Immunisation against rotavirus
There is an effective vaccine against rotavirus. The vaccine has been used in many countries and has been shown to be safe and effective.
In the UK it has now been decided to routinely vaccinate babies against rotavirus. From July 2013 babies will receive drops (by mouth) to help prevent rotavirus. These drops will be given at 2 and 3 months old. The vaccines will be given at the same time as their other routine vaccinations.
UK vaccination programme
The oral vaccine is expected to halve the number of cases of vomiting and diarrhoea caused by rotavirus and lead to 70% fewer hospital stays.
The following sites will tell you more
Around 18,000 children are thought to be admitted to hospital each year in England and Wales because of rotavirus infection. Most children with rotavirus infection do not need admission to hospital. About 1 child in 10 who has rotavirus infection needs to be admitted to hospital.
Rotavirus is a viral infection that can cause gastroenteritis. Gastroenteritis is an infection of the gut (intestines) which usually causes symptoms of being sick (vomiting) and diarrhoea. In most cases the infection clears within a few days, but sometimes takes longer. The main risk is a lack of fluid in the body (dehydration) and so the main treatment is to give your child lots to drink. It mainly affects young children, especially children between the ages of 6 months and 2 years.
With vomiting and diarrhoea, there is a risk of your child becoming lacking in fluid in their body (dehydrated). You should consult a doctor quickly if you suspect that your child is becoming dehydrated. Mild dehydration is common and is usually easily and quickly treated by drinking lots of fluids. Severe dehydration can be fatal unless quickly treated because the organs of the body need a certain amount of fluid to work normally.
Symptoms of dehydration – associated with any cause of gastroenteritis
In children symptoms include passing little urine, a dry mouth, a dry tongue and lips, fewer tears when crying, sunken eyes, weakness, being irritable or having no energy.
Symptoms also include drowsiness, pale or mottled skin, cold hands or feet, very few wet nappies, and fast (but often shallow) breathing. This is a medical emergency and immediate medical attention.
Fluids to prevent dehydration
You should encourage your child to drink plenty. The aim is to prevent dehydration. The fluid lost in what they bring up (their vomit) and/or their diarrhoea needs to be replaced. Your child should continue with their normal diet and usual drinks. In addition, they should also be encouraged to drink extra fluids. However, avoid fruit juices or fizzy drinks, as these can make diarrhoea worse.
If your child is mildly dehydrated, this may be treated by giving them rehydration drinks. Your doctor or nurse will advise about how to make up the drinks and about how much to give. This can depend on the age and the weight of your child. If you are breast-feeding, you should continue with this during this time. Otherwise, don’t give your child any other drinks unless the doctor or nurse has said that this is OK. It is important that your child is rehydrated before they have any solid food.
Babies under 6 months old are at increased risk of dehydration. You should seek medical advice if they develop gastroenteritis. Breast or bottle feeds should be encouraged as normal. You may find that your baby’s demand for feeds increases. You may also be advised to give extra fluids (either water or rehydration drinks) in between feeds.
Rehydration drinks may be advised by a healthcare professional for children not drinking enough or with severe diarrhoea and vomiting; especially if they have passed six or more very loose stools (faeces) or vomited three or more times in the previous 24 hours. They are made from sachets available from pharmacies and on prescription. You should be given instructions about how much to give. Rehydration drinks provide a perfect balance of water, salts, and sugar. The small amount of sugar and salt helps water to be absorbed better from the gut (intestines) into the body. Do not use home-made salt/sugar drinks, as the quantity of salt and sugar has to be exact.
If your child vomits, wait 5-10 minutes and then start giving drinks again, but more slowly (for example, a spoonful every 2-3 minutes). Use of a syringe can help in younger children who may not be able to take sips.
Note: if you suspect that your child is dehydrated, or is becoming dehydrated, you should seek medical advice urgently.
Sometimes a child may need to be admitted to hospital for treatment if they are dehydrated. Treatment in hospital usually involves giving rehydration solution via a special tube called a nasogastric tube. This tube passes through your child’s nose, down their throat and directly into their stomach. An alternative treatment is with fluids given directly into a vein (intravenous fluids).
Eat as normally as possible once any dehydration has been treated
Correcting any dehydration is the first priority. However, if your child is not dehydrated (most cases), or once any dehydration has been corrected, then encourage your child to have their normal diet. Do not ‘starve’ a child with rotavirus infection. This used to be advised but is now known to be wrong.
Breast-fed babies should continue to be breast-fed if they will take it. This will usually be in addition to extra rehydration drinks (described above).
Bottle-fed babies should be fed with their normal full-strength feeds if they will take it. Again, this will usually be in addition to extra rehydration drinks (described above).
Older children – offer them some food every now and then. However, if he or she does not want to eat, that is fine. Drinks are the most important, and food can wait until the appetite returns.
Medication is not usually needed
You should not give medicines to stop diarrhoea to children under 12 years old. They are unsafe to give to children, due to possible serious complications. However, you can give paracetamol or ibuprofen to ease a high temperature (fever) or headache.
How is rotavirus spread?
Rotavirus is present in the gut (intestines) of an infected person and can pass out in their diarrhoea. It is easily spread from an infected person to another by close contact. This is often because the virus is on the infected person’s hands after they have been to the toilet. For smaller children who wear nappies, it may be spread by the hands of the person changing the infected child’s nappy. Surfaces or objects touched by the infected person can also allow the virus to spread. The virus can be passed on if the infected person prepares food. Outbreaks of rotavirus that affect many people can occur – for example, in nurseries or schools.
NB Although this is advise in a case of Rotavirus the same advice should be followed in all cases of gastroenteritis.