When rotavirus infects a child, caution is needed

Crying without tears is one of the signs of dehydration, which is a serious complication of rotavirus infection. — Positive Parenting

Diarrhoea is a typical illness that many of us have probably experienced.

In children, one of the most common causes of severe diarrhoea is rotavirus.

By the age of five, your child would have been infected at least once, and it may happen again. But you can prevent this from occurring.

In 2013, the World Health Organization (WHO) estimated that about 215,000 children under the age of five die from rotavirus infection.

In Malaysia, rotavirus infections cause more than 8,500 hospitalisations a year.

Adults are also affected by rotavirus, but they have milder symptoms.

Symptoms usually start within two days after a child has been exposed to the virus.

The infection typically causes diarrhoea that lasts for three to eight days.

Other symptoms include vomiting, fever, abdominal pain and tiredness/lethargy.

Rotavirus is shed in the stool of infected people. Being a highly contagious virus, It can then spread easily through hand-to-mouth contact.

The virus can survive on human hands for about four hours, hard and dry surfaces for about 10 days and wet areas for weeks.

It remains infectious for a week, so any contact with surfaces or objects, and ingestion of water or food, which is contaminated within this period can also lead to infection.

For example, a child with rotavirus can spread the virus onto objects he touches after using the toilet.

Parents may also spread the virus after helping the infected child use the toilet or after changing diapers.

Another person can get infected if she touches the contaminated objects or surfaces (e.g. clothes, bedding, toys, utensils, door handles and stationery), and then touches her mouth.

The biggest concern of a rotavirus infection is dehydration due to severe diarrhoea and vomiting, coupled with poor oral intake.

Dehydration, or loss of body fluids, can be life-threatening, especially to infants, young children, older adults and people with other serious illnesses.

Plus children may not feel like eating or drinking due to their symptoms and babies are not able to express themselves to notify parents or caretakers about the condition of their body.

Beware the following symptoms of dehydration:

  • Little urination or dry diapers
  • Crying with no tears
  • Dry mouth and throat
  • Anxiousness
  • Dizziness
  • Extreme sleepiness
  • Sunken eyes

Management and prevention

Take your child to see a doctor if he has diarrhoea and vomiting, and/or signs of dehydration. Do not assume the symptoms are a general illness.

There is no specific medicine to treat rotavirus infection, but certain medications may be prescribed to alleviate the symptoms.

Antibiotics are not effective against this viral infection.

Preventing dehydration is the main focus of treatment.

Give your child plenty of fluids from drinks or foods.

Plain water or oral rehydration solutions are the best options for older children.

You can continue feeding your baby with breast milk or formula as usual.

Oral rehydration solutions may also be recommended for babies.

However, avoid carbonated drinks, apple juice, dairy products (except yoghurt) and sugary foods, as these may worsen the diarrhoea.

Practising good hygiene is the most basic method of preventing infections.

Frequent and thorough handwashing is crucial, especially after using the toilet, changing your child’s diaper or helping her use the toilet.

Surfaces in your home should also be disinfected regularly.

Alcohol-based disinfectants and anti-bacterial cleaning products may not be sufficient to kill the rotavirus.

A bleach solution (one part bleach to nine parts water) can be mixed instead to wipe all possible surfaces at home and in vehicles.

Rotavirus vaccines are also highly recommended as a preventive measure.

The first dose can be administered orally as early as six weeks after birth, with a total of two to three doses depending on the vaccine type.

WHO recommends the use of rotavirus vaccines as part of a comprehensive strategy to control diarrhoeal diseases, together with other prevention and treatment efforts.

The Malaysian Paediatric Association has been pushing for the inclusion of the rotavirus vaccine in the national immunisation programme (NIP) to follow WHO’s recommendation since 2017.

More than 80 countries have introduced the vaccine in their NIP, and hopefully, Malaysia will follow suit.

Until then, parents can get the vaccine from private general practitioners (GPs) and paediatricians.

Rotavirus infection is common, but it does not mean that parents should take it lightly.

Proper care and attention are still necessary to prevent further complications, including death, and transmission.

Datuk Dr Zulkifli Ismail is a consultant paediatrician and paediatric cardiologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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