What is rotavirus gastroenteritis - symptoms, treatment and reviews

Description of the disease

Gastroenteritis is the process of inflammation that is provoked by infectious agents - bacteria, viruses, protozoan microorganisms.
The reaction develops in the organs of the digestive system, affecting the small intestine and stomach. Gastroenteritis is an independent nosological form, less often perceived as a subtype of gastroenterocolitis.

Pathology in children usually develops in an acute form, leading to dehydration, which threatens not only the health, but also the life of the baby. The disease can be caused by viruses, bacteria, and some allergenic substances. In accordance with this, viral, bacterial, acute, nutritional or chronic lesions of the gastrointestinal tract (gastrointestinal tract) are distinguished.

More often the origin of the disease is infectious. Symptoms appear almost immediately after infection, but sometimes the incubation period can last up to 5 days.

The pathology is common among preschoolers. This can be explained by poor adherence to personal hygiene rules, since there are many ways of infection.

These include:

• food;
• water;
• contact.

Signs of damage develop unexpectedly and appear acutely. Parents should not panic, the main thing is to understand what is happening and call a doctor to select treatment tactics.

Types and pathogens

In medical practice, it is customary to distinguish several types of disease.

Classification for reasons divides gastroenteritis into the following types:

• toxic - develops under the influence of toxins of animal or plant origin;
• allergic - occurs due to the ingestion of certain chemical compounds, drugs or products into the gastrointestinal tract;
• nutritional - the source of infection is an unbalanced diet, when a person eats too much spicy food and constantly overeats;
• bacterial - develops when infected with pathogenic bacteria;
• viral - occurs under the influence of rotavirus, norovirus infection.

Diagnosis of rotavirus infection

Rotavirus infection: causes, symptoms, treatment of rotavirus in a child
When the first symptoms of rotavirus gastroenteritis appear, it is not possible to diagnose the disease only by symptoms, since it is differentiated from several pathologies. First of all, the doctor conducts a survey to identify the patient’s contact with the source of infection and track the method of infection. In addition, the survey allows you to determine how long the virus has been present in the body.

Stool tests are performed to diagnose the disease.

In the future, instrumental and laboratory diagnostic methods are used to make an accurate diagnosis:

• electron microscopy of stool to detect antigens to the causative agent of the disease (in some cases, fluorescence microscopy is used);
• polymerase chain reaction analysis for the presence of viral genetic material in the stool;
• serological blood test to detect specific proteins (antibodies) to certain types of viruses.

Additionally, during laboratory studies, the presence of undigested fiber, neutral fats, and starch grains in the stool is assessed, and the concentration of bifidobacteria is measured. All this allows us to assess how large-scale changes have occurred in the small intestine, and whether inflammation has spread to other parts of the digestive system (for example, to the large intestine).

Blood tests are necessary to make an accurate diagnosis

Only after confirming the diagnosis, the doctor prescribes treatment that corresponds to the current condition of the patient and the degree of changes that have occurred in the body.

Reviews

Dear readers, your opinion is very important to us - therefore, we will be glad to hear your feedback about rotavirus enteritis in the comments, it will also be useful to other users of the site.

Irina:

My four-year-old daughter began to constantly complain that her stomach hurt and she felt sick. I noticed that the child’s appetite became worse and she began to often ask to go to the toilet in a big way. The next day we went to the doctor; after examination and examination, the pediatrician diagnosed rotavirus enteritis. He explained that the child apparently put his dirty hands in his mouth or ate something unwashed. They were cured after 5 days.

Christina:

The teacher called from the kindergarten and said that in half a day my child had already gone to the toilet more than 3 times with diarrhea. They told me to see a doctor, as most likely the child had some kind of intestinal infection. I took time off from work and took the child home. We didn’t see a doctor right away because our pediatrician had been working since the morning. By evening, the child already had a fever, she refused to eat, and almost forced her to drink water. The next day, a rotavirus infection was diagnosed. We were treated for about a week and everything went away.

Rotavirus gastroenteritis in children and adults

Norovirus infection

Rotavirus gastroenteritis is an acute viral disease that negatively affects the functioning of the gastrointestinal tract and digestion. Treatment is complex and includes taking medications and following a diet regimen. Provided that therapeutic measures are started in a timely manner, complications can be avoided.

Rotavirus and enterovirus are two diseases with very similar symptoms. As a rule, they manifest themselves with the same symptoms and often act as complications of other ailments. But in addition to similarities, they also have differences.

For example, rotavirus differs from enterovirus in the nature of the clinical picture.

If rotavirus begins acutely and then declines, then enterovirus, on the contrary, begins unnoticed, and over time begins to progress more and more.

Rotavirus infection (or, as it is commonly called, “lesser cholera”) has another name - intestinal flu. Today it is one of the most common gastroenterological diseases of an infectious nature. It should be noted that in addition to serious complications, an advanced form of the disease can lead to death.

Isolated cases of this disease are quite rare. Mainly foci of infection occur:

1. in family.
2. At work.
3. in kindergartens.
4. in schools and other crowded places.

Rotavirus can be considered in terms of two types of pathological processes at once:

• infectious diseases;
• gastroenterological diseases.

Classification

Rotavirus infection can be classified according to several clinical and etiological characteristics.

The type can be:

Typical forms include:

1. gastritis.
2. enteritis.
3. gastroenteritis.

An atypical form, according to the nature of the clinical picture, can be:

Based on severity, the following forms are considered:

1. light.
2. moderate severity.
3. heavy.

According to the nature of the pathological process, it can be of the following type:

• spicy;
• protracted;
• with possible complications.

Symptoms

The incubation period of this disease lasts no more than 4 days. The onset of rotavirus gastroenteritis is characterized by a pronounced clinical picture. After 3-4 days, the symptoms subside, and the patient’s well-being improves.

The initial stage of the clinical picture is characterized by the following symptoms:

1. frequent and loose stools.
2. bloating.
3. increased flatulence.
4. nausea.
5. vomit.
6. belching.
7. heartburn.

In mild forms of the disease, the following symptoms appear:

• no vomiting;
• bowel movements do not exceed 6 times a day;
• general intoxication of the body is mild or completely absent;
• no elevated body temperature is observed.

With moderate severity of the pathological process, the following signs are noted:

1. The frequency of stools can reach up to 10 times a day.
2. on the first day, vomiting attacks reach up to 7 times a day.
3. general intoxication of the body is present, but not in an acute form.
4. elevated temperature is present, but does not exceed 37.5 degrees.

It should be noted that in some cases the general clinical picture may be supplemented by the following specific signs:

• labored breathing;
• dyspnea;
• unstable heartbeat;
• weak pulse;
• headache;
• dizziness;
• fast fatiguability;
• increasing weakness.

Rotavirus gastroenteritis is especially dangerous for people with HIV infection, since the human immune system is too weak to resist pathogenic organisms.

Possible complications

Possible complications include:

1. acute renal failure.
2. problems with the cardiovascular system.
3. disruption of the gastrointestinal tract.
4. gastroenterological diseases in chronic form.
5. dysbiosis.
6. metabolic problems.

Complications are only possible if you do not consult a doctor promptly and undergo treatment.

Forecast

For patients with mild to moderate disease, the prognosis is favorable. A fatal outcome cannot be excluded, however, only in the most extreme cases. Therefore, at the first signs of a clinical picture, you need to seek medical help and not self-medicate.

Forecasts

The prognosis for the disease is favorable. Serious complications occur only in the absence of seeking help from a doctor, prolonged self-treatment, or problems with the immune system. Mild and moderate severity of the disease occurs without complications; in the presence of acute rotavirus gastroenteritis, death cannot be ruled out. It is important to consult a doctor at the first manifestations of the disease without self-medicating, then complications and harm to health will not occur!

It is important to monitor your health, carefully observe the rules of personal hygiene, and wash your hands when you come home. When visiting crowded places, avoid eating unsafe foods and touch your face and mouth less often. It is important not to transfer possible accumulation of infection and viruses on your hands to your mouth and prevent them from entering the body.

High immunity and excellent physical condition should be ensured to facilitate recovery and the impossibility of infection in the presence of a pathogenic component. A strong body is able to independently suppress the development of a pathological process in the body, without the use of additional aids and medications. It is important to exercise regularly, follow a daily routine and the basics of a balanced diet. It’s a good idea to give up junk food, fatty, salty, spicy foods, and give preference to light types of meat and fish, vegetables and cereals. If you follow a balanced diet, it will be easier for the digestive organs to work, and the risk of damage to the mucous membranes and the development of all kinds of problems with digestion and elimination of excess will be reduced.

The coordinated work of the digestive tract organs will prevent the development and reproduction of viruses and infections inside the body, eliminating them in a timely manner, suppressing their reproduction and negative impact on health. If infection does occur, you should not try to cure yourself. It is better to seek help from a doctor in time, identify the cause and route of infection and get rid of the problem as soon as possible. This way the body is less exposed to stress and negative environmental influences and will recover faster.

Treatment for children

Rotovirus infection during pregnancy

Viral gastroenteritis in children most often occurs between the ages of three months and three years.

With proper therapy, all symptoms of the disease disappear within three days. In case of repeated infections in children, the disease will take a milder form.

During treatment, it is necessary to determine the type of viral pathogen, however, in this case, there is a possibility of delaying the necessary treatment due to the length of the incubation period. Since any intestinal infection poses a serious danger to the child’s body due to the threat of dehydration, doctors usually begin treatment without delay. For this purpose, broad-spectrum antibiotics are used against a large number of types of viruses and bacteria and antimicrobial drugs.

Dehydration is eliminated using parenteral or oral administration of solutions containing glucose and mineral compounds necessary for the body. Using this method, the disturbed water-salt balance is restored and the amount of fluid necessary for the body is replenished.

To bring the urinary system back to normal, it is recommended to take diuretics. In this case, with each excretion of urine, a certain amount of pathogenic microorganisms and their metabolic products will be removed from the child’s body. To prevent dysbiosis, the child is prescribed the use of probiotics containing bifidobacteria and lactobacilli. Taking probiotics will also be beneficial, creating a favorable environment for the vital activity of beneficial bacteria living in the intestines.

The duration of therapy in a child depends on the stage of inflammation and the type of virus. When treating any type of gastroenteritis, the following drugs are used:

• Antiemetics to prevent nausea;
• Enterosorbents and adsorbents for removing toxins from the body;
• Enzymes to facilitate the digestion of food;
• Antispasmodics to eliminate painful symptoms;
• Antacids for heartburn and sour belching;
• Nonsteroidal anti-inflammatory drugs in case of fever;
• Antihistamines at risk of developing allergies.

The viral form of gastroenteritis, even in its initial stage, disrupts metabolic processes in the child’s body. In this regard, children always experience an acute lack of biologically active and nutrients. In this case, a course of treatment with vitamin preparations and microelements can help, and immunomodulators and immunostimulants can restore the defenses of the child’s body and increase immunity.

Prevention

It is impossible to completely limit a child from the virus due to insufficient control by authorized services of the quality of products, water, and sanitary and hygienic conditions. To reduce the risk of developing an infection or infection, you must:

• Buy products in stores with a proven reputation;
• Visit public places with good sanitary and hygienic conditions;
• Provide products with appropriate storage;
• Subject food to full heat treatment;
• Thoroughly wash vegetables, fruits, herbs;
• Maintain cleanliness in the bathroom, toilet, wash floors, walls, sinks with a product containing chlorine;
• Wash your hands after returning from public places, before eating, teach children this rule.

Prevention of an epidemic of rotavirus gastroenteritis falls on the shoulders of local authorities and sanitary and epidemiological services.

Clinical manifestations

The most specific signs of rotavirus gastroenteritis are such manifestations as:

• vomit;
• nausea;
• acute diarrhea;
• severe abdominal pain.

Attacks of vomiting occur about five times in the first day, and an increase in bowel movements is observed within five to fifteen times. In the case of mild pathology, the stool is characterized by a mushy consistency. If the stage is acute, then it becomes foamy, watery, a sharp sour odor predominates, and the color of bowel movements becomes yellow-green. The stool should not contain blood or mucus.

The temperature can rise and persist for four days. In 70% of all cases, the development of acute respiratory syndrome is observed against the background of damage to the gastrointestinal tract. It is characterized by pharyngitis, sore throat, rhinitis, hyperemia of the soft palate.

Short-term transformations in the functioning of the kidneys appear:

• oliguria;
• microhematuria;
• cylindruria;
• albuminuria.

In severe cases of gastroenteritis, acute renal failure and decompensated metabolic acidosis may develop. The duration of the disease is about seven to ten days. The febrile intoxication period lasts three days, diarrhea can appear within six days. As for vomiting, it is usually present in the first two days.

The incubation period for this infection can last from 1 to 4 days, after which certain symptoms appear, which can be of varying degrees of severity (depending on this, mild, moderate and severe gastroenteritis are distinguished). An asymptomatic form of the disease or its course in an erased form is also possible.

Rotavirus gastroenteritis begins acutely. The patient vomits, experiences severe abdominal pain, and upset bowel movements. All this happens against the background of an increase in body temperature to 38 degrees (maybe higher). Let us consider in more detail the main clinical manifestations of this disease.

Symptoms of rotavirus gastroenteritis most often develop in children, but can also occur in adults. They are preceded by an incubation period that ranges from 1 to 5 days.

Clinical manifestations of rotavirus gastroenteritis in children

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Rotavirus gastroenteritis in children is manifested by the following clinical manifestations:

• nausea and vomiting;
• diarrhea (the frequency of stool increases and its consistency changes from mushy to liquid);
• severe weakness;
• bad feeling;
• irritability;
• tearfulness;
• lack of appetite;
• epigastric pain;
• a slight increase in body temperature (but it may remain normal);
• runny nose;
• sore throat;
• sore throat when swallowing, etc.

When examining and objectively examining small patients, the following signs are determined:

• intestinal peristalsis audible by the ear;
• abdominal pain on palpation;
• signs of dehydration (teeth marks on the tongue, tachycardia, dry tongue, thirst, etc.).

The incubation period of rotavirus gastroenteritis lasts no more than 48 hours. After this period, pronounced symptoms of the disease appear.

The pathological process begins acutely, a detailed clinical picture is observed at the 12th hour of illness. Indigestion is the main symptom of rotavirus infection.

It manifests itself in the form of diarrhea, nausea, vomiting, and pain in the epigastric region. Vomiting is observed only on the first day of the disease, attacks occur no more than 5 times a day.

Stool occurs 10-15 times a day; in mild cases, the disease has a mushy structure; in severe cases, it has a watery, foamy character. The feces acquire a yellow or greenish color and a strong, unpleasant odor.

Symptoms of gastroenteritis appear after an incubation period, which lasts from several hours to 5 days. The disease develops acutely, in the midst of complete health. Both gastrointestinal and respiratory manifestations appear. They can develop simultaneously or some manifestations precede others.

Respiratory symptoms of rotavirus gastroenteritis include:

• Redness of the pharynx, palate, uvula, tonsils
• The appearance of grain on these formations
• Feeling of nasal congestion
• Difficulty breathing
• Coughing.

All these clinical signs do not last long. Somewhat later, gastroenteritis manifests itself as gastrointestinal disorders, namely:

• Diarrhea, which is observed in almost all patients (from 5 to 20 times a day)
• The appearance of mucus in the stool
• Vomiting combined with diarrhea
• The temperature is low-grade and lasts for a short time
• Lethargy
• Adynamia and other signs of intoxication.

Treatment with folk remedies

To get rid of unpleasant symptoms and normalize the functioning of the digestive tract, folk remedies are used.

• Kissel. Envelops the walls of the stomach and duodenum, protects against irritation, reduces acidity, and eliminates heartburn. Made from berries and starch. The child should be given in small portions. It is allowed to drink from the first days of painful symptoms.

• Chicken bouillon. It has a beneficial effect on the mucous membrane of the digestive organs, improves overall well-being, and replenishes energy. The first broth is drained, and after boiling, a small amount of salt, a bay leaf, and possibly diced carrots and onions are added to the second broth. Before serving, remove the vegetables.
• A raw egg. Envelops the walls of the stomach and small intestine, protects, normalizes acidity, eliminates heartburn, pain, and a feeling of fullness. Add a pinch of salt, stir, drink at one time. It’s even better if you have the opportunity to be treated with quail eggs.
• Herb tea. Mix chamomile, linden, lemon balm, mint. Pour boiling water over and leave for at least 15 minutes. Add a small amount of sugar. Drink warm, like regular tea. The product eliminates nausea, improves overall well-being, reduces inflammation, and strengthens the immune system.
• Rice broth. Wash the cereal and fill it with water. Cook over low heat for 20 minutes, drain the mucus and leave to cool. Take or give the child 1 tbsp. A spoon every hour during an exacerbation, then reduce the dosage. Rice water calms the stomach and normalizes stool.
• Dried fruits compote. Removes toxins from the body, eliminates diarrhea, abdominal pain, raisin compote, dry pears. Add sugar to taste.

With a weak clinical picture, folk remedies act as the main medications for the treatment of rotavirus gastroenteritis. In difficult situations, supplement with tablets.

Symptoms and treatment of gastroenteritis

The severity of clinical manifestations depends on the type and number of microorganisms or toxin involved. Symptoms of gastroenteritis also vary depending on the resistance of a person's immune system.

Signs of gastroenteritis often begin suddenly, sometimes abruptly, with loss of appetite, nausea, or vomiting.

The stomach may experience rumbling, cramping, flatulence and bloating. Diarrhea is the most common symptom and can sometimes be accompanied by visible blood and mucus. A person may experience fever, exhaustion, muscle and joint pain.

Human pathology caused by viruses

Viruses cause watery diarrhea. The stool rarely contains mucus or blood. Rotavirus infection can last 5 to 7 days in infants and young children. Most children experience vomiting and some develop fever.

Norovirus causes more vomiting than diarrhea and lasts 1 to 2 days. The adenovirus causes mild vomiting 1-2 days after the onset of diarrhea. Diarrhea may last 1 to 2 weeks. Symptoms of astrovirus are similar to mild rotavirus infection.

Disease caused by dangerous parasites

Parasites usually cause diarrhea that can last a long time, as well as intermittent diarrhea, usually without traces of blood. With prolonged diarrhea, rapid weight loss and exhaustion with constant fatigue may begin.

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Effective treatment of the disease

The most common types of pathology resolve on their own within a few days. The main goal of treating gastroenteritis is to ensure that patients stay hydrated.

Drinking enough fluids and a proper diet for gastroenteritis will help relieve symptoms and speed up recovery.

You may need:

• diarrhea management;
• control of nausea and vomiting;
• increasing time for rest.

If the patient has large, loose stools and is unable to drink or keep down fluids due to nausea or vomiting, intravenous (parenteral) fluids may be needed.

Antibiotics are not often prescribed to treat common bacterial forms of the disease. If the diarrhea is very severe or the person has a weakened immune system, antibiotics may be needed. For viral forms, antibiotics are ineffective because they do not affect viruses.

You can purchase popular medications at the pharmacy that can help stop or slow down loose stools. Over-the-counter medications such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol) may help relieve symptoms in adults. These medications are not recommended for children.

These medications should not be used without consulting a doctor if the patient has bloody or severe diarrhea and fever.

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Symptoms of rotavirus enteritis

Looking at the list of probable preconditions for the occurrence of enteritis, you immediately become afraid for the well-being of yourself and your children, but the main thing is to notice in time the expression of signs of the disease. Otherwise, it will not be possible to quickly and efficiently provide medical care.

Particular care should be taken with young children, since their behavior does not always reveal the presence or absence of enteritis.

Main symptoms:

1. Frequent bowel movements (no more than 20 times a day).
2. Strong desire to drink.
3. Severe diarrhea.
4. Increase in body temperature.
5. Feeling nauseous.
6. Headache, migraine.
7. Vomit.
8. The skin becomes dry or, on the contrary, too oily.
9. Bloating.
10. Restless sleep, increased sweating during sleep.
11. Rumbling intestines.
12. Weakness, poor health, reluctance to get up from the couch and do something, fatigue.
13. Loose stools resembling clay mortar.
14. Severe pain.
15. The presence of inclusions and oily sheen in the stool.
16. The body's rejection of food and liquid.

Causes of the disease

The cause of the disease is the fecal-oral route of transmission, when infection occurs through food, water or common objects. The waterway poses a particular danger, as in this case the disease spreads to a large number of people. In patients, the mucous membrane of the oral cavity and pharynx, as well as those mucous membranes that line the walls of the small intestine, become inflamed.

The causative agent of the infection penetrates through the mouth into the gastrointestinal tract, penetrates into the cells that form the intestinal mucosa, where the active reproduction of the virus subsequently occurs. In this case, mucosal cells die with the rejection of villi involved in the absorption of nutrients.

Infection with viral gastroenteritis most often occurs in the following cases:

1. Failure to comply with personal hygiene requirements;
2. When drinking water that does not meet sanitary standards;
3. Through contaminated products, most often in this way, called alimentary, they become infected through milk and dairy products.

The source of infection can only be a sick person; this type of disease is not transmitted from animals. In addition to these routes of infection, there is another, less common airborne route. But this possibility is less common than direct contact with contaminated food.

Mechanisms of occurrence and development of the disease

The pathogen belongs to the family Reoviridae, genus Rotavirus. Rotaviruses get their name from the Latin rota, meaning wheel, because viral particles under an electron microscope look like small wheels with a thick hub, short spokes and a thin rim. The virion is icosahedral in shape, with a diameter of 65 - 75 nm. The capsid is two-layered, built according to the cuboidal type. Contain RNA.

Human rotaviruses can be cultured in green monkey kidney cells. Based on their antigenic properties, rotaviruses are divided into 9 serological types, of which types 1-4 and 8-9 are found in humans, types 5-7 are isolated from animals. Rotaviruses of animals (dogs, cats, horses, rabbits, mice, calves, birds) are not pathogenic to humans. Rotaviruses are stable in the external environment.

Epidemiology.

The disease is widespread in many countries of the world, accounting for about half of all intestinal disorders in children in the first two years of life in developing countries. In the United States, over 1 million cases of severe rotavirus diarrhea are observed annually among children aged 1 to 4 years, and in 150 patients the disease is fatal. In 90% of older children, anti-rotavirus antibodies are detected in the blood, which indicates the widespread distribution of this infection.

In Germany and Japan, antibodies against rotavirus serotypes 1 and 3 predominated. Different serotypes may predominate in different years in the same country. Thus, in Australia in 1975, rotavirus serotype 3 predominated, in 1977 and 1978 - serotype 2, and in 1980 and 1986 rotavirus serotype 1 was detected more often.

Children under 3 years of age are more likely to get sick, both in developed and developing countries. Rotaviruses are responsible for 30-50% of all cases of diarrhea requiring hospitalization and rehydration therapy. Often, adults in families where a child is sick also get sick, and older people with weakened immune systems also get sick.

Rotavirus infection accounts for about 25% of cases of so-called traveler's diarrhea. Rotavirus infection can also be asymptomatic; such cases have often been found in newborns. This course subsequently protects children from severe rotavirus gastroenteritis during the first 3 years of life.

Reservoir and sources of the pathogen: human, patient or carrier. Cross-antigenic relationships between rotaviruses of humans, monkeys and calves have been discovered, but the epidemiological significance of animal viruses has not been established.

Rotaviruses are found in the water of rivers, lakes, seas, and groundwater. The pathogen is excreted in feces (1 g of feces contains up to 10 viral particles) for up to 3 weeks (usually 7-8 days from the onset of the disease).

The mechanism of transmission of the pathogen is fecal-oral; transmission routes - water, food, household. The possibility of airborne or airborne dust transmission is speculative.

In tropical countries, rotavirus infection occurs all year round, with a slight increase in incidence during the cool, rainy season. In countries with temperate climates, seasonality is quite pronounced, with the highest incidence in the winter months.

A person becomes infected through nutrition. Reproduction and accumulation of reovirus occurs in the upper gastrointestinal tract, in particular in the epithelium of the duodenum. The absence of severe fever and symptoms of general intoxication (in the absence of information about viremia) suggests that the hematogenous route of spread of rotaviruses is not significant.

Rotaviruses cause the death of mature cells of the small intestine; they are replaced by immature absorptive cells that are unable to adequately absorb carbohydrates and other nutrients, resulting in osmotic diarrhea.

Intracellular metabolism of cyclic adenosine monophosphate or guanosine monophosphate is not important in the pathogenesis of rotavirus diarrhea.

Rotaviruses accumulate in the intestinal mucosa and then enter the intestinal lumen. Large losses of fluid and electrolytes are pathogenetically important, which leads to dehydration, usually no more than II-III degree. Rotaviruses were also found in small quantities in the colon.

Rotavirus infection is often combined with other viral (adeno- and coronaviruses) and bacterial (Escherichia, Shigella, Salmonella, Campylobacter) agents. However, rotaviruses themselves can cause damage to the gastrointestinal tract, which has been proven in animal experiments.

Pathomorphological picture.

Microscopic examination of the mucous membrane of the small intestine reveals areas with a smoothed surface, shortened villi, and infiltration of the mucous membrane with mononuclear cells. Electron microscopy can detect rotavirus particles. After 4-8 weeks, the mucous membrane of the small intestine is completely normalized.

With rotavirus disease, the epithelium of the villi of the small intestine, in which the synthesis of disaccharidases occurs, is partially destroyed. As a result, unsplit disaccharides accumulate in the intestines. The process of absorption of simple sugars is also disrupted. All this leads to an excess intake of disaccharides and simple sugars into the colon, which causes an increase in osmotic pressure. In this regard, liquid in large quantities comes from the tissues into the colon, which can lead to dehydration syndrome. This process is enhanced by inflammatory phenomena caused by rotavirus infection.

Immunity. In most cases, it occurs in early childhood after an illness. The immune system is fragile, so the disease may recur in adults with low antibody levels. Immunity in those who have recovered from the disease is caused not only by humoral, but also by secretory antibodies.

Diagnosis of Rotavirus gastroenteritis in children:

Diagnosis of rotavirus gastroenteritis is made using clinical, epidemiological and laboratory data together. The disease is characterized by the sudden appearance of watery, copious, foamy stools, without pathological impurities. Also among the characteristic signs of the disease: paroxysmal pain in the upper abdomen, loud rumbling in the intestines, an imperative urge to defecate with moderate short-term intoxication.

It is easier to diagnose this viral disease if there is evidence of an epidemic outbreak or a family focus of infection. It is worth considering that rotavirus gastroenteritis “activates” in winter and spring.

Sometimes negative test results for salmonellosis, dysentery, escherichiosis and other similar bacterial intestinal infections are important. The diagnosis is confirmed by detecting rotavirus antigen in the feces of a sick child, as well as antibodies in the blood.

When diagnosed, rotavirus gastroenteritis is distinguished from salmonellosis, escherichiosis, mild forms of cholera, enteroviral diarrhea, etc.

Coronavirus and gastroenteritis

The name “coronavirus” comes from the Latin Coronaviridae (crowned virus). This disease was “crowned” due to the spiny processes resembling the solar corona. This “crown” allows the virus to penetrate cells by imitating molecules to which transmembrane cell receptors respond. The receptor captures the fake molecule from the “crown”, after which the virus is pressed into the cell.

The disease can occur in a mild form of acute respiratory viral infection, or in a severe form with complications such as pneumonia or respiratory failure. There is a risk of death. In humans, coronaviruses cause acute respiratory diseases, atypical pneumonia and gastroenteritis.

In humans, coronaviruses cause acute respiratory diseases, atypical pneumonia and gastroenteritis.

Gastroenteritis is a very common inflammatory disease of the stomach and intestines. Vomiting, diarrhea, colic, weakness, and sometimes fever are its main symptoms that are familiar to many. Some symptoms are similar to acute gastritis.

Gastroenteritis is divided into two large groups: infectious and non-infectious. Viral gastroenteritis develops during infection with many types of viruses. Among them, the most common are rota-, noro-, adeno-, and coronavirus infections. They are all treated the same way, so the doctor does not need to differentiate between them.

Symptoms of coronavirus and gastroenteritis

Symptoms of gastroenteritis vary depending on the cause of the disease. Infectious gastroenteritis usually begins suddenly. Vomiting, diarrhea (diarrhea) with or without blood and mucus, intestinal colic, weakness, fever (moderate or high) are classic signs of an intestinal infection. The disease may also be accompanied by muscle pain and prostration.

When contracting coronavirus, the incubation period is limited to 2-3 days. With aerogenic infection, a clinical picture most often develops that is indistinguishable from a respiratory viral infection. The initial manifestations of coronavirus infection are characterized by malaise, moderate headache, pain when swallowing, sneezing, severe rhinitis, mild intoxication, and body temperature is often normal or subfebrile.

The main difference between coronavirus infection and gastroenteritis is the occurrence of copious, watery, transparent discharge from the nose

Severe respiratory syndrome (atypical pneumonia) with renal failure may then develop, leading to death. Less commonly, the disease occurs as acute short-term gastroenteritis without accompanying symptoms from the upper respiratory tract.

What is the difference between coronavirus and gastroenteritis?

The main difference between coronavirus infection and gastroenteritis is the occurrence of profuse, watery, clear nasal discharge, which, as the disease progresses, can be replaced by mucous rhinorrhea. The patient has difficulty breathing through the nose and a deterioration in the sense of smell. Children and weakened patients experience sore throat, rough unproductive cough and enlarged cervical lymph nodes.

When infected with coronavirus, only isolated damage to the digestive system is determined, which may be accompanied by nausea, vomiting, abdominal pain and loose, watery stools. In most cases, a benign course of gastroenteritis is observed, without the development of dehydration.

Prevention of coronavirus and gastroenteritis

Prevention measures for coronavirus and gastroenteritis are similar. Prevention of viral gastroenteritis and coronovirus consists of observing basic rules of personal hygiene, completely avoiding eating raw food and unwashed vegetables. During epidemics, try to visit crowded places, public transport and toilets less. If any family member does become ill, he should be isolated in a separate room for the entire period of treatment and provided with separate personal hygiene items.

Drug therapy

Drugs used in the case of childhood gastroenteritis are aimed at reducing the degree of intoxication, combating pathogens (in the infectious form), and restoring electrolyte balance:

• for cardiovascular symptoms, caffeine and cordiamine are prescribed in the form of subcutaneous injections;
• Corglicon or strophanthin is added to infusion fluids according to indications;
• antibacterial drugs are prescribed taking into account their effectiveness against specific pathogens;
• among antibiotics, it is advisable to use injections of Ceftriaxone, Amikacin;
• in case of viral nature of the pathology, children's Anaferon, Ergoferon, Kagocel are used;
• fight against elevated body temperature, if this does not interfere with the suppression of pathological processes;
• sorbents are used in case of severe intoxication - Smecta, Enterosgel, Polysorb.

In addition, to quickly restore the functionality of the gastrointestinal tract, the child is prescribed:

• stimulant drugs (plasma transfusions, Pentaxil);
• gamma globulin injections;
• vitamins B and C;
• enzymes (Creon, Mezim);
• eubiotics (Mexoform, Enteroseptol).

Treatment of rotavirus infection

In most cases, the body of both adults and children copes with rotavirus on its own, and recovery occurs within a week.

However, an increase in temperature, repeated vomiting, diarrhea and abdominal pain are always good reasons to call a doctor at home, especially when it comes to a child’s illness. This is due to the fact that similar symptoms are characteristic not only of rotavirus gastroenteritis, but also of more serious intestinal infections, as well as surgical diseases, such as appendicitis

Therefore, it is important that the doctor examines the patient and excludes conditions that are dangerous to life and health.

Mild forms of rotavirus infection can be treated at home. The doctor can prescribe a number of medications that will help you quickly cope with the symptoms of intestinal flu, alleviate the condition and, most importantly, avoid complications and the progression of the disease to a severe form. In severe cases, hospitalization in an infectious diseases hospital is recommended.

Diet for rotavirus infection

On the first day of illness, if there is frequent vomiting and lack of appetite, you can abstain from food. However, as soon as your health begins to improve, you need to gradually return to a nutritious diet to speed up recovery.

It is important to drink as much fluid as possible throughout your illness.

When infection develops in infants, they continue to be fed as before: breast milk or special formulas. It is only recommended to increase the frequency of feeding. In some cases, your doctor may recommend the use of dietary supplements or medications that contain lactase. This is an enzyme that breaks down milk and helps its absorption, which is especially important for infants. It is known that during rotavirus infection, the activity of the body’s own lactase decreases, which leads to poor absorption of dairy products, increased diarrhea and bloating.

For older children and adults, it is advisable to increase the frequency of meals by reducing the serving size. Dairy products, snacks, and processed foods are excluded from the diet, and the consumption of juices, raw fruits and vegetables, legumes and other foods rich in carbohydrates is limited.

The most preferred are porridges, liquid soups, boiled soufflés, steamed cutlets, and yesterday's bread. You should not eat fried, spicy, pickled or smoked foods. This diet should be followed until complete recovery and for 2-3 days after.

Drug treatment of rotavirus infection

To help the body cope with the virus faster, you can use antiviral drugs, for example: Arbidol, Viferon and others. The peculiarity of this treatment is the need to start taking the medicine with the first symptoms of intestinal flu. Otherwise, the effectiveness of antiviral agents is reduced. Antiviral protection is also enhanced by immune stimulating agents: Cycloferon, Antirotavirus immunoglobulin, Complex immunoglobulin preparation (CIP) and others. It is advisable to consult a doctor before use.

Antibiotics are not indicated for rotavirus infection. In rare cases, a doctor may prescribe them if there is a high risk of bacterial complications or mixed infections (when, in addition to rotavirus, bacterial infection is detected).

To combat intoxication and diarrhea, sorbents are prescribed. These are drugs that are able to absorb toxins and gases from the gastrointestinal tract with their surface. Many of them have a fixing effect, that is, they normalize stool. At the pharmacy without a prescription you can buy sorbents such as: Smecta, Polysorb, activated carbon, Filtrum-STI, etc. Sorbents must be taken separately from other medications, with an interval of at least 30 minutes.

To relieve the gastrointestinal tract and speed up the restoration of its full functioning, enzyme preparations are prescribed and taken with meals. These are Creon, Pancreatin, Mezim, Lactase, etc. In addition, pro- and prebiotic preparations are widely used in the treatment of rotavirus gastroenteritis: Enterol, Bactisuptil, Bifiform, Linex, Acilact, etc.

Treatment

Treatment of mild to moderate rotavirus gastroenteritis is carried out on an outpatient basis, in compliance with all specialist recommendations. Adults with severe pathology must be treated in a hospital under the supervision of a physician.

Special general therapy has not yet been developed. Therefore, the treatment regimen is determined by the attending physician, taking into account the form of the disease and the individual characteristics of each patient’s body.

Medicines

Unfortunately, at the moment there are no medications that can have a detrimental effect on viruses. Therefore, drugs of various groups are used for treatment. These include:

• enzyme agents that are indicated to normalize digestion;
• drugs to lower body temperature;
• symptomatic medications (for diarrhea, nausea, vomiting);
• probiotics to restore microflora in the intestines;
• sorbents are used to absorb and remove toxic substances from the body;

• rehydration solutions are used for severe dehydration;
• Immunoglobulins are used when there is a pronounced decrease in immunity.

Advice! It is worth noting that patients with rotavirus gastroenteritis do not receive antibacterial therapy. Antibiotics are indicated only if a secondary bacterial infection occurs.

Folk remedies

Traditional medicine can also be used to treat rotavirus gastroenteritis in adults. They will be especially effective for mild to moderate pathology. Popular folk remedies include:

• St. John's wort decoction. You will need 2.5 tbsp. raw materials and 300 ml of boiling water. The composition is kept in a water bath for 20 minutes. Then filter and add boiled water, bringing to the original volume. Take the decoction 3 times a day, 1/3 cup, 30 minutes before meals.

• Decoction of oak bark. For 1 l. water will require 40 g of raw materials. Place on fire and boil for 30 minutes. The decoction is taken up to 5 times a day, 0.5 cups. This remedy has a powerful astringent and soothing effect.
• Natural jelly. You can cook from any fresh berries. This drink restores digestion, soothes and protects the mucous membranes of the stomach and intestines. You need to consume jelly often and in small portions.

Advice! For rotavirus, experts also recommend drinking medicinal mineral water without gas (Borjomi, Essentuki).

Diet

Diet is an effective way to treat rotavirus gastroenteritis. Proper nutrition helps normalize digestion, reduce the burden on the gastrointestinal tract, and restore the body after recovery.

During the first days of pathology, as a rule, the patient has no appetite. During this period, you can drink low-fat chicken broth, weak sweet tea, jelly or herbal decoction.

In the following days, food should be steamed and consumed only pureed. All foods that feed the infection are excluded from the patient’s diet. These include:

• food of plant origin with difficult to digest fiber;
• dairy products;
• any canned food;
• sausages, sausages;
• junk food (salted, smoked, etc.);
• confectionery and butter products;
• various sweets.

As the condition improves, therapeutic nutrition includes:

• porridge (semolina, buckwheat, rice);
• soups (with vegetables or broth);
• steam cutlets from chicken, turkey, rabbit;

• steam omelette;
• skim cheese;
• boiled vegetables;
• baked apples;
• dried bread;
• homemade marmalade, marshmallows.

Prevention of rotavirus infection

Vaccination is used for primary prevention of rotavirus infection. Vaccine prevention is important only for children and is carried out in the first months of a child’s life. Vaccination can reduce the incidence of the disease by 50-70% and prevent up to 90% of all severe cases of rotavirus infection in children under 3-5 years of age. The effectiveness of vaccination is confirmed by statistical studies in those countries where vaccination against rotavirus gastroenteritis is included in the compulsory vaccination schedule for children (reducing the incidence of deaths and morbidity).

Russia does not use routine vaccination against rotavirus infection, but it is planned to introduce it by 2021. It can be done privately even now.

Secondary prevention of rotavirus infection consists of maintaining proper social and living conditions and protecting water resources from fecal contamination.

Personal prevention measures for rotavirus infection

• Maintain personal hygiene, wash your hands before eating and after using the toilet;
• Do not drink water from open natural sources without first boiling;
• Do not eat unwashed fruits, vegetables and greens;
• Try not to eat on the street - this especially applies to children;
• When away from home with your child, use hand sanitizer;
• Use separate dishes and kitchen utensils when preparing food for your child. Sterilize baby sippy cups and bottles by boiling or using special devices.

Sources

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2. Global, Regional, and National Estimates of Rotavirus Mortality in Children https://www.ncbi.nlm.nih.gov/pubmed/27059362
3. Rotavirus Vaccine, Family Practice - https://www.fpnotebook.com/ID/Immunize/RtvrsVcn.htm
4. Rotavirus Vaccination, CDC - https://www.cdc.gov/rotavirus/vaccination.html
5. Risk Factors Associated With Rotavirus Gastroenteritis During a Community Outbreak in Chiapas, Mexico During the Postvaccination Era, Journal of Pediatric Infectious Diseases - https://academic.oup.com/jpids/article/2/1/15/1085612/Risk-Factors -Associated-With-Rotavirus
6. Risk Factors for Severe Rotavirus Gastroenteritis Huppertz, Hans-Iko MD; Salman, Nuran MD; Giaquinto, Carlo MD, Journal of Pediatric Infectious Diseases - https://journals.lww.com/pidj/Fulltext/2008/01001/RiskFactorsforSevereRotavirus_Gastroenteritis.3.aspx
7. Rotavirus Symptoms, CDC - https://www.cdc.gov/rotavirus/about/symptoms.html
8. Rotavirus Overview, Mayo Clinic—https://www.mayoclinic.org/diseases-conditions/rotavirus/symptoms-causes/dxc-20186931
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