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  1. 1. Rotavirus Dr. B. K. Iyer
  2. 2. What is rotavirus? <ul><li>Rotavirus is the most important cause of severe life threatening gastroenteritis in children accounting for 20-70% of hospitalization of children worldwide. </li></ul><ul><li>Early diagnosis is essential for effective treatment and is a pre-requisite for the control of potential outbreak . </li></ul><ul><li>It is also known as viral gastroenteritis </li></ul>
  3. 3. Rotavirus and India <ul><li>In India, one of every 250 children or about 100-150, 000 children die of rotavirus diarrhoea each year. </li></ul><ul><li>The prevalence of rotavirus diarrhoea in India has been found to vary from 5-71 % in hospitalized children <5 yr of age with acute gastroenteritis. </li></ul><ul><li>The seasonal variation of rotavirus diarrhoea in India varies in different geographical regions with high incidence in winter months at low relative humidity in north India. </li></ul>
  4. 4. Rotavirus and India <ul><li>The distinctive features of rotavirus infection in India include the occurrence of severe disease at an early age and common neonatal rotavirus infections which are often asymptomatic. </li></ul><ul><li>The diversity of rotavirus strains and the high prevalence of mixed infections in India are unique features of rotavirus epidemiology in India and emphasizes that vaccines should be formulated against a broad range of strains including the G9 strains. </li></ul>
  5. 5. What are the signs and symptoms? <ul><li>Non-bloody diarrhea </li></ul><ul><li>Nausea </li></ul><ul><li>Vomiting </li></ul><ul><li>Dehydration in severe cases </li></ul><ul><li>Fever </li></ul><ul><li>Abdominal pain </li></ul>
  6. 6. Incubation and Contagious periods <ul><li>Incubation period: 2-4 days </li></ul><ul><li>Contagious period: Virus is present before diarrhea begins and can persist for up to three weeks after the illness </li></ul>
  7. 7. How is it spread? <ul><li>Fecal-oral route </li></ul><ul><ul><li>Organisms can be found on toys and hard surfaces </li></ul></ul><ul><li>Virus found in respiratory tract secretions and other body fluids </li></ul><ul><li>Most often passed along in families </li></ul>
  8. 8. How is rotavirus treated? <ul><li>No specific treatment because rotavirus is a self-limiting disease </li></ul><ul><ul><li>The body build up its own immunity to rotavirus </li></ul></ul><ul><li>Fluid intake should be increased to prevent dehydration </li></ul><ul><li>Then why must it be treated with vaccination???? </li></ul>
  9. 9. How is rotavirus controlled? <ul><li>Hand washing, especially after toileting or diapering and before contact with food or surfaces involved in preparations and serving food. </li></ul><ul><li>Surface sanitation that includes cleaning and rinsing of surfaces with detergent and water and then application of a 70% ethanol solution that is allowed to air-dry or sprayed on, freshly make 1:64 dilution of household bleach that completely wets the surface. </li></ul><ul><li>Vaccinations have been developed to help combat the virus. </li></ul>
  10. 10. Rotavirus Vaccines <ul><li>RotaTeq and Rotavarix are 2 currently available global vaccines against rotavirus </li></ul><ul><ul><li>Both are Oral vaccines </li></ul></ul><ul><ul><li>98% of children who receive the vaccine are protected from severe rotavirus, 74% of children never get it at all </li></ul></ul><ul><ul><li>Does not prevent diarrhea and vomiting due to other pathogens except by rotavirus </li></ul></ul><ul><li>Rotavirus vaccine is usually given at the same time as other childhood vaccines—if decided upon by the parent(s). </li></ul>
  11. 11. Rotateq & Rotavarix dosing <ul><li>Rotateq vaccine is given in 3 doses but all 3 doses should be given by 32 weeks of age </li></ul><ul><ul><li>1 st dose: 2 months </li></ul></ul><ul><ul><li>2 nd dose: 4 months </li></ul></ul><ul><ul><li>3 rd dose: 6 months </li></ul></ul><ul><li>Rotarix is given as a two-dose series that can be started when an infant is as young as 6 weeks old. </li></ul><ul><li>The second dose can be given as early as four weeks later and must be given before the baby is 24 weeks old. </li></ul>
  12. 12. Caregiver/Teacher & Family-roles <ul><li>Reeducate staff and family to ensure strict and frequent hand washing, diapering, toileting, food handling, and sanitation procedures. </li></ul>