Chronic rotavirus infection. Rotavirus infection (Rotavirus, stomach flu). Do I need to drink Enterofuril or other antimicrobial agents

Company viral infection- one of the most common causes of diarrhea in adults and the most common in children under 5 years of age. We can say with confidence: before the start of schooling, every child had been ill with it. The main clinical symptoms of this infection are diarrhea, vomiting and fever. However, each one has its own characteristics. What are the signs of this disease, diagnosis and how to treat rotavirus? Is it possible to protect yourself from the causative agent of infection and how effective are preventive measures? Everything about rotavirus can be found in this MedAboutMe article.

Rotavirus in adults

Rotavirus in adults is a disease that is very common. It is difficult to estimate its true prevalence, because not every patient seeks help from a doctor. In adulthood, it often proceeds quite easily and many mistake it for ordinary food poisoning. Very rarely, rotavirus is life-threatening, but the risk groups include people with reduced immunity (after chemotherapy or radiation therapy, suffering from cancer, taking cytostatics, suffering from HIV infection).

Rotavirus in adult males presents predominantly with diarrhea, vomiting, and mild fever. It develops as a result of eating poorly processed foods and contaminated water, with non-compliance with personal hygiene measures. Most often, men are infected by their own children, who become infected in kindergarten or, less commonly, school. It is also possible to get sick with rotavirus as a result of being in the infectious diseases department of a hospital for a completely different disease.

Rotavirus in women

Rotavirus in adult women in its clinical course is no different from that in men. However, there are two particular vulnerable categories for whom this disease may be dangerous.

Rotavirus during pregnancy can pose a threat to the fetus and mother, but the degree of danger depends on the period at which the infection occurred.

At an early stage, a woman can completely confuse the onset of the disease with toxicosis, which torments most of all pregnant women. And only if diarrhea begins or the temperature rises, she begins to worry. The most optimal solution would be to call a doctor at home, because in the antenatal clinic, while waiting in line in the corridor, she can infect all the other ladies. Usually, serious problems from the fetus is not observed, no severe malformations rotavirus does not cause. However, severe dehydration can lead to threatened miscarriage with rotavirus or even early miscarriage.

In the second and third trimester of pregnancy, rotavirus cannot directly harm the child, the fetus protects the placental barrier and antibodies produced by the mother's immune system. However, severe dehydration, attempts to vomit can provoke premature birth, placental abruption and other completely undesirable phenomena.

Rotavirus while breastfeeding

Rotavirus during breastfeeding can develop in any woman, as the source of infection is often older children attending kindergarten. As a result of the fact that protective antibodies are produced in the mother's body, which are immediately transmitted to the baby with milk, he is partly protected from this disease. However, it is impossible to give a full guarantee, therefore, if a mother falls ill, she must observe all the necessary hygiene measures to reduce the risk of infection: infants in the first months are extremely sick with rotavirus, for them it is a mortal danger.

Rotavirus in children

Experts say: before the age of five, all children at least once suffered a rotavirus infection. This is the most common cause of diarrhea in babies: half of all young patients hospitalized for loose stools suffer from this condition. Rotavirus in children poses a real threat to life, especially in infants of the first year of life and severely weakened. The reason is that diarrhea and vomiting, especially if they are uncontrollable, lead to quick loss fluids (dehydration). If such a child does not restore the volume of circulating blood in time, then cardiovascular failure, leading to hypoxia of all organs and tissues (mainly the brain), and complications from the kidneys.

Statistics say that boys are 2 times more likely than girls to suffer from this disease. Rotavirus infection accounts for about 5% of all child deaths under the age of 5 years.

Rotavirus in kindergarten

Rotavirus in preschool children is a very common disease. Epidemics occur 1-3 times a year, mainly in the winter-spring period. The reason is that fecal-oral transmission is much more common in children than in adults due to poor handwashing and shared toys. As a rule, after the detection of at least one laboratory-confirmed case, quarantine is imposed on the group for up to 2 weeks. Although there is no particular need for this: after an illness, the child continues to secrete viral particles for up to six months, although at the same time he can be completely healthy.

1 gram of feces contains 10 trillion viral particles, and only 100 are enough for infection. For this reason, it is extremely difficult to protect yourself from this disease while in the foci of infection, especially in childhood.

Rotavirus is very common at sea. This is the most common intestinal infection of all that can lie in wait at the resorts. There are many reasons for such a total prevalence of rotavirus at sea. Among them are very comfortable for viral particles natural conditions and a special diet. Very often, people who come to rest, from the first days, begin to buy various fresh vegetables, fruits, berries, which may well contain infectious agents. If you do not subject them to thorough washing and heat treatment, then you can get sick with a high degree of probability.

Another rotavirus at sea occurs when people prefer to eat in various points public catering that do not comply with all the necessary standards of cleanliness and processing of food and utensils. Even those who choose the all-inclusive meal option do not leave the risk group: food workers in canteens and cafes often purchase everything in the same markets and retail outlets.

Rotavirus at sea can often knock down all family members, as a result, they will spend half the rest in the bathroom. Compliance with elementary hygiene standards and food in reputable restaurants and cafes reduces the risk of this infection, but does not eliminate it completely.

What is rotavirus infection

Rotavirus infection is the most common intestinal infection. It is safe to say that, at least once in a lifetime, everyone has been ill with it. However, this disease is not the same for everyone: for some it is just a slight discomfort in the abdomen, for another - several episodes of vomiting and loose stools, and for others - infusion therapy in a hospital due to severe dehydration. Rotavirus in children is the most common cause infectious diarrhea, and the smaller the baby, the great danger he represents for him.

Causes of rotavirus infection

Causes of rotavirus in adults and children are infectious agent belonging to the genus Rotavirus, family Reoviridae. Externally at microscopic examination they resemble a wheel, and this word is Latin sounds like "rota". This is where the disease got its name from.

In total, scientists have identified 9 varieties of this microorganism, of which 6 are dangerous, and the rest can cause diarrhea in various animals. The reason for such a high prevalence of rotavirus infection is the high resistance of the pathogen to various factors environment: it can be stored in soil and water for a month, is relatively resistant to the action of various antiseptics and disinfectant solutions. It is for this reason that signs of rotavirus may appear in a person who has not come into any contact with infected people, but the microorganism got into his digestive tract along with contaminated food or water.

Another reason for the total prevalence of this disease is that the source of infection can be a person with rotavirus in the incubation period and an asymptomatic virus shedder. A person who has been ill with this disease continues to actively secrete viral particles for the first 2-3 weeks, but this can last up to six months. The route of transmission of the infection is fecal-oral, that is, stool particles that are transferred with contaminated hands to food, household and cutlery, are a source of infection for a healthy person.

Rotavirus, the symptoms of which at least once were in any person, is the most common after respiratory viral ailments. Most people tolerate this disease quite easily and are sure that diarrhea and vomiting are the result of banal food poisoning.

Every year there are about 25 million cases of rotavirus in the world, the signs of which are found in all countries and on all continents. However, experts say that this figure is greatly underestimated, because most people do not seek help from a doctor, especially those who take it to mild degree or is an asymptomatic virus carrier. It is alarming that 2-3% of all cases of this disease end in death: rotavirus, vomiting and diarrhea, in which they can become indomitable, sometimes leading to severe dehydration. In most cases, this concerns young children, especially infants in the first year of life.

Rotavirus: symptoms of the disease

Rotavirus, the symptoms of which are familiar to almost everyone and absolutely anyone with young children, is the most common intestinal infection. However, none of them is pathognomonic, that is, specific only for this disease. Therefore, the symptoms of rotavirus only make it possible to suspect this disease; a laboratory test is necessary for reliable confirmation.

Rotavirus: incubation period

If a person has already started rotavirus, the incubation period can last from 1 to 5 days. During this time, the patient has no signs of illness, but he is already actually sick and can be dangerous to others.

In children who have already developed rotavirus, the incubation period may be as little as 1 day, after which the full clinical picture of the disease begins. In some cases, and with a high viral load, the asymptomatic interval is reduced to several hours, but this occurs in extremely weakened people suffering from immunodeficiency, infants in the first months of life.

Signs of rotavirus

Signs of rotavirus are quite characteristic, which allows the doctor, and the patient himself, to quickly suspect this disease. Moreover, every next 1-2 days, similar symptoms appear in all other family members in turn. However, none of the signs of rotavirus is pathognomonic, that is, specific only to this disease. They occur in a number of other intestinal infections, but for each of them there are different nuances and clinical features.

The disease usually develops rapidly and already on the second day of the disease reaches its peak. It is characterized by 3 main symptoms: vomiting, diarrhea and intoxication, manifested by fever, chills, aching muscles, joints, bones. The severity of the symptoms of rotavirus is determined by the volume of fluid loss, and to a greater extent not only water, but also the most important electrolytes (potassium, sodium, magnesium).

If the patient's diarrhea and vomiting are minor and he does not have a febrile fever, most likely he will not have a large volume of fluid loss and in order to recover, he will only need to follow all medical recommendations at home. But with indomitable vomiting, intense diarrhea, especially if we are talking In babies, dehydration can come on very quickly and be severe. In this case, the question of how to treat rotavirus will be decided by the treating doctor in the infectious diseases department of the hospital.

If a patient has started rotavirus, this is a symptom that, perhaps, develops very first. It happens not in 100% of patients, but in the vast majority. It usually does not last long, maximum the first and second day of illness. If a patient has rotavirus, vomiting at first has impurities of the food eaten the day before, but very quickly it becomes more and more transparent. After a few episodes, she takes the form plain water, and has a foamy character.

With rotavirus, vomiting brings only temporary relief, the feeling of nausea returns after a few minutes, a maximum of an hour, and then everything repeats again.

Rotavirus: diarrhea

If the patient has a rotavirus, diarrhea will be an indispensable symptom of this disease. While vomiting is not present in all patients, liquid stool is the main and main feature diseases, as it belongs to the group of intestinal infections.

In the case when rotavirus has developed, diarrhea does not occur immediately, but on the 3-4th day of illness. Usually it replaces vomiting and in most cases the high fever subsides. Diarrhea begins with a feeling of discomfort, bubbling in the abdomen, spasmodic pain, which is often mistaken for food poisoning. The first portions of the stool usually do not differ from the physiological, emptying brings temporary relief and abdominal pain are significantly reduced. However, after the first time, after a few minutes or hours, another follows, as a result, the frequency of stools on the 3-4th day of the disease reaches up to 30 times a day.

The cause of diarrhea in rotavirus is that the pathogen leads to the death of the villi of the small intestine. As a result, the process of water absorption is disrupted, which is aggravated by ingestion. carbohydrate products food and dairy products. Thus, a dairy-free diet is the main key to success in the treatment of rotavirus, while the villi of the small intestine gradually regenerate on their own without any special treatment.

Diarrhea in rotavirus is the main diagnostic criterion, besides, feces have a specific frothy appearance and a characteristic smell. Doctors and nurses only one type of feces in a pot of a child who has just entered the hospital can suspect this disease. Outwardly, it resembles a stool in cholera, but unlike this dangerous disease if the patient has started rotavirus, treatment usually leads to a favorable outcome, and in some cases, no special measures not required. Feces do not contain pathological impurities such as blood or mucus.

Fever with rotavirus is not a mandatory symptom. Some people don't have a fever at all. However, in most patients who have started rotavirus, the temperature rises to subfebrile numbers, less often to febrile. The fever usually lasts for a short time - a maximum of 3-4 days. As a rule, the severity of the disease correlates with the level of fever, that is, often with febrile fever, this disease occurs in debilitated people and young children.

If the patient has started rotavirus, the temperature should be lowered with conventional antipyretics (paracetamol, ibuprofen). Fever leads to additional fluid loss through sweat and rapid breathing, therefore increasing the risk of dehydration.

Other signs of rotavirus infection

In addition to the three main symptoms of rotavirus (fever, diarrhea and vomiting), there are additional ones. They are nonspecific, that is, they occur with a large number of other viral infections. However, in conjunction with the main ones, they allow the doctor to quickly suspect this disease and take timely measures to treat it.

If the patient has just started rotavirus, the incubation period may not be accompanied by any symptoms, and may be manifested by slight soreness in the throat when swallowing, sometimes there is slight weakness, aches. These same symptoms often occur against the background of a detailed picture of the disease, sometimes they are supplemented by a slight runny nose and cough. Respiratory symptoms develop in 60-70% of patients with this disease.

With severe dehydration as a result of massive fluid loss with vomiting, diarrhea and then the kidneys are the first to suffer. Attentive parents, and the infected themselves, notice that their amount of urine is significantly reduced. If during the day the patient had only 1-2 episodes of urination, or it was completely absent, this is a very serious and dangerous symptom. It is necessary to deliver the patient to the hospital as soon as possible, since irreversible complications from the kidneys are possible. Rotavirus in adults is much less likely to cause nephropathy than in children, because dehydration occurs faster in young patients. Parents must certainly count the amount of urine, although it can be difficult to distinguish it from liquid feces, especially in a small child.

AT clinical practice the question often arises of how to distinguish rotavirus from other intestinal infectious diseases and food poisoning. It is unequivocally difficult to answer it, because for this disease there is not a single pathognomonic (that is, reliable) symptom. However, there are some strong points that allow doctors to suspect this particular disease.

It is very easy to answer the question of how to distinguish rotavirus from food poisoning. When ingesting poor-quality food products, vomiting develops, as a rule, after 15-20 minutes. After complete emptying of the stomach, the patient becomes much easier and after resting for a day, he completely comes to his senses. Loose stools with food poisoning are not common, and there is no fever. It is the last point that allows you to unambiguously answer the question of how to distinguish rotavirus from nutritional errors.

The differentiation of this disease from other infectious intestinal diseases (enterovirus infection, salmonellosis, yersiniosis, etc.) is more difficult. All these diseases can occur with fever, vomiting and loose stools. However, each of them has its own characteristics and is well known to infectious disease doctors. And, nevertheless, unequivocally answer the question of how to distinguish rotavirus from other infections digestive tract, allows only laboratory diagnostics, which can unambiguously confirm or refute this diagnosis.

Features of the course of rotavirus in children

Rotavirus in children can pose a real danger to health and even life. Every twentieth child under the age of 5 dies from this disease, which seems harmless at first glance. Here are some features of this disease.

• Most often, infection occurs in places where children are in close contact with each other (kindergartens, schools, developmental activities), but often infection occurs at sea or at airports. It is difficult to get infected with them on the street when playing on playgrounds.
• Rotavirus occurs, as a rule, with a high fever.
• Dehydration develops very quickly, and the smaller the baby, the higher the likelihood of this complication.
• Young children, as a rule, categorically refuse to drink, despite the large loss of fluid and intense thirst. This aggravates dehydration and forces parents to call ambulance. The only way restoration of circulating blood volume in addition to plentiful drink is infusion therapy (droppers with electrolyte solutions).
• It is difficult to answer the question of how to treat rotavirus in a child. Therapy will depend on the degree of fluid loss. Some will only need to drink a lot, while others need an infusion. Given the fact that parents cannot determine the degree of dehydration on their own, it is worth calling a doctor.
• Children who are on an artificial mixture during the period of rotavirus infection should be replaced with a lactose-free one, as transient lactase deficiency develops. Ingestion of the usual mixture leads to increased diarrhea.

Diagnosis of rotavirus infection

The diagnosis of this disease is based on a combination of clinical data, information about the presence of a focus of infection and its potential sources (information about quarantine in a kindergarten or school, cases of illness in the family) and, of course, positive tests for rotavirus. Only after comparing all the facts can the fact that the patient has this particular disease, and not food poisoning or another intestinal infectious disease, be reliably confirmed or refuted.

For a long time, the diagnosis was made only on the basis of the clinical picture. However, it is nonspecific and similar symptoms are present in other diseases from the group of intestinal infections. Fortunately, there are now reliable tests for rotavirus that can accurately confirm or deny the fact of this disease.

The main criterion for this disease is a laboratory express study of feces. This analysis for rotavirus is carried out as follows: a small piece of stool is taken and a search is made for the antigens of the infectious agent. It allows you to make a diagnosis within a few minutes.

There are other tests for rotavirus, but their significance for diagnosis is not so great, because the result can be obtained only after a few days. Their role is rather epidemiological evaluation morbidity at the site of infection. For this purpose, ELISA, RSK, RTGA are carried out - the result is evaluated by a four-fold increase in antibody titer to the causative agent of rotavirus infection. A positive result is detected after 2 weeks from the onset of the disease (when the patient is likely to be healthy). In research laboratories, PCR and electron microscopy are used - they allow not only to identify the pathogen, but also to identify belonging to a specific type.

Rotavirus test in children

The test for rotavirus in children is carried out mainly in the infectious diseases departments of hospitals. However, there are also options for home use, which can be purchased and applied independently, even without a special medical education.

One of the tests for rotavirus that you can do yourself is called the "Cito Rota Test". It is easy to make, the main thing is to carefully follow the instructions that are included in the package. The test for rotavirus is carried out as follows: you need to take one strip and place it at one end in a pot with the baby's feces (which, with this disease, have a liquid consistency). The result is displayed in the form of strips after 10-15 minutes: 1 - the analysis is negative, 2 - positive.

However, such a test for rotavirus does not give a 100% guarantee, so its implementation does not cancel the need for a doctor's consultation.

Rotavirus: treatment of the disease

If a patient has developed rotavirus, the treatment of the disease should be carried out individually. It depends on the severity, age, presence concomitant diseases and, most importantly, the level of dehydration. Since only a doctor (especially the last one) can evaluate the entire set of these data, you should not self-medicate, especially for babies in their first year of life, for whom this disease poses a real threat.

In the case where a person has rotavirus, treatment should include both drug and non-drug measures. The second point is especially important, since it is precisely the observance proper diet sometimes it allows you to recover quite quickly and even avoid drug treatment.

People often ask a doctor how to treat rotavirus. However, unfortunately, today there is nothing to please them: there is still no medicine that would lead to the death of the causative agent of this infection. Thus, there is no etiotropic treatment. However, fortunately, a person's own immune system quickly begins to produce antibodies against them, as a result of which, in the vast majority of cases, the disease proceeds favorably and completely ends on days 7-10.

However, sitting back and doing nothing for your own health is also not worth it, because the answer to the question of how to treat rotavirus still exists. The main link in therapy is to stop fluid loss as quickly as possible, because it is dehydration that determines the severity of the disease and the prognosis. To do this, you can use the following drugs:

Means for oral rehydration (Regidron, Regidrin, Gastrovit, Hydrovit, Normohydron, Orasan, etc.).

Considering the fact that with an extensive clinic of the disease, going to the pharmacy seems to be a very difficult action to perform, you should take care of the stocks of these drugs in your home first-aid kit in advance. They may be required not only for the treatment of rotavirus infection, but also for food poisoning. They must always be taken with you when traveling by sea.

Drugs to stop vomiting and diarrhea.

These include the following well-known drugs based on diosmectite - Smecta, Neosmectin, Dismectite, Endosorb.

Enterobrents, which allow to partially bind viral particles and remove them from the body with feces.

These include Activated carbon, Enterosgel, Filtrum Stee, etc.

Antipyretics and analgesics - paracetamol, ibuprofen, nimesulide, acetylsalicylic acid. They are used for fever above 38.5 ° C.

These groups of drugs are the answer to the question of how to treat rotavirus. However, if the degree of dehydration is such that it is impossible to cope with it at home, the person is subject to hospitalization and infusion therapy. He is injected with electrolyte solutions while his immune system produces antibodies against the virus itself.

How to treat rotavirus in a child

Sooner or later, any parents begin to be interested in the answer to the question of how to treat rotavirus in a child. It is more difficult to answer it than in the case when an adult is sick. For babies of the first year of life, this disease is dangerous and life-threatening. Therefore, the first thing to do if you suspect this disease is to call a doctor at home. If quarantine for this disease is declared in the kindergarten, the doctor will be able to quickly answer the question of how to treat rotavirus in a child, since he will need less time to diagnose.

The general principles of treating this disease are similar to those recommended for adults: it is necessary to stop dehydration as soon as possible and prevent serious complications from the cardiovascular system and kidneys.

Oral rehydration agents, smectite-based drugs, and enterosorbents can be used in children of any age. There are small restrictions, in particular they apply to the smallest (up to 2 years). All relevant information can be found in the instructions for medical use. Of the antipyretic drugs in pediatrics, only 2 drugs are used: paracetamol and ibuprofen.

However, sometimes it is very difficult to unequivocally answer the question of how to treat rotavirus in a child. After all, dehydration develops in them sometimes rapidly, especially in infants. Only a doctor can assess its degree, therefore, at the slightest suspicion, it is necessary to call an ambulance or go to the emergency department of an infectious diseases hospital on your own. Often, doctors are forced to carry out infusion therapy for babies, because they categorically refuse to drink liquid, and even more so oral rehydration agents that do not have the most pleasant taste.

If a patient has rotavirus, diet is the most important component of therapy. Of course, in the first 1-2 days, when a person has severe vomiting, they don’t feel like eating at all, only drinking. However, on the 3-4th day of the illness, it passes and it is replaced by loose stools. And at this moment, some patients make mistakes in the diet with rotavirus, leading to the fact that the disease does not want to recede.

Rotavirus leads to a relative lactase deficiency, as a result of which all dairy products are no longer digested. Taking them aggravates diarrhea and increases dehydration. It is not at all beneficial to eat food that causes fermentation, that is, various buns, cereals, vegetables, fruits, legumes, fruit juices.

Therefore, in the second stage of the disease and during recovery, if the patient has rotavirus, the diet is an event that must be strictly observed. Ideally, it is necessary to eat 2 types of cereals: buckwheat and rice, boiled in water without the addition of milk and butter. You can add lean beef, chicken or turkey, black whole wheat bread, bran, bread. Such a diet for rotavirus must be followed for at least a week and then gradually introduced into the diet of ordinary foods. However, the most important criterion for evaluating the safety of new products is well-being.

Particular attention should be paid to infants in the first year of life. Breast milk is not contraindicated in rotavirus, on the contrary, you need to feed as often as possible. If the baby will drink water at the same time - great. You can give him porridge from buckwheat and rice groats on the water, bread. If the child is on artificial feeding, then for the period of illness it should be transferred to a lactose-free mixture, and the rest of the principles of nutrition are similar.

Prevention of rotavirus

On the one hand, prevention of rotavirus is simple, on the other hand, it is a very complex undertaking. After all, if a person is in the focus of infection (for example, a child in a kindergarten or a pioneer camp), then it is extremely difficult to avoid infection, even if you follow all the rules of personal hygiene. Numerous studies show that even the sterile conditions of hospitals are not protection against the spread of this pathogen within the walls of hospitals and reliable prevention of rotavirus. This fact confirms the fact that the prevalence of this infection in prosperous countries and third world countries is the same.

However, when traveling by sea, a person can still protect himself, at least partially, and reduce the risk of infection. Measures for the prevention of rotavirus are similar to the methods of protection against all intestinal infections:

• frequent hand washing,
• the use of alcohol antiseptics (sprays, gels),
• use of disposable napkins and individual towels,
• eating only at public catering outlets that comply with all sanitary standards,
• thorough washing of vegetables, fruits and berries bought in the market or in street stalls.

Prevention of rotavirus does not give a 100% guarantee of protection against this disease, but still reduces the risk of its occurrence, so you should not neglect it.

Rotavirus vaccine

The rotavirus vaccine is by far the best way to protect against this disease in many countries today. It is mechanically impossible to protect yourself from it, and even sterile conditions are not a guarantee of success. It is for this reason that all more people choose rotavirus vaccination as an alternative to other prevention methods. To date, there are 2 types of vaccines:

• rotavirus vaccine Rotarix by GlaxoSmithkline,
• rotavirus vaccine Rotatek pharmaceutical company Merck.

This vaccine is currently included in the National vaccination calendars and is carried out for babies of the first year of life. It is not a guarantor of unequivocal protection, because there are several variants of the virus, but it has been reliably confirmed that in the case of the development of the disease, it proceeds easier, the degree of dehydration is lower, hence the risk of death and severe complications is much less. In our country, it is not included in the mandatory calendar, but it can be done independently in various private clinics involved in vaccination.

Rotavirus infection is defined as rotavirus, intestinal flu, rotavirus gastroenteritis. Rotavirus, entering the human body, causes an infectious process, which is characterized by high contagiousness, a short incubation period and an acute course.

Outwardly, the infection is manifested by a state of intoxication, damage to the stomach and intestines, and severe dehydration.

Rotavirus infection affects children and adults, but unlike children, adults have milder symptoms of rotavirus. A person becomes contagious when the first signs of the disease appear, and remains so until they disappear completely (2-7 days).

This disease is especially dangerous for children. younger age(the immune system in a small child is much weaker than in an adult), as well as for adults with reduced immunity and the elderly.

The reasons

What it is? The causative agent of the disease is rotavirus - a microscopic particle, covered with a three-layer shell and having the shape of a wheel. Rotaviruses are resistant to environmental factors. Microbes do not die when exposed to low temperatures, ether, chlorine, formaldehyde, ultrasound. Their pathogenic properties viruses lose during prolonged boiling or treatment with alkalis and acids.

An adult can catch a rotavirus infection only from a person, since animal rotaviruses do not pose a danger to humans. The main ways the virus spreads:

• contact household(through household items, in case of non-compliance with the rules of personal hygiene - including dirty hands);
• alimentary (together with food, poorly washed vegetables and fruits, when drinking contaminated water);
• airborne(when the patient sneezes or coughs).

Viruses penetrate the human body, reach the small intestine and begin to multiply actively in enterocytes - cells of the surface epithelium. Microbes exert their pathogenic effect, which leads to the destruction of mature intestinal cells and their replacement with defective and undifferentiated ones. The processes of splitting, absorption and biosynthesis of certain enzymes are disturbed. Intermediate metabolic products from the small intestine enter the large intestine, the osmotic pressure rises and diarrhea develops.

If we examine under a microscope a section of the mucosa that is affected by a rotavirus infection, then outwardly it will be smoothed out, the villi are significantly shortened, and inclusions of rotaviruses are noticeable in the mucosa itself. You can see them best with an electron microscope - this greatly improves the diagnosis of the disease. The intestinal lining is restored in about one to two months.

Symptoms of rotavirus infection

The disease includes an incubation period of about 5 days, an acute period of 3 days to 1 week, and a recovery period of 4-5 days. This disease is considered childhood, because the bodies of adults are more protected from rotaviruses. Adults have higher acidity gastric juice and a higher amount of secretory IgA produced.

Rotavirus infection is characterized by an acute onset - vomiting, sharp rise temperature, diarrhea, often very characteristic stools - on the second, third day, gray-yellow and clay-like. In addition, most patients develop a runny nose, redness in the throat, they experience pain when swallowing. In the acute period, there is no appetite, a state of loss of strength is observed.

The above symptoms are more typical for children. In adults, the symptoms of rotavirus infection often resemble those of a common indigestion. Perhaps a decrease in appetite, loose stools, an increase in body temperature, which persist for a short time. Often, rotavirus infection in adults occurs without visible signs, however, they are contagious to others. If there is a sick person in a team or family, then the people around him begin to fall ill in turn.

Differential Diagnosis

Very often, the diagnosis is made on the basis of the symptoms and complaints of the patient. At the same time, the most reliable method for diagnosing rotavirus infection is a specific analysis of feces (immunochromatography). Other studies are not indicative of a rapid diagnosis.

Differentiation of rotavirus infection should be with diseases, having similar symptoms. These include:

• cholera;
• dysentery;
• escherichiosis;
• gastrointestinal form of salmonellosis;
• intestinal yersiniosis;
• some types of protosonosis (giardiasis, cryptosporoidosis and balantidiasis).

As a rule, in an adult, the pathology proceeds without features, in the usual uncomplicated form. But in case of late diagnosis, initiation of treatment and significant suppression of immunity, complications may arise.

Treatment of rotavirus infection in adults

There are no specific drugs whose action would be aimed specifically at the destruction of rotaviruses.

In adults, complex medical measures are mainly assigned for the purpose symptomatic treatment, which is aimed at replenishing fluid losses in the body and combating intoxication. For this, rehydration and detoxification therapy is carried out.

If patients have reduced appetite, then you should not force them to eat, you can offer to drink homemade jelly from berries or chicken broth. Food and drink should be consumed in small portions so as not to provoke an attack of vomiting. You can not eat any dairy products, as they are a good environment for the spread of pathogenic bacteria.

Medical treatment

As already mentioned, there is no special medical preparation for the treatment of rotavirus infection in adults. If symptoms are severe, then drug treatment focused on the elimination of specific symptoms. Due to the fact that the disease is contagious, at the time of treatment the patient must be isolated thus limiting the spread of rotavirus infection.

Painful sensations and spasms of the intestines can be removed with the help of a conventional no-shpa. You can bring down the temperature when the mark is above 38 degrees, since most rotaviruses die at high temperatures. To relieve fever, you can use antipyretics:

1. Paracetamol;
2. Aspirin;
3. Analgin;
4. Nurofen;
5. Coldrex;
6. Rinza.

Getting rid of intoxication involves taking sorbents that absorb toxins and remove them from the body. For example:

1. Smecta;
2. Enterosgel;
3. Polysorb;
4. Activated carbon;
5. White coal;
6. Liferan;
7. Intravenous administration of glucose with a colloidal solution.

Rehydration solution is necessary in case of frequent diarrhea and vomiting. Because of them, the body rapidly loses fluid, and if the disease is accompanied by a high temperature, then the risk of dehydration increases dramatically.

Therefore, to preserve fluid, the drug rehydron is prescribed - this is a powder that is dissolved in water and drunk in a large (but limited) amount in small sips every 10-15 minutes. If there is no rehydron, you can include in the diet saline solution prepared by yourself at home. It is forbidden to force drink, as this provokes vomiting and a violation of the water-salt balance.

As you can see, if there is a rotavirus infection, treatment in adults is not so difficult. However, only if you start it in a timely manner, you can count on the fact that you can get rid of the disease as soon as possible. Otherwise, as mentioned above, the risk of developing various complications is very high.

Restoration of microflora

After the disappearance of all symptoms of the disease, it is necessary to restore the intestinal microflora. Usually they prescribe Linex or another. The course of treatment and dosage are set taking into account individual features organism.

Diet

Rotavirus infection completely excludes the use of such products as:

• fresh bread, sweets;
• canned food, sausage, cheese, smoked and raw fish;
• dairy and dairy products;
• pasta, barley, yachka, millet;
• cabbage, garlic, onion, radish;
• chocolate.

If a person can eat, you can feed him liquid chicken broth or rice porridge boiled in water without adding oil. But you need to feed in small portions with interruptions, so as not to cause an attack of vomiting.

Prevention

To avoid the occurrence of rotavirus gastroenteritis, the following rules must be observed:

• thoroughly wash vegetables, fruits and citrus fruits in running water immediately before use;
• regularly monitor the cleanliness of hands, as well as keep the house clean;
• eat only high-quality food;
• use boiled or bottled water for drinking.

Also as effective remedy against rotavirus, WHO recommends preventive vaccination.

The virus got its name from the Latin word "rota" - wheel. When magnified, the virus in the shell looks like a wheel with a rim. The group of rotaviruses includes 8 different species, they are designated in Latin letters, from A to H. More often than other species, rotavirus A becomes the source of human infection. It is also divided into several species (they are called serotypes).

The virus has a triple protein coat that protects it from digestive enzymes in the stomach and intestines. The reproduction of the virus occurs on the mucous epithelium of the intestinal cavity. The incubation period for rotavirus infection is 1 to 5 days.

After entering the mucous membrane, the virus tries to infiltrate its cells and make them sources for the reproduction of new rotaviruses. Sometimes the introduction does not occur, the disease is asymptomatic, the body forms antibodies to this virus. More often - an acute disease is formed.

Acute manifestations of the disease last up to 7 days, sometimes more. Rotavirus manifests itself as toxic poisoning: severe vomiting, diarrhea. In addition to indigestion, a runny nose appears (due to the ingress of toxins into the blood) and redness of the larynx. Naturally, there is no appetite, no strength. After the recovery period begins, which lasts 3-5 days.

Rotavirus infection in adults appears much less frequently than in children. This is due to the higher concentration of gastric juice in the stomach of an adult. It allows you to neutralize the virus even at the stage of penetration into the body.

Symptoms of rotavirus infection

Signs of rotavirus infection are most pronounced during the initial infection. They are diagnosed as acute poisoning and intestinal disorder. The child develops nausea and vomiting, the temperature rises, diarrhea develops.

Rotavirus has a characteristic feature. It is manifested by the color of feces. The consistency of the feces resembles clay, it becomes gray-yellow. Urine becomes dark in color (due to the elimination of toxins through the blood and kidneys), and may have blood flakes. Light color stool and dark urine can lead to misdiagnosis. A child can be diagnosed with hepatitis, but a blood test for liver tests will show that this disease is not present.

A severe acute reaction is observed in 80% of infected children. Runny nose and sore throat (with its inflammation, redness) are added to nausea, diarrhea and vomiting. This is a natural reaction of the body to toxic poisoning. It removes toxins through various organs (intestines, kidneys, throat, nose). Therefore, inflammation is formed on the mucous surface of the nasopharynx, increased secretion mucus to remove toxins.

Symptoms of rotavirus infection in adults are more vague. They may not be at all (the disease is asymptomatic, but a person is able to transmit the virus, infect another adult or child). If symptoms are still present, then perhaps it will be a slight relaxation of the intestines, soreness in the lower abdomen.

Since adults often do not visit a doctor with mild symptoms of the disease (maybe I ate something?), The question arises, how to treat rotavirus infection in adults, and is treatment necessary for mild symptoms of the disease? We will talk in detail about the principles of treating the virus further, we will only say that the treatment is carried out according to the symptoms. If you have a slight relief, and you suspect rotavirus, take an adsorbent and follow a diet. You may not need other treatments.

The signs listed above are indirect. That is, they indicate the likely presence of rotavirus in the body. An accurate diagnosis can be made only after a laboratory study of feces.

How is rotavirus transmitted?

Rotavirus is not in vain called the disease of "dirty hands" (just like Botkin). This infection is transmitted mainly through the mouth and through contaminated food. It can be transmitted through close contact (kissing) and sharing utensils. It is not transmitted when shaking hands (if you wash your hands thoroughly after them and if the child does not take fingers in his mouth). In the acute period of the disease, the virus is contained in the secreted mucus. Therefore, you can become infected with it when a sick person coughs and sneezes.

Let's look at how to treat rotavirus infection in children and adults.

Treatment of rotavirus infection with drugs

Medicine does not have any drug that is active against rotaviruses. The body fights on its own specific treatment this pathogen does not exist. They prescribe medicines and activities that treat and help recover from poisoning, sore throat and temperature. How to treat rotavirus infection?

Several groups of drugs are used:

• rehydrators;
• adsorbents;
• probiotics.

Rehydrators are the main drugs for the treatment of rotavirus

Rehydration therapy prevents dehydration. Any diarrhea and poisoning are accompanied by increased excretion of fluid from the body. Therefore, one of the main dangers of rotavirus is a violation of the water and electrolyte balance, dehydration of organs and tissues.

As a rehydrator, salted water is used (1 teaspoon of table salt per 1 liter of water), or pharmacy powder preparations-rehydrators. They are diluted with water according to the instructions and are used at intervals of every half hour.

You can also use dried fruit compote or raisin water as a rehydrator. In order to avoid new vomiting, the liquid is taken in small portions (¼ cup every 30 minutes).

The risk of dehydration is greatest for young children (babies). The lower the body weight, the faster the body loses water and weight. Signs of significant dehydration are "no tears" crying, no sweat, and infrequent urination (once every 3 hours).

If dehydration persists for more than 1 day, breathing difficulties may occur, convulsions may occur, pneumonia may develop. Therefore, young children who refuse to drink water are given liquid intravenously in a hospital setting.

Sorbents and enzymes

Sorbents are preparations for removing toxins from the intestinal cavity. Sorbents include pharmaceutical preparations Smektu, activated carbon, Polysorb, Enterosgel. Among natural sorbents- clay. It is taken in the form of a suspension, ½ teaspoon of dry clay is stirred in water and drunk until the suspension has sunk to the bottom of the glass. Enzyme preparations (Mezim, Pancreatin) are taken to improve digestion.

Should the temperature be lowered?

Treatment of rotavirus infection in adults does not use drugs to reduce fever. It is at 38º and above that the protein strands of the virus die. An artificial decrease in temperature in an adult or a child does not allow the body to fully resist the virus. You can lower the temperature only with severe intolerance (convulsions, schizophrenic).

In children, temperature reduction is also used for special indications. If the child tolerates 38 or 39º well, then antipyretic drugs should not be given.

The virus is not an antibiotic, it is insensitive to drugs antibiotic therapy. That is, treating any viral infection with antibiotics is not only ineffective, but also harmful. Why?

Antibacterial drugs are broad action. They kill not only pathogenic bacteria, but other representatives of the intestinal flora. Thus, local immunity is disturbed, which contributes to a stronger spread of the virus.

Use antibacterial drugs for treatment is possible if, against the background of infection with a virus, a bacterial infection has occurred.

However, this situation occurs not earlier than the 3-4th day of illness. Therefore, to prescribe antibiotics, a blood test and the detection of a high number of leukocytes, which indicate a bacterial infection, are necessary.

Nutrition for rotavirus infection

What to feed a child with rotavirus infection? Food should be dietary. If the child has no appetite, do not feed him at all. If the appetite is preserved, give porridge on the water, vegetable puree, yeast-free bread or soaked crackers, baked vegetables. With the disappearance of vomiting, you can give kefir, fermented baked milk, cottage cheese. A few days later - carrots, potatoes, a sweet apple.

What not to give with rotavirus:

• Milk porridge and whole milk.
• Rich broths and soups, borscht, other first courses on a steep broth.
• Animal proteins with high fat content (pork, beef, salmon).
• Sour berries, fruits.
• Yeast bread, muffins, pastries, confectionery.

One of the consequences of rotavirus is lactose intolerance (insufficient absorption of milk sugar). It is manifested by bloating, flatulence, and the preservation of loose stools. Therefore, often after the illness, the child ceases to absorb breast milk. This may last for 2-3 weeks.

During the recovery period, sometimes it is necessary to replace mother's milk with soy mixture or baby kefir (partially or completely for several days). As a rule, after 2-3 weeks, the production of lactose is restored, the previous nutrition, breastfeeding becomes possible.

Rotavirus infection during pregnancy

Like many viral infections, rotavirus can harm the baby in the womb when a woman first becomes infected during pregnancy. However, medical studies confirm that already at the age of 3, 100% of children have antibodies to this virus. Then people become infected with this infection during the first three years of their lives. Therefore, for most women, rotavirus infection during pregnancy does not carry catastrophic consequences for the baby in the womb.

The greatest danger to a pregnant woman when infected with rotavirus is dehydration.

To prevent it, you need to drink salted water or pharmacy rehydrators. And also take adsorbents to accelerate the removal of toxins.

Prevention, vaccinations and risk group

There is no guarantee that you will never encounter rotavirus. Therefore, the level of your reaction, the severity of the manifestation of symptoms will depend on the state of your immunity.

According to statistics, 100% of children older than 3 years have antibodies to rotavirus. However, this does not mean that it is impossible to get sick with a rotavirus infection a second time. Since there are 8 types of these viruses, among which 3 are found in humans, infection with one of them does not exclude the possibility of infection with another type of virus.

Formation external symptoms depends on the state of the immune system. With sufficiently strong protective reactions, the symptoms of rotavirus appear weakly or do not appear at all. The child may experience some digestive problems. However, more often the virus in children is acute.

Transmission of the disease reduces the likelihood of re-infection, but does not guarantee permanent immunity to rotavirus.

Prevention of rotavirus infection can be specific (medication) and non-specific (general measures to comply with sanitary standards and strengthen immunity).

• Specific measures include two types of vaccines with attenuated live virus. They are offered to make a baby under the age of 8 months.
• To non-specific - strengthening immunity with general health-improving measures (hardening, walking on fresh air), as well as good nutrition maintaining a healthy intestinal flora. If it is necessary to strengthen the immune system, with a lack of vitamins or minerals, vitamin-mineral complexes, active selenium, and iodine are used as specific prophylaxis.

To prevent the spread of the virus and the formation of strong local immunity, probiotic preparations (Linex, Acipol, Yoghurt) are used. Local immune reactions provide resistance to the virus at the entrance to the body, when it tries to infiltrate the cells of the human mucosal epithelium. Normal healthy microflora the intestine does not allow the virus to integrate into the cells of the epithelium, and begin to multiply in the body of a child or adult.

For adults, the prevention of rotavirus is the normal functioning of the stomach. At normal acidity, the virus dies in hydrochloric acid gastric juice. Therefore, people with an increased risk of rotavirus infection are low acidity, patients with gastritis with low acidity, as well as people with reduced digestive function, impaired microflora of the large and small intestines, overweight. Also, the risk group includes residents of large industrial centers who receive a daily dose of toxic substances from their polluted air.

The rotavirus vaccine is a live vaccine (contains a live attenuated virus, unlike many other vaccines that contain inactive dead virus particles). Therefore, it can only be done by a healthy child (in order to avoid complications and acute illness rotavirus).

important measure nonspecific prophylaxis- restriction of a sick child from contact with other family members, as well as compliance with sanitary rules (washing hands, cleaning drinking water). The virus is transmitted from dirty hands and through common utensils, so simple means of restriction can prevent infection of the entire family or children's team.

A viral infection manifests itself not only as a cold with a lesion respiratory tract. pathogenic microorganisms cause inflammation in the digestive organs. Invading the intestinal mucosa, they multiply intensively, which leads to intoxication of the body. The virus, vomiting, diarrhea and fever inevitably happen to every person. In adults, the manifestations of the disease disappear on their own after a few days without specific treatment. In children, such symptoms are more severe and require symptomatic therapy.

Why does vomiting and diarrhea develop with a viral infection

The cause of the development of high fever, which is accompanied by vomiting and diarrhea, are viruses. Similar states develop in such diseases:

• SARS;
• influenza, including intestinal;
• viral hepatitis A (Botkin's disease).

Temperature with a virus is a consequence of severe intoxication of the body. The more intensive reproduction pathogenic microbes, especially high performance body temperature. The degree of intoxication (poisoning) depends on the state of the immune system. In children, this symptom is more pronounced, due to the immaturity of the protective functions of the body.

Vomiting is another sign of intoxication. It appears as a result of an excess of toxins in the blood, which affect the vomiting center in the brain.

In children, high intoxication leads to a deficiency of glucose and the production of acetone. It is he who irritates the vomiting center and causes frequent vomiting at high temperature. The child may vomit in the acute phase of the disease every 40-60 minutes.

Diarrhea is a consequence of damage to the intestinal mucosa. With the introduction of the virus, the internal walls of the organ become inflamed, produce an increased amount of mucus. Absorption processes in the epithelium are disrupted, food is not digested properly. Intestinal dysfunction causes diarrhea. Its intensity depends on the degree of damage to the gastrointestinal tract.

Vomiting and diarrhea during infection (viral hepatitis) is more pronounced. Its appearance is associated with liver damage and a change in its functions (bile production).

Symptoms of a viral infection

The incubation period of a viral infection lasts an average of 2 days.. But this period can increase up to a week or decrease up to 6 hours. The shorter the incubation period, the more severe the nausea, vomiting and diarrhea.

The disease always begins acutely with a rise in temperature. A person experiences chills, cannot warm up for a long time. Appears headache in the temples, dizziness, general weakness, aching bones, the skin becomes pale.

Then comes nausea. The patient loses his appetite, increases the sensitivity of receptors to external annoying factors enhances the perception of smells and tastes. Some patients may experience hypersalivation - increased salivation.

At the height of the disease, vomiting joins. This symptom does not always occur, only in severe cases in debilitated, elderly patients and in children (especially preschoolers). As a rule, vomiting brings temporary relief or does not bring it at all. Involuntary contractions of the diaphragm cause severe discomfort and pain in the stomach. In severe cases, vomiting is accompanied by a fainting state.

Virus with vomiting and fever often causes diarrhea. It's a sign infection intestines. Stool with a virus, as a rule, is periodic, does not have such a systemic nature as in acute infectious diseases caused by bacteria. By its nature, it is more mushy than watery, does not contain pus or blood. In the feces, undigested elements of food products, single fragments of mucus are found.

If bowel movements are observed every hour and more than 8-10 times a day, an infectious disease caused by staphylococci, salmonella, shigella, escherichia should be suspected, and immediately contact the infectious diseases hospital for diagnosis.

Determining a viral intestinal infection in babies is difficult, as they cannot explain their condition.

Signs of the onset of vomiting and diarrhea viral origin in infants:

• constant crying without tears;
• refusal of baby food or breastfeeding;
• rise in body temperature to 38 ° C;
• regurgitation after each feeding;
• sleep disturbance and falling asleep phases;
• hard stomach due to the accumulation of gases in the intestines, rumbling;
• diarrhea is frequent, feces are liquid, frothy, yellow in color with a pungent odor.

The baby's condition is grave. Dehydration of the body develops rapidly, which significantly worsens the course of the disease.

How to give first aid

Condition at viral infection bowel does not require hospitalization of patients. But it is necessary to call a family doctor, especially for a child of preschool age.

Before the doctor arrives, the patient must be put to bed and ensure complete rest. Cancel any meal.

It is extremely important to prevent dehydration to give a person drink - water. room temperature . If a child is sick, he categorically refuses to drink water, it can be replaced with any drink, the main thing is that the liquid enters the body.

The ideal option for the prevention of dehydration in case of vomiting and diarrhea are preparations for oral rehydration - powders for the preparation of saline solutions:

• Regidron.
• Hydrovit.
• Orsol.
• Reosolan.
• Orasan.

These solutions replace salts and fluids lost during vomiting and diarrhea.

Periodically it is necessary to make control measurements of body temperature. If its indicators are 38.5 ° and higher, it is necessary to give an antipyretic agent - paracetamol, ibuprofen.

If you get sick infant, you need to constantly be near him and monitor his condition. The baby needs to be laid on its side. So that it does not roll over, make rollers from improvised means (a blanket, a pillow, a towel) and put it from the back. This is necessary so that during vomiting the child does not choke on vomit.

Treatment of vomiting and diarrhea in viral infections

There is no specific treatment to kill viruses.. Therapeutic measures are taken to eliminate the symptoms.

If the patient has severe nausea He is prescribed antacids. These are drugs that regulate acidity in the gastrointestinal tract, envelop the mucous membrane, relieve inflammation and irritation. Their use brings noticeable relief, reduces the likelihood of vomiting.

Antiemetic drugs, for example, cerucal, are not prescribed for a virus. Such drugs affect the central nervous system, cause serious side effects and have many contraindications, including children's age. With a decrease in body temperature and compliance with the drinking regimen, vomiting passes independently and quickly.

If children are vomiting elevated acetone, it is enough to give a drink a 5% glucose solution (1 tablespoon or 1 ampoule).

To eliminate diarrhea, sorbents are prescribed:

• Activated carbon;
• polysorb;
• enterosgel;
• smecta;
• atoxyl;
• polyphepan.

To facilitate the work of the digestive tract and improve the processes of digestion of food, the patient is prescribed pancreatic enzymes - pancreatin, mezim, festal, creon.

For the prevention and treatment of dysbacteriosis, lacto- and bifidobacteria are indicated.:

• linex;
• bifiform;
• lactobacterin;
• acidolac;
• enterogermina.

Before the diagnosis is made by a specialist, it is impossible to drink antibacterial drugs on your own at the first symptoms of diarrhea and vomiting. With a viral infection, their reception is impractical.

Vomiting and diarrhea with a virus do not pose a threat to human health. The disease and its symptoms are treated on an outpatient basis. At adequate therapy diarrhea and vomiting pass within a few days and do not cause serious consequences or complications.

Previously, this disease was also called intestinal flu, although rotavirus has nothing to do with the influenza virus. The fact is that the peak incidence of rotavirus infection occurs in the cold season ( that is, for the autumn-winter period), when a large number of people also suffer from colds, including the flu.
As a result, in many people with influenza, after infection with rotavirus, symptoms of intestinal damage also began to appear, which was the reason for the similar name of the pathology.

Epidemiology ( incidence of rotavirus infection)

The causes of the spread of rotavirus infection among children can be:

• Weakness of the immune system. Immunity ( body's ability to resist infections) of a newborn and a child of the first three years of life is not yet fully formed and cannot provide full protection, and therefore the risk of infection with various viruses increases.
• Anatomical structure of the intestinal mucosa. As a result laboratory research it was found that rotavirus ( infectious agent) is easily attached to the cells of the mucous membrane of the small intestine of the child. At the same time, it attaches very poorly to the mucous membrane of the small intestine of an adult, which reduces the risk of infection.

The peak incidence, as well as the development of epidemics, falls on the cold season ( October to April), while rotavirus infection is extremely rare during the summer months. This is due to the properties of rotavirus, which survives very poorly in heat, but can exist for quite a long time at low temperatures.

Etiology, causative agent, ways of transmission and infection ( How is rotavirus transmitted from person to person?)

The main route of transmission of the virus from a sick person to a healthy person is fecal-oral. Its essence is as follows. After entering the human body, the virus enters the cells of the intestinal mucosa, starting to multiply actively in them. In the future, these cells are separated from the mucous membrane and, together with feces, are excreted from the human body. At the same time, the viral particles in them retain their viability.

If in the future a healthy person comes into contact with any objects contaminated with the feces of the patient ( it can be soil, poorly treated toilet surfaces, toilet door handles, towels, unwashed hands of a sick person, and so on.), viral particles can get on the skin of his hands. If after that a person takes any food with unwashed hands ( or just put your fingers in your mouth, which is common in young children), viral particles will fall into its gastrointestinal tract. After passing through the stomach and reaching the intestines, they are reactivated and penetrate into the cells of its mucous membrane, causing their damage and the development of the clinical picture of rotavirus infection.

Is rotavirus infection contagious in animals?

It is assumed that the interaction of animal rotavirus with human rotavirus ( for example, being an asymptomatic carrier of an infection) in the "human" virus, certain changes can occur, as a result of which it can be activated and cause a clinical picture of the disease. However, to date, scientists do not exclude the possibility of direct human infection with animal rotaviruses.

Is rotavirus transmitted by airborne droplets?

On the one hand, in many children before the onset of diarrhea ( diarrhea) caused by rotavirus, there are signs of damage to the upper respiratory tract. Moreover, even after the onset of symptoms of rotavirus infection, these children do not develop either a cold or flu. This may suggest that rotavirus initially infects the respiratory mucosa and then enters the intestine and infects its mucosal cells.

At the same time, it is worth noting that as a result of many laboratory studies, scientists have not been able to isolate viral particles from the cells of the mucous membrane of the respiratory tract. At the same time, rotaviruses are detected in the cells of the intestinal mucosa in almost 100% of cases of infection.

pathogenesis ( development mechanism)

AT normal conditions The intestinal mucosa consists of so-called villi - outgrowths that protrude into the intestinal lumen. The villi are covered with epithelial cells ( mucosal cells), which provide digestion and absorption of nutrients from the intestines into the blood. It should be noted, however, that suction nutrients can only "mature" ( differentiated) epitheliocytes, which are located in the region of the tops of the villi. At the same time, immature cells are located at the base of the villi, which cannot normally absorb products from the intestinal lumen. As they differentiate, immature epitheliocytes move higher and higher, reaching the top of the villus at the moment when they become fully "mature".

The essence of rotavirus infection is that viral particles affect only mature epithelial cells of the small intestine. The cells affected by the virus are destroyed and rejected by the mucous membrane, as a result of which its absorption capacity is reduced. This triggers compensatory reactions, as a result of which "immature" cells begin to move to the top of the villi much faster. At the same time, they do not have time to fully differentiate, as a result of which they cannot ensure normal absorption of nutrients from the lumen of the small intestine.

As the disease develops, there is also a violation of blood microcirculation in the area of ​​the mucous membrane, that is, its ischemia develops ( oxygen starvation). This triggers the development of local inflammatory processes and release into the tissue of so-called biologically active substances that support inflammation. As a result of the described reactions, there is an even greater damage to the mucous membrane and an even more pronounced malabsorption in the intestine, which increases the severity of the clinical manifestations of the disease.

It is also worth noting that in uncomplicated cases, the virus affects only the mucous membrane of the small intestine. At the same time, with a decrease defensive forces body, viral particles with blood and lymph can spread to other tissues and organs ( to the liver, brain and spinal cord and so on), causing their defeat and violation of their functions. This may be accompanied by the development of systemic manifestations of the disease and other symptoms associated with damage to certain organs.

Rotavirus infection - specialist advice

Symptoms, signs and course ( how does rotavirus infection manifest itself in children, adolescents, adults?)

Rotavirus infection can manifest itself:

• vomiting;
• diarrhea ( diarrhea);

• an increase in body temperature;
• general weakness;

How long is the incubation period?

The incubation period is the time from the moment a person becomes infected until the first symptoms of infection appear. During incubation period rotavirus has already entered the human body, struck the mucous membrane of his intestines and began to actively multiply in it. At the same time, digestion has not yet been disturbed, and there are no systemic manifestations of the disease, since viral particles have not yet entered the bloodstream, and the body's immune system has not yet begun to fight the infection.

It is worth noting that during the incubation period, some patients may complain of weakness, fatigue, sore throat, cough, fever, or other similar symptoms. This may be due to a viral infection of the upper respiratory tract that developed before the infection with rotavirus.

The incubation period is followed by an acute onset of the disease, accompanied by rapid development and the growth of all characteristic features. From the moment the first symptoms appear to the full development of the clinical picture of rotavirus infection, it takes from 1 to 4-5 hours.

Nausea and vomiting

The cause of vomiting is the penetration of the virus into the intestinal mucosa and its defeat. This triggers the body's defense mechanisms, the purpose of which is to prevent infection and toxins from entering the body. Peristalsis ( motility) the intestines are disturbed, and the patient has an urge to vomit. After vomiting, the patient usually experiences some relief associated with gastric emptying and upper divisions small intestine.

In more than half of the cases, vomiting stops by the end of the first day of the development of the disease, but sometimes it can last 2-3 days.

diarrhea ( diarrhea)

As mentioned earlier, when the cells of the intestinal mucosa are destroyed by rotaviruses, the absorption of nutrients from the lumen of the small intestine is disrupted. Non-absorbed substances remaining in the intestinal lumen have the so-called osmotic activity, that is, the ability to attract fluid to themselves. As the disease progresses, the concentration of osmotically active substances in the small intestine increases, as a result of which a large amount of fluid begins to move into its lumen. Moreover, these substances prevent the absorption of fluid in the large intestine, which also contributes to its accumulation in the intestinal lumen. This is the main reason for the development of diarrhea, as well as many complications. this disease.

Diarrhea in rotavirus infection is characterized by:

• Sudden and frequent urge to defecate. They can occur from 2 to 3 times a day ( at easy course diseases) up to 20 - 50 or more times a day ( in severe disease).
• imperative ( imperative) the urge to defecate. These urges are so strong that the patient cannot restrain them.

Stool with rotavirus infection:

• Liquid- first in the form of gruel, and then watery.
• Foamy- after a bowel movement, foam may be observed on the surface of the stool.
• Fetid- felt after a bowel movement bad smell, the occurrence of which is explained by the intensification of the processes of putrefaction and fermentation in the large intestine.
• Greenish or yellowish.

Stomach ache ( my stomach hurts)

Bloating

As mentioned earlier, with this pathology, the absorption of nutrients from the small intestine is disrupted, as a result of which they attract fluid and move on ( into the large intestine). Colon a person normally contains a variety of all kinds of bacteria that take part in digestion. However, in the normal absorption function of the mucous membrane, only a small amount of nutrients enters the large intestine.

With the development of rotavirus infection, nutrients that are not absorbed in the small intestine penetrate into the large intestine, where they become food for the bacteria living there. Their digestion and breakdown is accompanied by the production a large number gases ( methane, hydrogen, carbon dioxide and so on), which leads to overflow of the colon with gases and bloating. Moreover, due to increased peristalsis (motility) intestinal gases in it constantly move from one department to another, which is accompanied by a pronounced "rumbling" in the stomach, which stranger or the doctor can hear even at a great distance from the patient.

Temperature

The mechanism of body temperature increase in rotavirus infection is associated with the activation of the immune system, which occurs in response to the penetration of foreign viral particles into the human body. At the same time, cells of the immune system produce special substances that activate the temperature regulation center in the brain, thereby increasing heat production in the body.

It should be noted that with rotavirus infection, the temperature remains elevated for 2 to 3 days from the onset of the disease. In the same time, fever of the body may be associated with a concomitant respiratory tract infection, against which the infection with rotavirus occurred. That's why evaluate this symptom should only be combined with other clinical and laboratory data.

Weakness and headaches

The syndrome of general intoxication of the body can manifest itself:

• general weakness;
• increased fatigue;
• decrease in working capacity;
• lethargy;
• "brokenness";
• headaches;
• shortness of breath ( feeling short of breath) during physical activity and so on.

Cough

The cough associated with rotavirus infection is usually dry, painful, and is not accompanied by sputum or mucus. The reason for its development is the defeat and destruction of the mucous membrane of the trachea and bronchi, which leads to irritation of the organs located there. nerve endings (cough receptors). During coughing, an even greater traumatization of the mucous membrane occurs and the patient wants to cough even more. That is why the cough itself does not bring any relief to the patient, but only worsens his well-being.

Is there a rash with rotavirus infection?

Stages of rotavirus infection

In the development of rotavirus infection, there are:

• incubation period. Lasts from 15 hours to 5 - 7 days. During this period, there are no clinical signs of infection. The patient may look completely healthy, although rotavirus is already developing in the mucous membrane of his intestines.
• acute period. Lasts 3 to 7 days from the onset of the first symptom. During acute period disease, the severity of symptoms gradually increases and reaches its peak. It is in the acute period that patients usually turn to medical institutions for help. If you do not start treatment in the acute period of rotavirus infection, the risk of complications increases significantly.
• Recovery period. Lasts from 3 to 5 days. During this period, the severity of the patient's symptoms gradually subsides. General state the patient improves, but his body remains weakened and still needs adequate treatment.

Manifestations of rotavirus infection in newborns, infants and children

In almost 100% of cases, rotavirus infection in children of all ages begins with three main symptoms - vomiting, watery diarrhea and fever. At the same time, the temperature in children is higher than in adults ( from the first days of the disease can reach 38 - 39 degrees). At the same time, it is worth noting that some children may have a high fever and diarrhea. the only symptoms infection, while vomiting may be absent.

Another feature of the development of rotavirus infection in children is a decrease or complete lack of appetite. This is due to a violation of the motility of the gastrointestinal tract, with the overflow of the large intestine with gases and with the development of a syndrome of general intoxication of the body. Sick children refuse to eat, become lethargic, inactive, may cry for a long time and be capricious. If the child can already talk, he may complain of pain in the abdomen, headaches, and so on.

It is important to note that the child's body is not able to compensate for developing digestive disorders for as long as the body of an adult. Within a few hours after the onset of the acute period of rotavirus infection, a child may develop serious complications posing a danger to his health or even life. That is why, if one or more symptoms of the disease are detected, you should consult a doctor as soon as possible, without wasting time on self-treatment.

How many days does a rotavirus infection last?

Clinical forms of rotavirus infection

Can rotavirus infection occur without symptoms ( no fever, no diarrhea, no vomiting)?

An asymptomatic course of a rotavirus infection can be observed when a rotavirus enters the body of a healthy person whose immunity is not impaired, and there are antiviral antibodies in his blood ( that is, if he has already had this infection). In this case, the virus will be present in his body for a certain time ( which can be confirmed by special laboratory tests), but no clinical signs disease will not be detected.

In some cases, the onset of the disease may occur in the absence of one of the characteristic manifestations of rotavirus infection. For example, patients may have only diarrhea and fever ( without vomiting) or, conversely, high fever and vomiting ( without diarrhea). At the same time, by the end of 1-2 days, the classical clinical picture of the disease usually develops, including all the symptoms listed above.

In people with extremely severe violations immunity ( for example, in patients with AIDS - acquired immunodeficiency syndrome) the disease can proceed without temperature. This is due to the fact that late stages diseases, the immunity of such patients weakens so much that it is not able to adequately respond to the introduction of foreign viruses into the body. Similar disorders can be observed in people with cancer ( tumor) diseases that undergo courses of radiation therapy or chemotherapy ( these procedures also disrupt the immune system). At the same time, other signs of rotavirus infection ( diarrhea, vomiting and abdominal pain) in such patients will be observed from the first days of the disease.

Which doctor should I contact for rotavirus infection?

During the examination of the patient, consultation may be necessary:

• gastroenterologist ( enroll) ;
• otorhinolaryngologist ( Laura) (enroll) ;

• resuscitator.

• questioning the patient;
• clinical examination;
• consultations of other specialists;
• laboratory diagnostics.

When interviewing a patient, the doctor is interested in:

• What worries the patient at the moment?
• When did the symptoms first appear?
• The order in which symptoms appear.
• The nature of the vomiting if it exists), its frequency, color, smell, presence or absence of blood, and so on.
• The nature of the chair if it exists), its frequency and consistency, color, smell.
• Is the patient's body temperature elevated? at the same time, the doctor measures it again during the examination, but asks the patient to clarify to what figures the temperature has risen since the onset of the disease).
• Does the patient have signs of airway disease ( cough, sore or sore throat, runny nose, nasal congestion and so on)?
• Has anyone in the patient's family had similar symptoms in the last few days?
• Has the patient received any treatment? If so, which one and who appointed him?

Clinical examination includes:

• Inspection. On examination, the doctor may notice dryness of the skin, a decrease in the natural luster of the skin. This may be due to dehydration loss of large amounts of fluid from the body) caused by frequent diarrhea and vomiting. Retraction may also indicate the presence of dehydration. eyeballs in the eye sockets.
• Palpation. The essence of the method is to assess the condition of the skin, musculoskeletal system and other organs through their palpation. On palpation, the doctor can detect a decrease in turgor ( elasticity) of the skin, which will indicate severe dehydration. To do this, he will slightly squeeze the skin on the patient’s arm into a fold with two fingers, and then release it. Under normal conditions, the skin will immediately straighten and return to its original shape, while dehydration can leave a wrinkle on the skin that lasts for a few seconds or minutes. Also, with palpation of the abdomen, the doctor may note its swelling and increased rumbling ( due to the accumulation of large amounts of gas in the intestines).
• percussion ( tapping). This method is not of particular diagnostic value for rotavirus infection. With it, you can only confirm the presence of gases in the intestines. To do this, the doctor presses one hand to the surface of the patient's abdomen, and lightly taps the finger of the first hand with the finger of the second hand. The presence of gas or air in the intestines will be indicated by a characteristic tympanic sound, reminiscent of the sound of tapping on a drum.
• auscultation ( listening). This study is carried out using a stethoscope - a device consisting of a special membrane and sound-conducting tubes. By listening to the abdomen, you can determine the presence of increased peristalsis ( motility) intestines, which is typical for rotavirus infection. Listening to the heart can reveal muffled tones, which is an unfavorable prognostic sign and indicates a severe course of the disease. Also, all patients are advised to listen to the lungs ( to exclude inflammatory diseases respiratory system).

Also, the infectious disease doctor can refer the patient for consultations to other specialists if he doubts the diagnosis ( in this case you may need to consult an ENT specialist, which will rule out the presence of an upper respiratory tract infection). If the patient develops severe complications of rotavirus infection ( for example, loss of consciousness due to severe dehydration), you should immediately call for a consultation with a resuscitator or immediately transfer the patient to the intensive care unit, where he will be provided with the necessary assistance.

If, against the background of the treatment, the patient's condition begins to improve, it will be extremely important to choose the right and balanced diet for him, which will restore the normal function of the gastrointestinal tract and replenish fluids, electrolytes, trace elements and other substances lost with diarrhea and vomit. To resolve these issues, the patient may need to consult a dietitian.

Methods of laboratory diagnostics ( tests for rotavirus infection)

It is better to conduct all studies before starting treatment, because the use of antibiotics or antiviral drugs can distort the data obtained and make it difficult to make a diagnosis, thereby reducing the effectiveness of therapeutic measures.

For research, you can use:

• fecal masses;
• vomit;
• urine;
• blood;
• saliva and other tissues.

• general blood analysis ;
• express tests.

General blood analysis

With rotavirus infection in the KLA, there may be:

• Leukocytosis ( increase in the level of leukocytes in the blood). Leukocytes are blood cells that perform protective function in the human body. When the virus enters the body, the active production of leukocytes begins, and therefore their number increases at the onset of the disease. At the same time, leukocytosis is observed in almost any infectious pathology.
• Leukopenia ( decrease in the level of leukocytes in the blood). Short-term leukopenia develops at the height of the disease due to increased exposure to the virus and weakening of the body. At the same time, it is worth noting that leukopenia is characteristic of many viral diseases, and not only of rotavirus infection.
• Lymphocytosis ( increased levels of lymphocytes in the blood). Lymphocytes are a type of blood cells that also perform a protective function. When a virus enters the body, lymphocytes are activated, producing antibodies against viral particles, which contributes to the destruction of the virus.

• An increase in hematocrit. Hematocrit is the percentage of blood cells and its liquid part. Normally, the hematocrit in a man is 40 - 48%, and in a woman - 36 - 46% ( due to fewer blood cells in the body). With rotavirus infection, the patient experiences intense diarrhea and vomiting, which are accompanied by fluid loss from the body. If these losses are not made up, the share cellular elements in the blood will increase, as a result of which the hematocrit will also increase. This is dangerous because the blood in this case will become more viscous, it will be more difficult for it to pass through small blood vessels and deliver oxygen to the tissues. At the same time, the heart muscle will have to work much harder to push the viscous blood through the blood vessels. All this can lead to disruption of the functions of many organs and systems ( including brain, heart, liver, kidney and so on).
• ESR decrease ( erythrocyte sedimentation rate). SOE is laboratory indicator, which also allows you to assess the degree of dehydration of the body. To determine the ESR, the blood taken from the patient is placed in a test tube and the time during which the heavier red blood cells ( erythrocytes) will sink to the bottom. The fact is that blood cells have the ability to repel each other. Consequently, the more of them there are in the test tube, the stronger they will repel and the slower they will settle to its bottom. Normal ESR in men is 2 - 10 mm per hour, and in women - 2 - 15 mm per hour. At the same time, when dehydrated ( against the backdrop of diarrhea and vomiting), the concentration of erythrocytes in the blood can increase significantly, as a result of which the ESR will also increase.

Analysis of urine

To get the most accurate results, the analysis of urine needs to be handed over in the morning. On the evening before the test, you need to carry out a hygienic toilet of the genital organs. You should also avoid foods that can change the color of your urine ( beets, carrots). A small amount of ( about 50 ml) urine at the very beginning of urination should be skipped. Then, without interrupting urination, about 50-100 ml of urine should be collected in a pre-prepared sterile container, tightly closed with a lid and taken to the laboratory for research.

Fecal analysis ( coprogram)

For a coprogram with rotavirus infection, it is characteristic:

• Liquid ( mushy or watery) stool consistency- due to the transition of a large amount of water into the intestinal lumen.
• Yellowish or greenish stools- due to the processes of decay and fermentation of products in the large intestine ( under the influence of bacteria living there).
• The presence of a characteristic fetid odor - also associated with the processes of decay and fermentation.
• The presence of a small amount of mucus in the stool.
• Small amount of blood in stool- due to defeat destruction) of the mucous membrane, which is accompanied by rupture of small blood vessels.
• Determination of undigested foods in feces- fiber, fat, starch, muscle fibers, proteins and so on.

Feces must be collected in a small amount (up to 5 grams) in sterile dishes, which can be bought at the pharmacy. It is important to collected material did not come into contact with anything be it the surface of the toilet bowl, baby potty and so on), since foreign microorganisms can get into it, which will distort the results of the study. In infants, feces can be collected from the diaper with a sterile stick.

The collected material should be delivered to the laboratory for examination within the first 2-3 hours after collection. The study itself usually does not take much time, so that after a few hours you can get the results of the analysis.

PCR ( polymerase chain reaction)

It is better to take an analysis within the first 3 to 10 days from the onset of the disease, when the concentration of the virus in the body is maximum. The rules for collecting feces for this study are the same as for the general analysis of feces. The day before the collection of feces, it is necessary to abandon drugs that affect peristalsis ( cuts) intestines or may change the color of the stool ( iron preparations, bismuth), as this may distort the results of the study. For the same reason, you need to abandon enemas and rectal suppositories (candles).

The essence of the method is that the test material is mixed with special enzymes, placed in an incubator and "grown" under special conditions for a certain time. If there is at least 1 section of rotavirus RNA in the biomaterial, many copies of viruses will be created on its basis, which then allows you to easily determine the presence and type of the pathogen.

It should be noted that the PCR procedure is quite lengthy and expensive, as a result of which it is carried out only in special research laboratories.

Rapid test for rotavirus infection

You can buy a rota test at any pharmacy. At the same time, the purchased kit includes all the devices necessary for the study, as well as detailed instructions for them.

The test includes:

• instruction;
• sterile gloves;
• test panel;
• a plastic tube filled with a special solution, in which there is a stick for collecting feces.

To conduct a rapid test for rotavirus infection, open a plastic tube ( cone) and remove a sterile stick from it. A small amount of test material should be collected on the tip of the stick ( up to 2 grams). For this it ( tip) should simply be vertically immersed several times in the feces, without trying to take them “more”. After taking the material, the stick should be placed back into the flask with the solution, closed and shaken several times. The result should be a homogeneous liquid solution. If you collect too much feces, the solution will turn out to be thick and the result will not show anything ( the test will fail).

When a homogeneous solution is formed in the flask, you should take the test panel out of the sterile package and open it. Externally, this panel has the shape of a rectangle, on the surface of which there are 2 windows ( grooves) are oval and rectangular. The oval window is intended for applying the test material, and the results of the test will be displayed in the rectangular window. Above the rectangular window are 2 letters - "C" and "T".

To conduct a study, you need to break the top on the lid of a plastic cone and apply the resulting solution ( 4 drops) on the test panel in the oval window, and then wait 10 minutes. After 10 minutes, colored stripes will appear in the rectangular window, by which it will be possible to judge the result of the analysis.

After conducting a rapid test for rotavirus infection, you can get:

• Positive result ( there are rotaviruses in the stool). In this case, a green stripe will appear opposite the letter "C", and a red stripe will appear opposite the letter "T".
• Negative result ( no rotavirus found in stool). In this case, a green bar will appear opposite the letter "C", and nothing will appear opposite the letter "T".
• Inaccurate result. If 10 - 20 minutes after the application of the material, no stripes appear in the rectangular window, and also if only a red stripe appears, the test is considered incorrect. In this case, the study must be repeated on a new test.

Differential Diagnosis ( how to distinguish rotavirus infection from intestinal enterovirus infection, food poisoning, dysentery?)

Rotavirus infection should be differentiated ( differ):

• from enterovirus infection. Enteroviruses are a group of viruses that can also infect the intestines and cause watery diarrhea, vomiting, and symptoms of general intoxication. At the same time, the frequency of stools in enterovirus infection usually does not exceed 6-8 times a day, while the body temperature rises to 39-40 degrees from the first day of the disease. A rota test can help in the diagnosis ( if it is negative, the patient most likely has an enterovirus infection).
• From food poisoning. The cause of food poisoning can be pathogenic bacteria or their toxins that enter the human body along with food products. Clinical manifestations depend on the type of pathogen, but in most cases, before the development of symptoms, a person eats poorly processed, contaminated foods ( fresh vegetables, meat or dairy products and so on), which can be reported to the doctor. Also, with food poisoning, vomiting first appears ( which can be abundant and repeated), and a little later - loose stools, which can also be watery. In this case, the general condition of patients worsens significantly ( body temperature can rise to 39 degrees or more), and signs of damage to other organs and systems may also appear.
• From dysentery. This disease is caused by the microorganism Shigella. Shigella penetrate the human gastrointestinal tract and affect the mucous membrane of the large intestine, which is also accompanied by profuse watery diarrhea and the appearance of symptoms of intoxication of the body. At the same time, Shigella or the toxins they release can enter the blood of the patient and affect various systems and organs ( especially the nervous system), which will be accompanied by characteristic clinical manifestations. This will distinguish dysentery from rotavirus infection by early stages disease, however, laboratory tests will be required for an accurate diagnosis.

Are SARS and rotavirus the same thing?

The essence of rotavirus infection has been described previously. At the same time, SARS acute respiratory viral infection) can be caused by a number of viruses ( parainfluenza viruses, adenoviruses, rhinoviruses and so on). All of these viruses enter the human body along with inhaled air and infect the mucous membrane of the respiratory tract, which leads to the appearance of characteristic clinical manifestations ( sore throat, cough, runny nose, fever and so on).