Rotavirus disease

Rotavirus disease is an acute viral disease with a predominant incidence of children; Characterized by symptoms of general intoxication, gastrointestinal tract damage, dehydration. Determines about half of all intestinal disorders in children of the first 2 years of life.

Etiology, pathogenesis. The causative agent is rotavirus; Are divided into two antigenic variants; Resistant to the external environment. The person is infected by an alimentary route. Reproduction and accumulation of rotavirus occurs mainly in the upper parts of the gastrointestinal tract. Characterized by large losses of fluid and electrolytes, which leads to dehydration of I-III degree. After the transferred disease, immunity develops.

Symptoms, course. The incubation period lasts from 15 hours to 7 days (usually 1-2 days). The disease begins acutely. The detailed picture of the disease is formed after 12-24 hours from the onset of the disease. In children, severe fever usually does not happen. Characteristic abundant liquid watery stools without any admixture of mucus and blood. The more severe course is usually due to the stratification of the secondary infection. Vomiting is noted in half of the patients. In adults, the pain in the epigastric region, vomiting, and diarrhea appear against the background of moderate intoxication and subfebrile temperature. Only in some patients vomiting is repeated on the 2-3rd day of the disease. All patients have a copious, watery stool with a pungent odor; Sometimes unclear-whitish excrements may resemble feces of a cholera patient. Characterized by a loud rumbling in the abdomen. Desires for defecation of an imperative nature, there are no false desires. In some patients, mucus and blood are found in feces, which always indicates a combination of rotavirus disease with bacterial infection (shigellosis, escherichiosis). In these patients, fever and intoxication are more pronounced. With an abundant fluid stool, dehydration may develop; 95-97% of patients have dehydration usually 1 or 2 degrees, children sometimes experience severe dehydration with decompensated metabolic acidosis. In these cases, acute renal failure and hemodynamic disorders are possible.

With palpation of the abdomen, tenderness is observed in the epigastric and umbilical regions, rough rumbling in the right ileal region. The liver and spleen are not enlarged. With sigmoidoscopy, most patients have no changes. The amount of urine in the acute period of the disease is reduced, in some patients, there are albuminuria, white blood cells and erythrocytes in the urine; The content of residual nitrogen in the blood serum increases. At the beginning of the disease, there may be leukocytosis, which in the peak period is replaced by leukopenia;

ESR is not changed.

Diagnosis. When recognizing, clinical symptoms and epidemiological prerequisites are taken into account. The diagnosis is confirmed by the detection of rotavirus in feces by various methods (electron microscopy, immunofluorescence method, etc.). Less important are serological studies (DSC, etc.). Differentiate from cholera, dysentery, escherichiosis, intestinal yersiniosis.

Treatment. The basis is the pathogenetic methods of therapy, especially the restoration of fluid and electrolyte losses. When dehydrating I-II degree solutions are given orally. On the recommendation of WHO, use the following solution; Sodium chloride 3.5 g, sodium hydrogencarbonate 2.5 g, potassium chloride 1.5 g, glucose 20 g / l. The solution is given in small doses every 5-10 minutes. In addition to the solution, other fluids are recommended (tea, mors, mineral water).

The prognosis is favorable.

Prevention. Patients are isolated for 10-15 days. In mild forms, patients can stay at home under the supervision of a doctor if treatment and sufficient isolation are provided. Carry out the current and final disinfection. Specific prophylaxis is not developed.