Main symptoms of rotavirus enteritis - information for patients

Sinitsyn

Olga Valentinovna

33 years of experience

Highest qualification category of infectious disease doctor

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Rotavirus infection is a disease of viral origin that has an oral-fecal transmission mechanism. The peculiarity of the pathology is a combination of symptoms of damage to the digestive system with respiratory signs at the acute stage of the disease. The disease can be diagnosed in patients of any age, but more often in children under 2 years of age, in whom rotavirus accounts for up to 50% of all reported cases of intestinal infections.

The causative agent of rotavirus infection and mechanisms of infection

The causative agent of intestinal flu is rotavirus (from Latin rota - wheel), a virus from the Reoviridae family. The virus owes its name to its shape - it looks like a wheel with short spokes and a thick rim. Rotavirus is resistant to low and high temperatures, ultrasound, and does not die in chlorine and formaldehyde.

The most common mechanism of spread of rotavirus infection is fecal-oral. The virus enters the body from contaminated objects and dirty skin of the hands - which is why the key measure to prevent rotavirus infection is personal hygiene.

The disease is also spread by airborne droplets (by contact with a sick person) and nutritional routes (by eating poorly washed foods and contaminated water).

Causes

The causative agent of rotavirus infection in children and adults is rotavirus, which has the ability to survive even when treated with potent disinfectant solutions. In the feces of a sick person, its vital activity persists for 7 months, in environmental conditions - for more than a month. The infection is transmitted from a carrier or a sick person through the fecal-oral route through water, food and household items, especially when the sanitary and hygienic condition of the premises is unsatisfactory.

Patients at risk for rotavirus include:

• childhood;
• with disturbances in the functioning of the immune system, when it is suppressed;
• with chronic intestinal diseases;
• with violations in the diet, as well as when changing baby food;
• working or visiting large groups;
• not observing the rules of personal hygiene.

Epidemiology

Rotavirus infection is a typical seasonal disease. According to statistics, in almost 93% of cases the disease develops in the winter months.

The infection often spreads in epidemic outbreaks - especially in kindergartens, hospitals, nursing homes and other institutions where children or adults with weakened immune systems are in close contact.

Children are most susceptible to infection. The share of rotavirus infection is 39.4% of all episodes of diarrhea under the age of 5 years.

Drug therapy

How to treat rotavirus infection in adults

? No specialized treatment for rotavirus infection has currently been developed. Diseases of mild and moderate severity go away on their own: you just need to adhere to a strict diet during the period of illness, as well as correct the lack of enzymes in the body. The drugs Festal or Pancreatin can cope with this task.

To eliminate the symptoms of the disease, medications such as smecta or activated carbon - enterosorbents - are used. The use of antibiotics during the treatment of rotavirus infection is not required.

If the patient shows signs of dehydration, the specialist prescribes intravenous administration of a glucose-saline solution.

Signs and symptoms5

• Uncontrolled diarrhea is the most dangerous symptom of rotavirus gastroenteritis. In some cases, diarrhea leads to dehydration, which can in turn be fatal. 17.8% of deaths from diarrhea under 5 years of age are due to rotavirus infection.
• Excessive vomiting is another symptom that leads to dehydration.
• Severe stomach and intestinal cramps, flatulence.
• Dry cough, nasal congestion, sore throat are symptoms due to which, in the early stages, rotavirus infection can be confused with the flu or tonsillitis (sore throat).
• Conjunctivitis, enlarged lymph nodes.
• General weakness, apathy.
• Appetite disturbances - up to complete refusal to eat and drink in severe forms of the disease.
• Pale skin, dry mouth, chapped lips.
• Severe increase in body temperature.

Methods for treating rotovirus

To treat rotavirus pathology, symptomatic and etiological therapy is prescribed. Patients are also prescribed a diet and auxiliary methods.

The main goal of treatment is to prevent dehydration. For this purpose, rehydration drugs are used for parenteral and oral administration. Such drugs prevent large fluid loss, improve well-being and relieve intoxication syndrome. Representatives are: Regidron, Acesol, Kvartasol, Refortan.

To remove pathogenic pathogens from the body, sorbents are prescribed. They accelerate the restoration of the mucous membrane, suppress pain and flatulence. Activated carbon, Polysorb, Enterosgel, Karbolen are prescribed.

Antiviral drugs based on interferon are indicated as etiotropic treatment.

To improve the normal intestinal microflora, probiotics are prescribed - Acipol, Linnex, Enterol, Bifiform.

Additionally, patients with rotavirus pathology are prescribed painkillers, antiemetics and antipyretics.

Course of the disease7

The following stages are characteristic of intestinal flu:

• The incubation period is from 12 hours to 5 days.
• Acute onset - as a rule, already in the first hours of illness the patient’s temperature rises sharply, chills appear, a strong cough begins, and the nose gets stuffy. A little later, the main symptoms appear - nausea, diarrhea with watery stools, cramping pain in the stomach and intestines.
• If the infection is properly treated, diarrhea will last from 5 days to a week. In the first 2-3 days, the stool remains watery (in infants it may become colorless), then it becomes clay-like.
• Pain and sore throat, runny nose and cough disappear after 2-3 days. At the same time, the body temperature remains elevated.
• The rehabilitation period after rotavirus gastroenteritis is 5-7 days.

Diagnosis of the disease

In order to correctly establish a diagnosis, you need to consult a specialist. Only a doctor can conduct all the necessary examinations and prescribe a treatment plan for rotavirus infection.

Making a diagnosis requires the patient to undergo the following tests:

• General blood analysis. Rarely does a patient have an elevated white blood cell count.
• General urine analysis. These values ​​remain unchanged.
• General analysis of stool. Characterized by an increased number of leukocytes, starch, and muscle fibers.

The final diagnosis of rotavirus infection is made by a specialist only after the presence of a bacterial infection has been ruled out using various tests and analyses. It is equally important to wait for the results of studies such as virological and serological before treating rotavirus infection in adults

.

Possible complications8

Rotavirus infection poses the greatest danger to young children from the first days of life to 3-5 years and pregnant women:

• At an early age, intestinal flu is a deadly disease - severe dehydration of the body can lead to death.
• Dehydration caused by rotavirus gastroenteritis during pregnancy leads to the risk of miscarriage.

Possible complications of rotavirus infection:

• Pancreatitis, gastritis, enlarged pancreas.
• Intestinal inflammation.
• Hemorrhagic gastroenteritis.
• Acute renal failure.
• Circulatory disorders.
• Gasser syndrome.
• Necrotizing enterocolitis.

To minimize the risk of the disease and prevent the development of complications, it is important to promptly diagnose rotavirus infection and begin adequate treatment.

Intestinal flu - causes, symptoms and treatment

Rotavirus infection is an infectious disease caused by rotaviruses. Rotavirus, the symptoms of which manifest themselves in moderately severe symptoms of enteritis or gastroenteritis, is often combined with respiratory and intestinal syndromes during the initial manifestation of the disease. People of any age are susceptible to rotavirus infection, however, the incidence is most often observed among children from six months to two years. GENERAL DESCRIPTION

Rotavirus infection is also defined as RI, rotavirus gastroenteritis, rotavirosis, stomach or intestinal flu. The virus is transmitted primarily through food, that is, through unwashed food, dirty hands, etc. Thus, infection is possible in a variety of ways and, again, through products with rotavirus (in particular, dairy products should be highlighted here, which are especially susceptible to infection due to the specifics of their production). It is noteworthy that rotaviruses can live even in the refrigerator for a long period of time; chlorination of water does not affect them. Contrary to the generally accepted opinion regarding the effect of holy water on viruses due to its altered structure, it should be emphasized that it does not in any way affect the activity of rotaviruses.

Considering that rotavirus also provokes inflammation in the respiratory tract, its spread occurs in a similar way to the traditional influenza virus, that is, by droplets (coughing, sneezing). The virus penetrates the mucous membrane of the gastrointestinal tract (GIT), with the small intestine being predominantly affected. When the gastrointestinal tract is affected, rotavirus infection causes a disease such as enteritis, which manifests itself in inflammation of the intestinal mucosa, respectively, after which symptoms characteristic of rotavirus infection occur. They are expressed, in particular, in disturbances in the digestion of food, which provokes the development of diarrhea with simultaneous dehydration.

ROTAVIRUS INFECTION: SYMPTOMS IN CHILDREN

The course of the disease in children is more severe than in adults. The patient becomes a spreader of the virus from its first manifestations, remaining infectious until their complete completion along with the disease itself. Recovery, as a rule, comes in five to seven days, and the body develops a fairly strong immunity to the virus, which allows us to assert that subsequent infection with rotavirus is practically impossible. The incubation period ranges from 1 to 5 days, with the acute period beginning in children from 3-7 days. The severe course of the acute period of the disease can provoke a subsequent intensification and duration of this period, in this case it can be over 7 days. It takes about 4-5 days to recover from an illness.

Rotavirus infection is characterized by an acute onset. Its main manifestations are vomiting and a sharp increase in temperature, and diarrhea is possible. Stool with rotavirus infection is quite characteristic. So, on the first day it is yellow, liquid, on the second and third - clay-like, gray-yellow in color. As a rule, among the sick there is a runny nose and redness of the throat, as well as pain that occurs when swallowing. The acute period is characterized by a lack of appetite, as well as a state of loss of strength. Most often, rotavirus infection in children is characterized by the following scenario. So, the child gets up in the morning with lethargy and moodiness, and in the morning nausea appears. Vomiting is possible (often with mucus), and it is relevant even if the stomach is empty. Appetite is significantly reduced, after eating, vomiting occurs with the release of pieces of undigested food, and it also occurs after drinking liquid in a volume of over 50 ml.

The temperature then rises, and by the evening it can exceed 39°C. It is noteworthy that the disease is characterized by a stable and high temperature, that is, it is very difficult to bring it down. The duration of the condition with a high temperature can be about 5 days. Additionally, symptoms of rotavirus infection manifest themselves in the form of loose stools with an unpleasant odor, as well as abdominal pain. In very young children who are not yet able to explain their painful sensations, crying with a characteristic rumbling in the tummy is a sign of the presence of pain. Babies become irritable and whiny, in addition, they also rapidly lose weight. The second day of illness (as well as subsequent days) is characterized by drowsiness. Correct treatment allows you to eliminate all manifestations of the infection in question within up to 7 days, after which complete recovery occurs. The only thing that may subsequently cause discomfort for some time is loose stools. As for the intensity of manifestations, as well as the severity and duration of symptoms that rotavirus infection brings with it, in general they are different. It is noteworthy that the symptoms characteristic of infection are similar to the symptoms of other diseases of a more severe nature. These include, for example, salmonellosis or cholera. It is for this reason that if a child’s temperature rises, as well as nausea and/or loose stools, a doctor should be immediately called to the home. If you experience severe abdominal pain as an additional symptom, you should call an ambulance. Self-medication should be excluded until specific doctor's instructions.

COMPLICATIONS OF ROTAVIRUS INFECTION IN CHILDREN Proper treatment of rotavirus infection does not cause complications. However, if you exclude frequent drinking during diarrhea and vomiting, especially for children under one year of age, dehydration can even lead to death (up to 3% of all cases). Failure to take the required measures can also lead to the addition of an intestinal bacterial infection to the virus, which will further complicate the course of the disease and the child’s condition. It is imperative to monitor the child’s temperature, because if it rises for a long time within 39°C, the load on the cardiovascular system increases significantly, and convulsions are possible. In general, the disease does not carry with it any long-term consequences, so one can indicate favorable prognoses for the future.

SYMPTOMS OF ROTAVIRUS INFECTION IN ADULTS

As we have already noted, the course of the disease in adults is milder than in children.
As for recurrent incidence, here, in contrast, with a low level of antibodies, immunity is not developed properly against rotavirus infection, and therefore its symptoms may recur again. The specificity of the disease is the same. So, it is also a viral gastroenteritis, the course of which affects the gastrointestinal tract, and is also expressed in dehydration and general intoxication. The most common method of infection is contact with contaminated food, but household, water and other contact cannot be ruled out. In adults, intoxication is moderate, with lethargy, muscle weakness, headache and weakness, low-grade fever (up to 37.7°C). The pharynx becomes swollen, a white coating appears on the tongue, and the heart sounds are muffled (as determined by examination by a doctor). The onset of the disease is also characterized by its own severity, which manifests itself during the first day from the moment of infection. Pain in the abdomen (epigastric region) also occurs. The stool is watery (within 3-9 times per day), nausea and vomiting are also present among the symptoms. With this infection, diarrhea is profuse, characterized by a sharp odor and pale color, in some cases there may be an admixture of mucus, lasting up to a week. Given the severity of fluid loss, dehydration also develops quickly, which, in turn, can lead to circulatory failure and the body stopping the production of urine (anuria). It should be noted that rotavirus infection is often a current phenomenon that occurs as a complication of diseases affecting the respiratory tract (rhinitis, pharyngitis). Meanwhile, in many cases, the disease is characterized by a mild course with the absence of its characteristic symptoms in the form of nausea and vomiting, while stools are loose and infrequent. In any of the variants of the course of the disease, the patient is a carrier of the infection, and accordingly, in this he is dangerous for the people around him. ROTAVIRUS INFECTION: TREATMENT IN CHILDREN
There are no drugs as such to eliminate rotavirus. For this reason, treatment of infection is symptomatic, and, therefore, is aimed at normalizing the condition by restoring the water-salt balance, which is disrupted due to vomiting and diarrhea. Also, the goal of treatment is to combat the results obtained from infectious exposure in the form of dehydration, toxicosis and disturbances in the functioning of the urinary and cardiovascular systems. The manifestation of symptoms indicating gastrointestinal disorders in a child should in no case allow the consumption of milk and dairy products in any form, because they currently represent an excellent aid for the growth of bacteria. The child may also have a decreased appetite or it may be completely absent - in any case, there is no need to force him to eat. A good alternative to food in this state would be a small amount of jelly (water, jam and starch, that is, homemade), you can also give chicken broth. If the child does not refuse food, you can give him liquid rice porridge without oil (slightly sweetened). The main thing in nutrition is the insignificance of portion sizes, which will prevent the gag reflex with gradual saturation.

The main treatment, in addition to dietary restrictions, is the use of rehydration therapy; sorbents (activated carbon, attapulgite, dioctahedral smectite) are also applicable. Days on which severe vomiting or diarrhea occurs require replenishment of salts and fluid volumes lost through vomit and loose stools. This provides for the possibility of using rehydron (a sachet per liter of water) 50 ml at intervals of every half hour or hour until the liquid runs out. If you miss taking this solution because of sleep, you should not wake up the child, just as you should not give him a solution in a volume exceeding 50 ml for this reason, because he may simply vomit it. As for temperature, an important point is the fact that the virus dies at 38°C, therefore, there is no need to lower the temperature below this limit. This applies not only to rotavirus infection, but also to, say, a common cold - the well-known fact is that lowering the temperature before reaching this point is highly not recommended (figuratively speaking, the body and its immune system in particular need to be allowed to “fight”). To bring down a higher temperature, the doctor will prescribe suppositories for children under 3 years of age (ceficon); for older children, paracetamol is prescribed (in accordance with the dosage for a specific age). To bring down the temperature, you can also use rubdowns using a weak vodka solution (the whole body is wiped without allowing temperature changes in the areas between its individual sections). Rubbing is performed half an hour after taking medication for fever if there is no result. Gastrointestinal disorders with fever are eliminated by taking Enterofuril as prescribed by the doctor in the dosage indicated by him. The drug is intended for the treatment and prevention of infection, as well as to prevent prolonged diarrhea in a patient. Abdominal pain is eliminated with no-shpa, again, as prescribed by the doctor and in the dosage specified by him (usually in the form of a solution).

ROTAVIRUS INFECTION: TREATMENT IN ADULTS

Considering the greater adaptability of the adult organism to this type of shock (and the adaptability of the gastrointestinal tract to them in particular), as well as their stronger immunity, the disease occurs in a mild form of exposure. Considering this, special treatment is not required in this case. If the symptoms are severe, then treatment is aimed at eliminating specific symptoms. So, this may include preventing dehydration by frequently drinking saline solutions (based on rehydron), as well as water and tea.

Additionally, sorbents are taken to accelerate the removal of toxins and improve well-being, as well as astringent medications. An important point is also the dietary restriction (in particular, the restriction applies to the consumption of foods rich in carbohydrates in the form of fruits, sugar, vegetables), again, dairy products are excluded. Due to the fact that the disease is contagious, the patient must be isolated during treatment, thereby limiting the spread of rotavirus infection. Hospitalization is possible based on epidemiological and clinical indications. If you suspect a rotavirus infection, you should contact your primary care physician (pediatrician) or infectious disease specialist, who will determine the necessary treatment based on the tests required. Additionally, he can refer the patient to a gastroenterologist.

Prevention

The key measure to prevent rotavirus is to observe the rules of personal hygiene - timely washing of hands, eating only thoroughly washed and properly processed foods, using only filtered boiled water for drinking. Water used for domestic purposes must be treated or chlorinated.

Rotarix and RotaTek vaccines show high effectiveness in preventing rotavirus infection.

• Rotarix is ​​a live monovalent vaccine of an attenuated strain of human rotavirus. The vaccination course consists of two doses. The first dose should be given to the baby from 6 weeks of age. The interval between doses should be at least 4 weeks. The vaccination course is preferably completed by 16 weeks of age and must be completed by 24 weeks of age.
• RotaTek is a live oral pentavalent vaccine containing five live reassortant strains of rotavirus. The vaccination course consists of 3 doses with an interval between doses of 4 to 10 weeks. The course must be completed before the baby reaches 32 weeks of age.

Where does rotavirus live and how is it transmitted?

Every year, about 200 thousand people die from rotavirus around the world, most of them children. Half of this number is in the top five developing countries. This infection is typical for hot climates. In our country, vacationers on the Black Sea coast are at greatest risk in August. In the rest of Russia, outbreaks occur in winter and spring due to weakened immunity.

A feature of rotavirus is its extreme resistance to environmental factors. For example, it tolerates low temperatures and even repeated freezing. This is due to the presence of a protective shell on the virus itself. Therefore, it lives for a long time on the surfaces of objects and even in water. The most effective means of combating the virus in the external environment are alcohol, chlorine and boiling. It is also destroyed when exposed to acids and alkaline solutions.

Rotavirus infection occurs through the fecal-oral route. This means that the virus is excreted in feces and gets onto objects and into the mouth through poorly washed hands. Within 12 hours, the virus particles end up in the intestines, where they begin to multiply. At this moment, the first signs of the disease appear. Medicine does not give an exact answer to the question: “Is the virus transmitted by airborne droplets?”

Treatment12

Drug treatment for rotavirus infection is prescribed by a doctor. In most cases the following are used:

• To remove toxins: activated carbon, Smecta, Enterosgel.
• To restore the functions of the gastrointestinal tract: digestive enzymes (Festal, Somilase, Solizim).
• To reduce the temperature (in cases where it rises above 38 ºС): antipyretic drugs (Ibuprofen, Paracetamol).
• To relieve stomach pain: antispasmodics (No-Shpa, Enterofuril).
• To suppress bacterial infections that often accompany rotavirus gastroenteritis: antibiotics.
• To restore electrolyte balance: probiotics.

General recommendations:

• Drink small amounts of fluid frequently to prevent dehydration. You should drink clean boiled water, dried fruit compotes, berry fruit drinks, and unsweetened tea.
• The patient's menu should include light, quick-to-digest, protein-rich foods - dairy-free cereals, steamed poultry and fish cutlets, fruit and vegetable purees. From the patient’s diet it is necessary to exclude everything fried, smoked and salted, sweets, foods high in fats and carbohydrates, flour products (including pasta), millet and pearl barley porridges, milk and fermented milk products, spices, coffee, legumes (and other products , which can cause flatulence).

Questions and answers

How is rotavirus infection transmitted?

The mechanism of transmission of the virus is fecal-oral, where the causative agent of the disease enters the environment along with the feces of the carrier or patient, and then on dirty hands into the body of a healthy person. Household items, food, dirty water - all this can become a source of infection.

What can you eat if you have rotavirus infection?

Recommendations for a patient with rotavirus infection include dietary table No. 46 with restrictions on the amount of carbohydrates and dairy dishes, as well as an increase in the amount of protein foods. This diet plan is aimed at restoring the body’s immune system and stabilizing the digestive system that has been hit by the virus.

How long does rotavirus infection last?

The duration of the disease depends on the state of health of the person and his immune system. It may take 10-15 days from the moment of infection to complete recovery, where the first 6-7 days are an acute period with a whole bunch of unpleasant symptoms. The incubation period lasts from several hours to five days, after which the infection immediately makes itself felt with a sharp deterioration in the patient’s condition.

Kagocel for rotavirus infection

Post-registration studies of the drug Kagocel have shown that in case of combined viral lesions of the respiratory and gastrointestinal tracts (which includes rotavirus infection), taking Kagocel in combination with other medications promotes faster recovery and alleviation of the disease. Proven effects of Kagocel:

• increase in pathogen elimination by 3 times;
• reduction in the duration of fever by an average of 1.1 days;
• reduction in the duration of intoxication symptoms (headache, lethargy and loss of appetite) by 1.2 days;
• regression of catarrhal phenomena (relief of symptoms of pharyngitis and rhinitis by the 3rd–4th day of treatment);
• reduction in the duration of diarrhea by 1.5 days;
• acceleration of normalization of stool frequency for several days;
• acceleration of restoration of the function of the villous epithelium of the small intestine by 1.5 times.

Also, taking Kagocel allows you to reduce by 3 times the likelihood of re-infection of the patient with rotavirus gastroenteritis.

Chronic enteritis in adults - clinical symptoms, treatment

Enteritis is an inflammation (acute or chronic) of the small intestinal mucosa, characterized by dystrophic changes in the lining and dysfunction of the organ.
Signs of acute enteritis in children: loose stools, attacks of nausea, rumbling in the stomach, fever, dry skin, headache. The causes of this condition may be viruses, bacteria, toxic substances, allergic reactions to foods or medications. Causes of chronic enteritis in adults:

• autoimmune diseases;
• giardiasis;
• intoxication with chemical, toxic substances;
• overeating fatty foods;
• heredity;
• chronic gastrointestinal diseases;
• long-term use of medications;
• intestinal operations.

Predisposing factors include a sedentary lifestyle, abdominal trauma, poor circulation, and adhesions.

When to see a doctor?

So, you have noticed your child has a runny nose, cough and loose stools. What to do? Perhaps there is no need to tempt fate by believing that this is just a mild intestinal upset due to the fact that the baby ate a little more fruit the day before or had a slight cold.

Therefore, if the child’s condition allows, go to see a doctor. Whereas if your baby has a high body temperature, frequent diarrhea and vomiting, call an ambulance immediately.