Rotavirus is a major cause of diarrhea in infants and young children worldwide. It spreads easily between people through the fecal-oral route. Diagnosis is made through enzyme immunoassays detecting the virus in stool samples. Treatment focuses on fluid replacement through oral rehydration therapy. Two oral rotavirus vaccines provide protection against the most common strains causing infection. Development of an indigenous rotavirus vaccine called Rotavac could help reduce the 100,000 annual child deaths from rotavirus in India.

1. SAURABH WANI
PGDPM 10
GARWARE COLLEGE
ROTAVIRUS

2. INTRODUCTION
Rotaviruses are the major cause of diarrheal illness in
human infants in the world
Adults also get infected because of rotavirus
Young animals like calves and piglets are also
infected
Rotavirus infection spread easily and outbreaks
usually occur in the winter and early spring between
about November and April
Rotavirus infections often spread in settings where
many children's are together, such as daycare
centers

3. “TRANSMISSION
ROTAVIRUS”
OF
Primary mode of rotavirus transmission is fecal to oral
Highly communicable and transmissible disease
Close person to person contact and environmental
surfaces are common vectors of transmission
Incubation period is 1-3 days
Large quantities of virus are shed in stool from just prior
to onset of symptoms until about 10 days after onset
Amount of virus shed in stool [10-100 billion virion/gram
of stool]infection
Amount of ingested virus required to cause infection as
few as 10 infective virions

4. ROTAVIRUS
• First recognized in
1973, rotavirus belongs
to viral family
Reoviridae
• Rotavirus has
characteristic wheel
like appearance when
viewed under electron
microscope
• Rotavirus is triple
layered capsule

5. • The Rotavirus genome consist of 11 double stranded
RNA segments each encoding one viral proteins
• Scientist have describe seven Rotavirus group [A to
G]
• Only groups A, B AND C infect humans
• Group A which has multiple strains cause majority of
childhood infections
• Vaccine candidates are designed to protect against
group A Rotaviruses
• The G type and P type define the serotype
• They are critical to a vaccine development because
they are the vaccine for stimulating a protective
immune response

6. “ SEROTYPES”
Serotypes are described as variations within species of
bacteria or viruses or among immune cells of different
individuals
G1P[8] is the most common serotype worldwide and
accounts for over two thirds of rotavirus infections
worldwide
Infections with G1,G2,G3,G4 AND G9 together
comprise almost 95% of rotavirus serotype observed
Because the two gene segments that encode these
protein can segregate independently, A typing system
which consist of both G and P type is used i.e.
G1P[8],G2P[4],G3P[8],G4P[8],G9P[8] and G9P[6]

7. STEPS IN VIRAL REPLICATION
1. Receptor mediated
endocytosis leading to
formation of endosome
2. Viral RNA dependent RNA
polymerase creates m RNA
transcript of double stranded
viral genome
3. Viral genome is in the core of
two layered protein shell called
as double layered particle

8. VIRAL REPLICATION
4.
Third layer is disrupted
5. By remaining in the core, the viral RNA evades innate host immune
responses called RNA interference that are triggered by the presence of
double-stranded RNA
6. Viroplasm is formed around the cell nucleus as early as two hours
after virus infection, and consists of viral factories thought to be made by two
viral nonstructural proteins: NSP5 and NSP2

9. 7. In this viroplasm RNA is replicated and the DLPs are assembled
8. The DLPs migrate to the endoplasmic reticulum where they obtain their
third, outer layer
9. Progeny viruses are released from the cell by lysis

10. WHY ROTAVIRUS INFECTION CAUSES DIARRHEA
Infection of villus epithelial cells causes cell destruction, decreased
absorption of salt and water and decreased dissachridase activity leading
to osmotic load in the gut lumen
 The osmotic load in the gut and increased fluid secretion leads to
diarrhea and without fluid replacement it will ultimately lead to
dehydration and acidosis
 Rotavirus induced gastroenteritis in children with immunodeficiency may
cause persistent infections lasting weeks or months

11. DIAGNOSIS OF ROTAVIRUS INFECTION
Diagnosis of infection with Rotavirus follows diagnosis of gastroenteritis of
severe diarrhea
Most children's are admitted to hospital with gastroenteritis are tested for
Rotavirus A
Specific diagnosis of infection with rotavirus A is made by finding the virus in
child’s stool by enzyme immunoassay
Children with immunodeficiency disorders may be treated with specific
rotavirus immunoglobulin preparation

12. DIAGNOSIS OF ROTAVIRUS
Laboratory diagnosis
Electron microscopy is used in the detection of
Virus in the stools which helps in early detection
Of disease
OTHER DIAGNOSIS METHOD INCLUDE
• ELISA
RAPID ANTIGEN DETECTION BY ELISA OF
ROTAVIRUS IN STOOL SAMPLES
• GENOTYPING

13. TREATMENT FOR ROTAVIRUS DIARRHEA
Therapy for rotavirus induced diarrhea involves replacement of fluid and
electrolyte loss during infection
ORAL REHYDRATION THERAPY is recommended in children with mild
or moderate dehydration
Fruit juices and soft drinks are not recommended due to there high
glucose content low sodium content and high osmolarity
 Antibiotics, antisecretory drugs, antimotility drugs, absorbents and
antiemetic’s
Do not clear acute infection but it prevents reinfection and reduce fluid
losses during rotavirus induced gastroenteritis and hence do not play role
in treatment

14. INFECTION CONTROL
Home and daycare facilities
1.HAND WASHING AREAS
2.Food preparation areas
3.Diaper changing surfaces
4.Diaper disposable containers
5.Toys
Hospital areas and clinics
1.HAND WASHING AREAS
2.Medication preparation areas
3.Equipment
4.Patient care areas

15. Rotavirus vaccine - Two oral,live,attenuated rotavirus
vaccines

17. INDIA UNVEILS FIRST INDIGENOUS ROTAVIRUS
VACCINE
Rotavirus responsible for approximately 4,53,000 child deaths due to
diarrhea globally each year
The Phase-III clinical trial of low cost Indian-made rotavirus vaccine
Rotavac has demonstrated strong efficacy and excellent safety
profile and if approved by the Drugs Controller General of India, it
would be available at Rs. 54 per dose.
Clinical study has demonstrated for the first time that Rotavac is
efficacious in preventing severe rotavirus diarrhea in low-resource
settings in India, and developing countries in Asia and Africa. Strain
diversity, too, has not apparently affected its efficacy.

18. Rotavirus is responsible for approximately 4,53,000 child deaths due to
diarrhea globally each year. It is particularly threatening in India where —
according to a recent study — around 1,00,000 children die each year
from severe diarrhea and dehydration caused by rotavirus.
India accounts for 22 per cent of the estimated global deaths from
diarrhea-causing rotavirus.
Rotavac is an oral vaccine and is administered to infants in a three-dose
course at the ages of 6, 10 and 14 weeks.
It is given alongside routine immunizations' in the Universal Immunization
Programed (UIP) vaccines recommended at these ages.

19. The randomized, double-blind, placebo-controlled phase-III clinical
trial enrolled 6,799 infants in India (aged six to seven weeks at the time
of enrolment) at three sites — the Centre for Health Research and
Development, Society for Applied Sciences, in New Delhi; Shirdi Sai
Baba Rural Hospital, KEM Hospital Research Centre in Vadu; and
Christian Medical College in Vellore.
Infants received Rotavac and the UIP vaccines, including the oral polio
vaccine (OPV).
Result showed that infants receiving OPV at the same time as Rotavac
generated comparable immune responses to all three polio serotypes
as the infants receiving OPV without Rotavac, supporting the
concurrent administration of OPV and Rotavac.

20. VACCINATING KIDS AGAINST ROTAVIRUS MAY
REDUCE RISK OF SEIZURES
The researchers found that children who were fully vaccinated
against rotavirus had an approximately 20 percent reduced risk of
seizure-related hospitalizations and emergency department visits
during the year following vaccination, compared to unvaccinated
children
Latest study estimated that rotavirus vaccination could potentially
save more than $7 million in U.S. health care costs each year by
preventing approximately 1,000 hospitalizations and 5,000 emergency
room visits for seizures among young children. "Caring for children
who have seizures can be expensive and emotionally taxing for
families," Dr. Payne said. "Seizures sometimes lead to painful
procedures, medication regimens, trips to the emergency room, or

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