the immunity and nutritional status of the child.
The primary burden of Rota virus is on child’s health (morbidity & mortality), which also translates into a significant economic impact which can be direct and indirect. Direct costs include medical costs resulting from hospitalizations, out patient visits, diagnostics and medication. Indirect costs include those incurred to the society and households as a result of lost work and time when parents are forced to stay home to care for their sick children. Intangible costs such as pain and suffering resulting from Rota virus disease should not be forgotten.
As a result of this heavy burden of Rota virus infection WHO strongly supports vaccination for Rota virus and the good news is that a safe vaccine has been successfully developed. To add to the relief this is an oral vaccine which means no injections are required. The recommended age for the vaccine is from one and half month of age to six months of age. Two doses are given at an interval of four weeks and it can be given along with other vaccines such as polio,DPT and pneumococcal.