They are highly contagious and extremely viable – they survive up to four hours on hands and up to 10 days on objects. Only 10 virus particles are enough for infection! About how to protect a child from the attack of cunning microbes, we ask the pediatrician Dr. Piotr Hartmann.
Doctor, who is most at risk of rotavirus infection?
Dr. Piotr Hartmann: Small children, especially those in nurseries and kindergartens. Rotaviruses are very contagious – all you need to do is contact a sick or virus-transmitting peer or put a dirty toy or hand in your mouth and the disease is ready. The infection can occur even during contact with a toy that was played by a sick child several hours earlier.
The smaller the child, the more serious the infection is?
Yes, newborns and infants are harder to treat. It is easier to work with an older child, so firstly we can explain to him how important hygiene is, and secondly, in the event of an infection, it is easier for the older child to hydrate. And most importantly, we are able to notice signs of dehydration much faster, i.e. to catch the moment when the patient requires a visit to the doctor or hospitalization. In babies who are breastfed or bottle-fed, it is usually much more difficult for the parent to judge.
Many parents do not vaccinate their children, thinking that taking care of hygiene is sufficient protection …
Taking care of hygiene, including frequent hand washing (before meals, after using the toilet, after contact with the patient’s toys) is certainly a very important element of prevention. We must remember that no vaccination protects us 100%. against rotavirus infection.
In our country, the main role of vaccinations is to prevent a severe course of infection, and thus the need for hospitalization and possible complications of infection. In other words, vaccination against rotavirus does not guarantee that a child will not get sick at all, but protects against severe rotavirus diarrhea and hospitalization.
And can breastfeeding stop rotaviruses?
Breastfeeding mothers reduce the chance of infection because there is less risk of transmission. By preparing formula milk in a bottle without observing the rules of hygiene, we can infect a child, especially if there are other children in the family who are ill and, for example, by trying milk from a bottle of a younger brother or sister, they can transmit the virus. In this context, breastfeeding has a certain protective effect, but it is not so that breastfed babies do not get sick and do not end up in hospitals, and artificially fed babies do.
How can we tell if rotavirus has attacked our baby?
The main symptoms of infection are vomiting, often violent and acute watery diarrhea that lasts for several or even several days. The fever does not always occur, but when it does occur it is often very high.
The most serious effect of an infection is dehydration, what signals should we be concerned about?
If our child does not drink or urinate for many hours, stops eating, has a very high fever, is lethargic, sleepy and does not feel like any activity, then we should definitely worry. In toddlers, an alarm signal that parents can easily see is a dry diaper for several hours.
What complications may be a consequence of severe dehydration?
Fortunately, due to access to medical care in our country, unlike in developing countries, children do not die from rotavirus diarrhea. The first complication is that the child has to go to the hospital. Needing a venipuncture, intravenous irrigation, and a stay in a hospital bed are very uncomfortable and not a pleasant experience. When it comes to health complications, there are gastrointestinal disorders, intussusception, i.e. a pathological condition in which part of one section of the intestine slides into another, and in rare cases, the need for surgical intervention.
In children who are prone to febrile seizures, rotavirus infection with a very high fever may be a trigger for seizures. In addition, a child with a history of rotavirus infection more easily acquires further infections – after such a long diarrhea, infection of the perineum, vulva or urinary tract infection may occur. The very treatment of irritation around the buttocks, especially in infants, may take several weeks.
Suppose the black dehydration scenario does not take place. Can we treat a child at home, or is it worth consulting a doctor anyway?
It all depends on the age of our child. If it is an infant and vomiting and diarrhea are severe, it is always worth consulting a doctor. Maybe not right away, but after the first two or three hours of the onset of symptoms of infection. Sometimes parents seek medical advice after a few loose stools, which is not always a good solution …
Dlaczego?
Because they will go to a place where sick children are. And unfortunately, a child who has not yet been very ill, after a few hours’ stay in the emergency room or in the hospital emergency department, is already a child who is stuck with other infections.
And an infected one becomes infected with another. The parents can cope with the infection in older children – such children, in most cases, as long as they are able to hydrate the child. There is then no need to see a doctor, who cannot always offer more than what caregivers are aware of how to deal with rotavirus infection.
How long should a toddler stay at home?
This is a very difficult question – because rotavirus has been taking out quite a long time. There have been various studies on this, and some studies indicate the shedding period is two weeks, others say six. Of course, the question arises: is it still the same rotavirus or is it possible that the child has encountered another rotavirus that did not necessarily cause symptoms, but is excreted.
Certainly, the child who has finished the symptoms keeps shedding rotavirus and may be contagious. For this reason, she should not come into contact with other children. This also works the other way around – a child with rotavirus infection, as after any other disease, is more likely to suffer from other infections, not just the gastrointestinal tract. Personally, I recommend that parents do not go to a nursery or kindergarten for at least a week after the symptoms have ceased.
Does your practice show that parents do not vaccinate their children due to a financial barrier, or maybe the problem is low awareness of rotaviruses?
Looking through the children’s health books, I have the impression that since pneumococcal vaccination was included in the free vaccination program, parents actually decide to vaccinate against rotavirus more often. Perhaps in a situation where they do not have to pay for one vaccination, they can afford another. The vaccination itself is not painful – it is administered orally, which is very pleasant for the child.
As for the lack of awareness, this applies especially to young parents who, having no other children, associate rotavirus infection with mild diarrhea. By the time they learn that an infection may lead to dehydration and hospitalization, it is usually too late. This is the main problem – preventive vaccinations are best done in the first 16 weeks of a child’s life (i.e. the first vaccine should be administered at the age of 12 weeks at the latest). So we have little time and it is worth thinking about it during the first vaccination visit (i.e. in the 6th week of life).