Rotavirus is a common infection that happens all over the world, yet it remains a relatively unknown problem until the recent outbreak in Perak. Urban Health gets an insight on this infection from Dr. Zulkifli Ismail, a consultant paediatrician and paediatric cardiologist at KPJ Selangor Specialist Hospital:
WHAT IS ROTAVIRUS?
Dr Zulkifli: Rotavirus causes an intestinal viral infection, resulting in fever, vomiting and severe diarrhoea which leads to dehydration and hospitalization. In temperate areas, for example, China, Hong Kong and Taiwan, the peak season for rotavirus infection occurs from December to March. In tropical countries such as Malaysia, Thailand and Vietnam, there are no obvious seasonal peaks of rotavirus infection.
HOW COMMON IS IT?
Dr Zulkifli: Rotavirus infection is the leading cause of severe diarrhoea and vomiting in infants between six and 24 months worldwide. Infants are at the greatest risk. According to World Health Organisation estimates, by the age of five, nearly every child will have at least one episode of rotavirus diarrhea. It is believed to be among cause about 125 million episodes of gastroenteritis, resulting in about 440,000 deaths around the world- which is one child every minute. Before the recent outbreak happened, rotavirus was detected in about 50% of children below five years of age admitted to hospitals with diarrhea in Malaysia. Improvements in hygiene have no influence upon the incidence of the disease because it is highly infectious, through droplets in coughs and sneezes.
WHAT ARE THE SYMPTOMS?
Dr Zulkifli: Up to 96% of children will experience vomiting and severe diarrheoa of up to 10-20 bowel movements daily. Affected children will also have fever and abdominal pain for 3-9 days, but the diarrheoa can last up to 3 weeks. The main danger is that the child will develop gastroenteritis and et severely dehydrated from the vomiting and diarheoa. Rotavirus gastroenteritis can suddenly become very serious when children become dehydrated
HOW IS ROTAVIRUS TRANSMITTED?
Dr Zulkifli: Rotavirus is highly infectious and the predominant mode of transmission is the faecal-oral route. As the virus can survive in the environment for up to a week on hands and solid surfaces, transmission can occur through person-to-person contact, ingestion of contaminated water or food and contact with contaminated surfaces, such as toys. In human faeces, te virus remains stable and infective for up to one week.
WHAT ARE THE TREATMENT OPTIONS?
Dr Zulkifli: There is no specific treatment available for rotavirus. There are only measures to relieve the symptoms caused by rotavirus such as oral or intravenous fluids and fever management.
WHAT IS THE ECONOMIC BURDEN OF ROTAVIRUS INFECTION?
Dr Zulkifli: The primary burden of rotavirus infection is on child health (mortality and morbidity). Direct costs include medical costs resulting from hospitalisation, outpatient visits, personnel, facilities, diagnostics and medication. Indirect costs include those incurred to society and households as a result of lost work time when parents are forced to be absence from work to care for sick children.
HOW CAN WE PREVENT ROTAVIRUS INFECTION?
Dr Zulkifli: Improved general hygiene and sanitation standards have been known to be ineffective in reducing the incidence of rotavirus infections because of the highly infectious nature of the disease. The rotavirus vaccine would offer the best protection for the baby and the community against rotavirus infections, providing up to 90% efficacy in protecting infants against severe rotavirus gastroenteritis. The vaccine is usually done at the age of one month and is recommended for all children under the age of five.