Rotavirus Gastroenteritis

Rotavirus is a non-enveloped, double-stranded RNA virus in the Reoviridae family. It spreads mainly by the faecal-oral route through direct contact, contaminated hands, surfaces, objects, and, less often, food or water. Its environmental stability allows transmission to continue on shared equipment and in childcare settings even when the original source is no longer apparent. The virus infects mature enterocytes near the tips of small-intestinal villi. Damage causes villous blunting and reduces the absorptive surface, so nutrients and fluid remain in the intestinal lumen. The viral protein NSP4 also acts as an enterotoxin, increasing intracellular calcium signalling and stimulating secretion. The resulting diarrhoea therefore has both a malabsorptive, or osmotic, component and a secretory component. The clinical pattern is usually abrupt: fever and vomiting appear after an incubation period commonly lasting 1 to 3 days, followed by profuse watery, non-bloody diarrhoea. Gastrointestinal symptoms generally settle within 3 to 7 days, although fluid losses can become dangerous much sooner. Infection may be asymptomatic, mild, or severe enough to cause hypovolaemic shock. The first infection after about 3 months of age is usually...