Rotavirus
What is rotavirus?
Rotavirus is a virus that causes diarrheal illness. It is most common in infants and young children, and can be severe in these populations. Older children and adults can also become infected, but illness is usually not as severe as in younger children. Symptoms usually last three to eight days. There are two rotavirus vaccines available in the United States (RotaTeq and Rotarix), which have been shown to be safe and effective at preventing severe illness. Vaccinated and unvaccinated people may develop rotavirus infection more than once because there are many different types of rotavirus. Usually a person’s first infection with rotavirus causes the most severe symptoms. Rotavirus infection can occur any time of the year but is more likely to occur in the winter and spring months.
Signs and symptoms
- Watery, non-bloody diarrhea (can be severe)
- Abdominal pain/cramps
- Loss of appetite
- Nausea
- Vomiting
- Fever
- Dehydration
Incubation period
Ranges from1-3 days
Contagious period and spread
- People ill with rotavirus shed the virus in their feces (stool). The virus is easily spread (especially among young children) by the fecal→oral route, meaning that the virus is shed by people with infection in their feces and then enters susceptible people's mouths (by contaminated hands, toys, surfaces, food, water, etc.) to cause infection.
- The infection can be spread to others as long as the virus is in the feces, which can occur before symptoms appear and up to 21 days after a person becomes ill. People are most contagious while having diarrhea and during the first three days after they recover.
Public health reporting requirements
- Report all cases of watery diarrhea to the facility director, school nurse, or child care health consultant.
- Individual cases of rotavirus are not reportable to public health.
- Suspected outbreaks of all types (including rotavirus and other diarrheal illness) are reportable to state or local public health within four hours. Generally speaking, it is considered an outbreak if there is an increase in the number of ill children and/or staff members at the school or child care.
Control of spread
- Encourage and teach the importance of frequent handwashing, especially after using the toilet, changing diapers, before eating, and before food preparation. Sample signs showing when and how to wash hands are included on the department’s child care health regulations webpage under “Preventing illness” and in the hand hygiene section of website section. Post them or similar signs throughout the school or child care center to remind people to wash their hands.
- Promptly sanitize contaminated surfaces (like diaper-changing areas) and other commonly touched surfaces (like toys), and discard food or water if it is thought to be contaminated. See Disease Prevention: The Facility Environment.
- Encourage routine rotavirus vaccination in infants.
- Consult with local or state public health for help with implementation of control measures.
Vaccination
Routine child recommendations:
The first dose of rotavirus vaccine should be given before a child is 15 weeks of age. The series should never be initiated after age 15 weeks, 0 days. Children should receive all doses of rotavirus vaccine before they turn 8 months old.
Colorado school-required vaccines:
- There is no requirement for rotavirus vaccine.
- Adult/adolescent/other recommendations:
- The rotavirus vaccine is not recommended for individuals over the age of 8 months.
Treatment
There is no treatment for this infection. Because rotavirus is caused by a virus, antibiotics will not help. People with infection should drink plenty of fluids to prevent dehydration. Oral rehydration fluids (like Pedialyte and similar fluids) should be used if possible.
Exclusion
- Exclude all infected children and staff, including food preparation staff, until at least 24 hours after diarrhea symptoms have resolved, without the use of anti-diarrheal medications. Exclusion may be extended during outbreaks.
- Children should not transfer to other schools or facilities during the exclusion period.
Role of teachers, caregivers, and family
- Encourage routine vaccination according to current immunization recommendations.
- Practice good handwashing, especially after changing diapers, going to the bathroom or helping a child go to the bathroom, or handling food.
- Diapering, bathroom, and food preparation areas should be cleaned and disinfected frequently.
- Ensure proper cooking and storage of food.