Saturday 17 May 2014

Rotavirus Gastroenteritis – A mothers nightmare

Wanjiku considered herself one of the lucky mothers because when her baby Wayne was born her younger sister Linda had finished form 4 and since she was not immediately reporting to college, she offered to stay with her and help with the baby. She never had to worry about how the baby would be fed, cleanliness and comfort since Linda handled this very well. This was however to change when Linda was called to college.
For some reason every house girl she received required a lot of training on basic issues like hand washing, appropriate handling of the baby’s food and literally everything around the house not to mention that the baby also had to adjust to the new girls. None of them seemed to measure up to Linda and it was getting really frustrating. So when a neighbour offered to babysit Wayne for a few days it was a big relief. This was after her fourth girl decided to leave without notice and Wanjiku could unfortunately not get permission to stay away from work.
For a few days things seemed to settle but after 3 days the neighbour informed her that Wayne had refused to eat his food and was running a mild fever. That night Wanjiku did not sleep, Wayne vomited everything he was fed and had so many loose motions. By the next morning when Wanjiku was taking the child to hospital he was immediately admitted and started on fluids. The doctors informed her that her child was severely dehydrated and if she had wasted any more time at home, she might have lost her baby. Further investigations revealed that Wayne had a rotavirus infection, which was shocking to Wanjiku as she had never heard about it. When Wanjiku called her neighbour to brief her on what was happening, the neighbour confessed that her child had also suffered the diarrhoea but it had not been severe and it was resolved quickly.

What is Rotavirus Gastroenteritis?
Rotavirus Gastroenteritis is an infection that is caused by a virus called Rotavirus. It is one of the commonest causes of diarrhoea in children and infants and tends to occur between 4 months and 2 years of age, but still affects children up to 5 years of age. During the course of the infection the child may additionally experience fever and vomiting.

The virus easily spreads from an infected person to another person through contact.
The virus is usually present in the stool of the infected child so when handling the stool of an infected child e.g. when changing their diapers, the virus may contaminate the hands of the caregiver who in turn passes the virus onto any surfaces they touch if they do not clean their hands well.
If the child is able to use a toilet or potty the surfaces may be contaminated or the child may contaminate their hands in the process. If they don’t wash their hands well with soap and water then the virus will be spread to any surfaces they touch.
When another child touches the infected surfaces or items and puts their hands in the mouth or eats foods, they get the virus into their bodies and subsequently get the infection.
The reason why the virus spreads so easily is because it can live for long on surfaces if it’s not disinfected immediately.

How to minimize transmission
  • Hands should always be washed thoroughly with soap and water after nappy or diaper change.
  • If the child is able to use the toilet or potty their hands should also be thoroughly cleaned with soap and water.
  • When a child has an infection, toilet seats and potties should be thoroughly cleaned with soap and water and a disinfectant if available, after every use.
  • Soiled nappies and diaper should not be left on the bed or other surfaces and should be discarded or washed immediately.
  • Toys, doorknobs, sinks, tables and any other surfaces at risk of contamination should be cleaned regularly with soap and water.

Symptoms of rotavirus
The symptoms of the infection may appear after about 48 to 72 hours of contact with the virus. Among the main symptoms are:
  • Vomiting    
  • Fever    
  • Large bouts of foul smelling watery diarrhoea
  • Abdominal cramps    
The diarrhoea may last between 3 and 8 days and the severity may vary depending on the child.
In certain instances when the diarrhoea and vomiting are severe and the child is unable to keep any food or drink in the stomach, the child may become dehydrated i.e a situation where the child has lost too much water from the body. This can be life threatening and requires immediate medical attention.

How would you know that your child is getting dehydrated?
  • When the child vomits every food or drink they take and is unable to retain anything.    
  • If your child has many large watery diarrhoeas.    

How would you know that your child is dehydrated?
  • If the child does not passing any urine for a period of six hours.    
  • If your child is crying and no tears are running down their eyes. The eyes may be sunken in severe cases.   
  • If the child’s mouth and tongue appear dry.    
  • If your child appears very weak and lethargic or very irritable.    
  • If the child’s hands and feet become cold.
  • If your child sleeps for too long and struggles to wake up during the course of the illness.

These symptoms require immediate medical attention and if you suspect that your child is getting dehydrated you should immediately take the child to the hospital.

How is rotavirus diagnosed in hospital?
A small sample of your child’s stool is collected and sends to the laboratory for analysis, which reveals the presence of the rotavirus in the stool.
How is rotavirus treated?
Because this is a viral infection there is no specific drug treatment for the virus.
Antibiotics and antidiarrhoeal drugs that may be used to treat other forms of diarrhoea have no role in the management of children with rotavirus.
The goal of treatment is to ensure that the child does not get dehydrated.

While at home:
  • Encourage the child to drink as much fluid as possible so as to replace what they is losing in the diarrhoea.
  • If the child is vomiting, give small amounts of fluid regularly to encourage it to stay down.
  • If the child is breastfed, encourage them to breastfeed more to compensate dehydration.  
  • Change your child’s diaper or nappies immediately after they get soiled and keep the child comfortable.
  • If your child develops a nappy rash because of the frequent diaper changes, you can apply a nappy rash cream to soothe and heal the sore buttocks.
  • Use cotton wool and warm water to clean the baby to minimize irritation.

In hospital:
The management of your child will depend on the severity of the illness and the degree of dehydration. Your doctor/nurse will prescribe treatment depending on their assessment.
  • If your child is mildly dehydrated, your nurse or doctor will advise you on the quantity of appropriate rehydration fluid to give your child.
  • You will be advised to encourage your child to drink the rehydration fluid as tolerated.    
  • If the child is unable to drink you may be advised to give the fluid with a cup and spoon.
  • If the dehydration is severe your doctor might advise that your child be admitted and started on a drip. This is a fluid containing different salts that is infused into your child’s body through the vein.
  • In other cases your doctor might recommend that a tube called a nasogastric tube is put through your child’s nose and goes directly into the stomach. This tube is used to give your child the rehydration fluid when they are completely unable to drink.    
  • If your child has a fever the doctor might prescribe a drug to control the fever.
During this time if the child is breastfed they should continue breastfeeding as normal.
If the child eats encourage them to eat small quantities of food as tolerated and resume to normal feeds as soon as it is possible.
Parents are discouraged from giving fizzy drinks like sodas and citrus fruit juices because these can irritate the stomach and worsen the abdominal pain normally experienced.

How to prevent rotavirus.
  • It may not be completely possible to prevent rotavirus however vaccines have been produced and are given to children from the age of 2 months.   
  • The vaccine may not stop a child from acquiring the infection but it is said that vaccinated children get a less severe form of the infection.

    Attribution: Avallain Ltd


  1. Informative piece! Back in the days, parents would say if a child diarrhoeas, it could be as a result of teething.

  2. Rotavirus is responsible for the deaths of an estimated
    600,000 children worldwide each year, 80 percent of whom
    live in developing countries!!! And yet, the control is within our reach. Sad. Thanks for this

  3. Wow! very informative indeed. This helps me as a young mother for early signs of rotavirus. Such symptoms may be taken for granted but prove severe if ignored. Thanks and keep up the good job iAfya.

  4. Being a young first time mother, this is going to be very helpful in particular on some of the ways the baby my get infected like during diaper change.Thanks!

  5. This is such a good article....all mums should read this and the rotavirus will cease to be a nightmare...With this it would be very easy to identify the symptoms and act accordingly.

    Keep up the good work.