Rotavirus infection

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

ICD-10 code

A08.0. Rotavirus enteritis.

Epidemiology

Epidemiology of rotavirus infection

The main source and reservoir of rotavirus infection is a sick person, releasing a significant amount of viral particles with feces (up to 10 ¹⁰ CFU per 1 g) at the end of the incubation period and in the early days of the disease. After the 4th-5th day of illness, the amount of the virus in the bowel movement is significantly reduced, but the total duration of rotavirus release is 2-3 weeks. Viral particles are permanently isolated from patients with impaired immunological reactivity, with chronic concomitant pathology, lactase deficiency. The source of infection can also be healthy virus carriers (children from organized collectives and hospitals, adults: first of all, medical personnel of maternity hospitals, somatic and infectious departments), from the feces of which rotavirus can be isolated for several months.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]

Causes of the rotavirus infection

What causes rotavirus infection?

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

Pathogenesis

The pathogenesis of rotavirus infection

Rotavirus infection has a complex pathogenesis. On the one hand, the structural (VP3, VP4, VP6, VP7) and nonstructural (NSP1, NSP2, NSP3, NSP4, NSP5) proteins of the virus attach great importance to the development of rotavirus gastroenteritis . In particular, NSP4-peptide is an enterotoxin that causes secretory diarrhea, similar to bacterial toxins; NSP3 affects the replication of the virus, 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 found in the epithelium of the duodenal mucosa and the upper parts of the jejunum, where it multiplies and accumulates. Penetration of rotavirus into the cell is a multi-stage process. For introduction into the cell, some rotovirus serotypes need specific receptors containing sialic acid.

Symptoms of the rotavirus infection

Symptoms of rotavirus infection

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

There is a typical and atypical rotavirus infection. A typical rotavirus infection, depending on the severity of the leading syndromes, is divided into mild, moderate and severe forms. To atypical refers to the erased (clinical manifestations are weak and short-term) and asymptomatic forms (complete absence of clinical manifestations, but laboratory detect rotavirus and specific immune response). The diagnosis of virus carrying is determined by the detection of rotavirus in a healthy person who did not have any specific changes in dynamics during the examination.

Diagnostics of the rotavirus infection

Diagnosis of rotavirus infection

In practice, the diagnosis of rotavirus infection is most often based on the detection of viral antigen in coprofiltrates using RLA, ELISA in the 1-4 days of the disease.

[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27]

Treatment of the rotavirus infection

Treatment of rotavirus infection

Hospitalization is subject to patients with moderate and severe forms of rotavirus infection, as well as patients with high epidemiological risk (decreed contingents).

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

From the diet exclude milk and dairy products, restrict the consumption of carbohydrates (vegetables, fruits and juices, legumes). Food should be physiologically complete, mechanically and chemically sparing, with sufficient protein, fat, mineral salts and vitamins. It is necessary to increase the multiplicity of meals. Vaccination against rotavirus infection is also carried out .

Forecast

What is the prognosis of rotavirus infection?

Rotavirus infection usually has a favorable prognosis. The patients are discharged with a full clinical recovery, occurring in most cases by the 5-7th day from the onset of the disease.