Rotavirus infection - Symptoms

Rotavirus infection has an incubation period, which ranges from 14-16 hours to 7 days (on average - 1-4 days).

Typical and atypical rotavirus infection are distinguished. Typical rotavirus infection, depending on the severity of the leading syndromes, is divided into mild, moderate and severe forms. Atypical forms include latent (clinical manifestations are weak and short-lived) and asymptomatic forms (complete absence of clinical manifestations, but rotavirus and specific immune response are detected in the laboratory). The diagnosis of virus carriage is established when rotavirus is detected in a healthy person who did not have changes in specific immunity over time during examination.

Rotavirus infection most often begins acutely, with an increase in body temperature, typical symptoms of rotavirus infection appear: intoxication, diarrhea and repeated vomiting, which allowed foreign researchers to characterize rotavirus infection as DFV syndrome (diarrhea, fever, vomiting). These symptoms are noted in 90% of patients; they occur almost simultaneously on the first day of illness, reaching maximum severity within 12-24 hours. In 10% of cases, vomiting and diarrhea appear on the 2nd-3rd day of illness.

It is also possible for the disease to begin gradually, with a slow increase in the severity of the process and the development of dehydration, which often leads to late hospitalization.

Vomiting is not only one of the first, but often the leading symptom of rotavirus infection. It usually precedes diarrhea or appears simultaneously with it, can be repeated (up to 2-6 times) or multiple (up to 10-12 times or more), and lasts for 1-3 days.

The increase in body temperature is moderate: from subfebrile to febrile values. The duration of fever fluctuates within 2-4 days, the following symptoms of rotavirus infection are observed: lethargy, weakness, loss of appetite, up to anorexia.

Intestinal dysfunction occurs mainly as gastroenteritis or enteritis, characterized by liquid, watery, foamy stools of yellow color without pathological impurities. The frequency of bowel movements often corresponds to the severity of the disease. With abundant liquid stool, dehydration may develop, usually of I-II degree. Only in isolated cases is severe dehydration with decompensated metabolic acidosis observed, with acute renal failure and hemodynamic disorders possible.

Abdominal pain may be observed from the very beginning of the disease. Most often, it is moderate, constant, localized in the upper half of the abdomen; in some cases, it is cramping and severe. When palpating the abdomen, pain is noted in the epigastric and umbilical regions, and a rough rumbling in the right iliac region. The liver and spleen are not enlarged. Signs of damage to the digestive organs persist for 3-6 days.

Some patients, mainly young children, develop catarrhal symptoms of rotavirus infection: coughing, runny nose or nasal congestion, rarely - conjunctivitis, catarrhal otitis. During examination, attention is drawn to hyperemia and granularity of the soft palate, palatine arches, and uvula.

The amount of urine in the acute period of the disease is reduced, in some patients there is slight proteinuria, leukocyturia, erythrocyturia, as well as an increase in the content of creatinine and urea in the blood serum. At the onset of the disease, leukocytosis with neutrophilia may be. During the peak period, it is replaced by leukopenia with lymphocytosis; ESR is unchanged. The coprocytogram is characterized by the absence of signs of a pronounced inflammatory process, while starch grains, undigested fiber, and neutral fat are detected. Most patients with rotavirus infection have a violation of the composition of the fecal microflora, primarily a decrease in the content of bifidobacteria, as well as an increase in the number of opportunistic microbial associations. Signs of lactase deficiency are detected, including acidic pH values of feces.

Symptoms of mild rotavirus infection:

• subfebrile body temperature:
• moderate intoxication for 1-2 days:
• infrequent vomiting;
• stools of liquid gruel up to 5-10 times a day.

Symptoms of moderate rotavirus infection:

• febrile fever:
• severe intoxication (weakness, lethargy, headache, pale skin):
• repeated vomiting within 1.5-2 days;
• copious watery stools from 10 to 20 times a day;
• dehydration of I-II degree.

Severe forms of rotavirus gastroenteritis are characterized by a rapid onset with increasing severity of the condition by the 2nd-4th day of illness due to significant fluid loss (dehydration grades II-III), repeated vomiting and countless watery stools (more than 20 times a day). Hemodynamic disturbances are possible.

Complications of rotavirus infection:

• circulatory disorders;
• acute cardiovascular failure;
• acute extrarenal renal failure;
• secondary disaccharidase deficiency:
• intestinal dysbacteriosis.

It is necessary to take into account the possibility of superimposition of secondary bacterial infection, which leads to changes in the clinical picture of the disease and requires correction of the therapeutic approach. Due to the possibility of complications in rotavirus gastroenteritis, high-risk groups of patients are identified, which include newborns, young children, the elderly, and patients with severe concomitant diseases. The symptoms of rotavirus infection in individuals with immunodeficiencies (for example, HIV-infected individuals), who may experience necrotic enterocolitis and hemorrhagic gastroenteritis, have not been sufficiently studied.

Fatal outcomes are more common in young children with severe immunological deficiency and malnutrition, as well as among elderly patients with severe concomitant pathology (such as atherosclerosis, chronic hepatitis), and in some cases with mixed infection.

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