Rotavirus is a highly contagious agent that causes viral gastroenteritis, an infection that leads to inflammation of the stomach and intestines. It causes severe episodes of diarrhea and vomiting, particularly in infants and young children. The typical duration of the illness, from the onset of symptoms to resolution, spans about three to eight days.
The Clinical Course and Duration of Rotavirus
A rotavirus infection begins with a short incubation period, the time between exposure to the virus and the first appearance of symptoms. This period is usually brief, lasting only one to three days. During this time, the virus replicates rapidly within the small intestine, but the patient remains symptom-free.
The acute phase of the illness, marked by the most severe symptoms, typically lasts for three to seven days. This phase is dominated by vomiting, which often begins first, followed shortly by watery diarrhea. While vomiting may lessen after the first day or two, the diarrhea persists for the longest duration of the illness.
The overall duration of the illness varies depending on factors like the age and health of the person infected. First-time infections in young, unvaccinated children are often the most severe and may last toward the longer end of the eight-day range. Older children and adults who have been vaccinated or previously exposed often experience much milder, shorter illnesses, sometimes lasting only a few days.
Recognizing Rotavirus Symptoms and Severity
The primary symptoms of a rotavirus infection include a sudden onset of fever, vomiting, and severe, watery diarrhea. Fever and vomiting are frequently the initial signs but usually subside within the first two days. The characteristic watery diarrhea, which is often non-bloody, can be intense and persist for up to a week.
The greatest concern with rotavirus is the potential for rapid fluid loss, which can quickly lead to dehydration, especially in small children. Signs of this complication include decreased urination (fewer than four wet diapers in 24 hours for an infant). Other indicators are crying with few or no tears, a dry mouth and throat, and unusual fussiness or sleepiness.
In severe cases, dehydration manifests as a sunken appearance in the eyes or the soft spot on an infant’s head. Recognizing these physical manifestations is important, as dehydration is the main reason children require hospitalization. A loss of appetite and abdominal discomfort may also accompany the gastrointestinal symptoms.
Transmission and How Long Rotavirus Is Contagious
Rotavirus spreads easily from person to person primarily through the fecal-oral route. This occurs when microscopic particles of stool from an infected person are ingested by another, often through contaminated hands, objects, or surfaces. The virus is stable and can survive on hard surfaces for extended periods, contributing to its high communicability.
An infected person begins shedding the virus in their stool, making them contagious, up to two days before any symptoms like diarrhea or vomiting start. Contagiousness continues throughout the period of active illness, which is when the highest amount of virus is shed. Viral shedding often extends for several days after symptoms have completely resolved, with the virus sometimes remaining detectable in stool for up to 10 days post-resolution.
For most people, the infectious period is less than one week after the diarrhea stops, but individuals with compromised immune systems can excrete the virus for months. Because the virus is shed before symptoms appear and afterward, strict handwashing and hygiene protocols are necessary to limit transmission.
Managing Symptoms and When to Seek Medical Care
Since rotavirus is a viral infection, there is no specific medication to cure the illness; treatment focuses entirely on supportive care. The most important management strategy is preventing dehydration through consistent fluid replacement. Oral rehydration solutions (ORS) are formulated to replace lost water and electrolytes efficiently and are the preferred method of supportive care.
Patients should avoid sugary drinks like juice or soda, which can worsen diarrhea due to their high sugar content. Small, frequent amounts of fluid are better tolerated, especially if vomiting is present. Returning to a normal, age-appropriate diet, including solid foods, as soon as possible aids in intestinal healing.
Medical consultation is necessary if signs of moderate to severe dehydration are present, such as lethargy, dizziness, or significantly reduced urination. Immediate medical attention is needed if a child cannot keep fluids down due to persistent vomiting, or if the diarrhea contains blood or is accompanied by a fever above 102 degrees Fahrenheit. If symptoms do not begin to improve within five to seven days, professional medical advice should be sought.