2. • RV is a naked double-strand RNA (dsRNA) virus. It has
shorter (<3 days) incubation period and transmitted via
person to person by the fecal–oral route or contaminated
infected surfaces. This virus is highly resistant at room
temperature and can survive for months.
• RV primarily infects enterocytes, which results severe
diarrhea in children. It infects the villi of small intestinal
epithelial cells, where it can replicate to cause clinical sign
and symptoms of the disease
• The mucosal tissues in the gastrointestinal tract is
considering as a main portal entry of RV, which cause
severe acute intestinal infection in children’s and livestock
animals.
• The main symptoms of RVs gastroenteritis are nausea,
low-grade fever, vomit, and acute watery
diarrhea. However, it can spread systematically to cause
viremia and infect multiple organs.
3. • Rotavirus is recognized as the single most important agent for causing diarrhea
in infants which occur worldwide. Most symptomatic infections occur in
children between 3 months and 2 years of age.
• In temperate countries, rotavirus infections show winter seasonality, whereas
infections occur year-round in most tropical countries. Rotavirus spreads via
the fecal–oral route, primarily through person-to-person transmission. Only
a few virus particles are required to infect the susceptible host
• Initially virus infects enterocytes that induce diarrhea due to the destruction of
absorptive enterocytes and it stimulates intestinal secretion by rotavirus non-
structural protein 4 for activation of the enteric nervous system.
• The severe infection of rotavirus can lead to acute gastroenteritis and
viraemia. Also, rotavirus able to replicate in systemic sites, but it is limited.
Reinfection of rotavirus is common throughout life, but the severity of
disease decreased with repeated infections .
• Rotavirus infection has broad spectrum of targets apart from the intestine
such as nervous system, liver, pancreas and etc., In addition, it triggers the
development of autoimmune diseases like celiac disease and type-1-diabetes
(T1D).
4. • Better understanding on mechanism of
interactions between virus, host, and
microbiota could provide new approach for
vaccine development.
• Although vaccines have proven effective in
decreasing the strength of RV-induced
diarrhea, researchers are searching
continuously for alternative ways to prevent
this disease.
• Probiotics have the capacity to prevent and
improve health conditions against rotavirus
5. Treatment of rotavirus infection
• Treatment of RV diarrhea mainly depends on supply of oral rehydration
solutions for the replacement of fluid loss. However, this strategy is not
effective to reduce the severity and shorten the duration of the disease .
There is no specific medicine for the treatment of rotavirus infections.
Administration of a variety of liquids, non-specific anti-viral medicines as
well as nursing to relieve symptoms are commonly used as clinical
treatments for rotavirus infections
• To prevent the RV infection, vaccines are available but they are not
globally implemented due to the high cost and requirements of cold
storage. RV vaccines offer low protection in developing countries as a
consequence of malnutrition, micronutrient deficiencies, and
suboptimal breastfeeding .
• Two rotavirus vaccines viz. RotaTeq (Merck, USA), and Rotarix
(GlaxoSmithKline, Belgium) are being used worldwide to reduce the
number of outbreaks in many countries and were proven safe. Both
vaccines are are highly (>90%) effective in preventing severe rotavirus
disease in high-income countries but efficacy is reduced in low-income
countries to ≈50% to 60%
6. Efficacy of probiotics
• Probiotics are regarded as alternatives for treatment of infectious diseases,
including gastroenteritis caused by rotavirus infections .
• Application of probiotics, alone or combined with other treatment procedures has
attracted attention to food microbiologysts and pediatricians.
• Commonly used probiotics for the treatment of rotavirus infections in infants and
young children include, L. lactis, L. Paracasei, L. Rhamnosus, B. longum, B.
infantis and Enterococcus faecalis.
• The efficacy of a commercially available probiotic product containing two
probiotic cell types, such as Bifidobacterium longum BORI and Lactobacillus
acidophilus AD031, was tested in infants and/or toddlers with rotavirus-associated
symptoms.
• The results showed that a probiotic formula containing B. longum BORI and L.
acidophilus AD031 could reduce the duration of rotavirus diarrhea in young
Korean children
7. • Some of the probiotics from Bifidobacterium and Lactobacillus species
along with prebiotics (inulin, GOS, FOS) showed improved antiviral
response and increased levels of specific anti-rotavirus IgAs.
• Moreover, these probiotics and prebiotics are useful for the prevention
of RV infection and reduced incidence of reinfections.
• In 2020, Ignasi Azagra-Boronat et al., reported beneficial effects of
probiotic (Lactobacilli and Bifidobacteria) supplementation with different
strains in infectious diarrhea caused by rotavirus (RV) in young
children.
• Preclinical models of RV infection were adopted as a good strategy to
screen for the efficacy of new probiotic strains or to test their comparative
efficacy.
• Neonatal Lewis rats were supplemented with B. breve M-16V, L.
acidophilus NCFM, L. helveticus R0052, or L. salivarius PS2 from days
2–14 of life.
• All probiotics viz. L. acidophilus NCFM, B. breve M-16V, and L.
helveticus R0052 caused a reduction of several clinical variables of
severity and incidence of diarrhea except L. salivarius PS2
8. • Probiotics such as Lactobacillus and Bifidobacterium species, and
Saccharomyces boulardii have been associated with the prevention of
RV infection, to shorter duration and severity of RV diarrhea, to reduced
incidence of reinfections and to the modulation of the immune response
and viral shedding .
• Moreover, Lactobacillus and Bifidobacterium species have been
associated to the stimulation of production of cytokines resulting in
improved intestinal barrier function, and increased regulatory immune
responses.
• Lactobacilli and bifidobacteria provide significant health benefits to
host by improving feed conversion and growth performance,
modulating immune responses ultimately protecting the host from
pathogens including RV.
• The strongest evidence of Lactobacilli/Bifidobacteria mediated
protection against RV diarrhea and infection was observed in pediatric
patients by human clinical trials
9. Conclusion
• Due to the potential benefits in enhancing gut barrier functions
and innate immunity of recipients, as well as being generally
regarded as safe, probiotics were recommended as effective
alternatives to prevent or treat childhood rotavirus infections.
• Although multiple probiotic microorganisms could be utilized
in rotavirus treatments, some studies have not identified any
significant therapeutic effects.
• The beneficial activity of probiotics and prebiotics are
associated with the healthy intestinal microbiota balance,
intestinal epithelial barrier and the interactions with viral
particles to prevent RV cell entry.
• More evidence is needed to support the beneficial effects and
the mechanisms of prebiotics and probiotics against RV
gastroenteritis
