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Rotaviruses are the leading cause of severe diarrhoeal disease and dehydration in infants and young children in both developed and developing countries. Illness can range from mild, watery diarrhoea of limited duration to severe diarrhoea with vomiting, abdominal cramps and fever. Persistent diarrhoea and vomiting can lead to severe dehydration of the child in which hospital treatment may be required. Children can be affected with rotavirus several times. On average one death to rotavirus each year occurs in Australia.
Most kids will have had a rotavirus episode before their 3rd birthday. Most symptomatic episodes occur between 6 months and 2 years of age with a peak incidence between 7 and 15 months. In Australia, it is estimated that there are approximately 10, 000 hospitalisations due to rotavirus in children less than 5 years of age each year, with Rotavirus accounting for around half the hospitalisations for any acute gastroenteritis in this age group. Indigenous Australian infants and children have an estimated 3-5 times higher incidence of hospitalisation. In addition to this, an estimated 115,000 children under 5 years of age visit a GP, and 22,000 children require an emergency department visit.
Rota virus infections in adults are usually asymptomatic but may occasionally result in illness. Prevalence of rotavirus has been vastly underestimated until recently.
Rotavirus is highly contagious, transmitted by faecal-oral route. Large numbers of viral particles are shed in faecal matter (for up to a week after infection) and the virus is stable in the environment, so contamination of hands and objects is relatively easy. In addition virus excretion can occur in individuals without symptoms. Outbreaks in day-care centres and hospitals can spread rapidly among non-immune children, presumably through person-to-person contacts, airborne droplets, or contact with contaminated toys.
Rotavirus infection is usually treated by support to the child, comfort and management of dehydration.
Yes; Vaccination the best option for providing protection from rotavirus. Currently there are two vaccines available in Australia. Both are oral vaccines containing a live weakened strain of the virus. They are registered for use in infants only; Rotarix (given in a 2 dose schedule at 2 and 4 months of age); and RotaTeq (given in a 3 dose schedule at 2, 4 and 6 months of age). Immunisation of older infants or children is not recommended.
Vaccination will reduce the risk of developing severe rotavirus gastroenteritis (by 85-100%) and any rotavirus gastroenteritis (by 70%). The vaccine will not prevent severe diarrhoea and vomiting from other infectious agents. Rotavirus vaccine is part of the national immunisation schedule. The use of the two vaccines vary between states.
The currently licensed rotavirus vaccines have undergone some of the largest and most stringent testing in clinical trails ever seen for any vaccine. This has part been because a Rota virus vaccine in the past (in America) was associated with an increased risk of intussusception (a bowel condition in which the bowel telescopes on itself and may require surgical intervention to correct) and withdrawn from the market. However, intussusception occurs for unknown reasons in about 1 child per 10,000, regardless of whether or not they have received any vaccine, and it most often occurs in infants 4 to 10 months of age. Current vaccines differ in composition to the past rotavirus vaccine and the clinical trials of the new rotavirus vaccines were done with a large study trial ( more than 60,000 infants) which gave no evidence of increased risk of intussusception when compared to the placebo group. Trails of Rotarix and RotaTeq limited administration of the first dose of vaccine to infants under 3 months of age, and did not give subsequent doses to children past a certain age (6 months for Rotarix and 7.5 months for RotaTeq)
Catch-up vaccination or immunisation to older children is not recommended as safety of the current vaccines was not studied in older infants or children; plus the main burden of the disease is in children less than 3 years of age.