Rotavirus infection

Rotavirus infection (rotavirus gastroenteritis) is an acute infectious disease caused by rotaviruses, characterized by symptoms of general intoxication and damage to the gastrointestinal tract with the development of gastroenteritis.

Epidemiology

The main source and reservoir of rotavirus infection is a sick person who excretes a significant amount of viral particles (up to 10 ¹⁰ CFU in 1 g) with feces at the end of the incubation period and in the first days of the disease. After the 4th-5th day of illness, the amount of virus in feces decreases significantly, but the total duration of rotavirus excretion is 2-3 weeks. Patients with impaired immunological reactivity, with chronic concomitant pathology, lactase deficiency excrete viral particles for a long time. The source of the infectious agent can also be healthy virus carriers (children from organized groups and hospitals, adults: first of all, medical personnel of maternity hospitals, somatic and infectious departments), from whose feces rotavirus can be isolated for several months.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ], [ 11 ]

Causes rotavirus infection

Rotavirus infection is caused by a member of the Reoviridae family, genus Rotavirus. The name is based on the morphological similarity of rotaviruses to a wheel (from the Latin "rota" - "wheel"). Under an electron microscope, viral particles look like wheels with a wide hub, short spokes and a clearly defined thin rim. The rotavirus virion, 65-75 nm in diameter, consists of an electron-dense center (core) and two peptide shells: an outer and inner capsid. The core, 38-40 nm in diameter, contains internal proteins and genetic material represented by double-stranded RNA. The genome of human and animal rotaviruses consists of 11 fragments, which probably determines the antigenic diversity of rotaviruses. Replication of rotaviruses in the human body occurs exclusively in the epithelial cells of the small intestine.

Pathogenesis

Rotavirus infection has a complex pathogenesis. On the one hand, structural (VP3, VP4, VP6, VP7) and non-structural (NSP1, NSP2, NSP3, NSP4, NSP5) proteins of the virus are of great importance in the development of rotavirus gastroenteritis. In particular, NSP4 peptide is an enterotoxin that causes secretory diarrhea, similar to bacterial toxins; NSP3 affects virus replication, and NSP1 can "prohibit" the production of interferon-regulating factor 3.

On the other hand, already in the first day of the disease, rotavirus is detected in the epithelium of the mucous membrane of the duodenum and the upper parts of the jejunum, where it multiplies and accumulates. Penetration of rotavirus into a cell is a multi-stage process. To penetrate into a cell, some serotypes of rotavirus require specific receptors containing sialic acid.

Symptoms rotavirus infection

Rotavirus infection has an incubation period that 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.

Diagnostics rotavirus infection

In practice, the diagnosis of rotavirus infection is most often based on the detection of viral antigen in coprofiltrates using RLA and ELISA on the 1st to 4th day of illness.

[ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ], [ 17 ], [ 18 ]

Treatment rotavirus infection

Patients with moderate and severe forms of rotavirus infection, as well as patients who pose a high epidemiological risk (decreeed contingents), are subject to hospitalization.

Complex treatment of rotavirus infection includes therapeutic nutrition, etiotropic, pathogenetic and symptomatic therapy.

Milk and dairy products are excluded from the diet, and carbohydrate consumption is limited (vegetables, fruits and juices, legumes). Food should be physiologically complete, mechanically and chemically gentle, with sufficient protein, fat, mineral salts and vitamins. It is necessary to increase the frequency of meals. Vaccination against rotavirus infection is also carried out.

Forecast

Rotavirus infection usually has a favorable prognosis. Those who have recovered are discharged upon complete clinical recovery, which occurs in most cases by the 5th-7th day from the onset of the disease.