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Rotavirus: Common cause of hospital admissions

health talk:with Dr Johannes Marisa

A lot has been said and written about Covid-19 that has wreaked havoc across the world. Close to 800 000 people have lost their lives in the past eight months with the United States, Brazil, India, Mexico and the United Kingdom topping the list of mortalities. The World Health Organisation is still to find a vaccine for the deadly virus. Public health measures remain critical in both the containment and mitigation of the virus.

Rotavirus is a very contagious virus that causes diarrhoea and in Zimbabwe usually contributes to about 40% of paediatric hospital admissions. Every year, it is estimated that 215 000 people die from this virus, but casualties are mainly children below the age of five years. The majority of the kids who die are from low-income countries. Twenty-two percent of all global rotavirus deaths as of April 2016 occurred in India. Four countries — namely India, Nigeria, Pakistan and Democratic Republic of Congo — accounted for half of all the global rotavirus deaths in 2013. What a disaster!

Zimbabwe introduced a two-dose live oral monovalent rotavirus vaccine in May 2014 as part of the routine infant immunisation programme and recommended the vaccine be administered at six and 10 weeks with oral polio and the pentavalent vaccines. Since then, there has been significant reduction in diarrhoea-related admissions among children at hospitals. Some children have not been lucky lately as many health centres have run short of these vaccines, including the most popular BCG (for TB protection). We urge the responsible authorities to expedite the processes of acquiring these special vaccines. Our mothers are crying as I write.

Symptoms
A rotavirus infection starts within two days of exposure to the virus. Initial symptoms are fever and vomiting, followed by three to eight days of watery

diarrhoea. The infection can cause abdominal pains as well. Visit your clinician if your child has some of the following:

lDiarrhoea for more than 24 hours.

lFrequent episodes of vomiting.

lBlack or tarry stool containing blood or pus.

lHigh temperature of higher than 38.5.

lHas lethargy, irritability and severe pain.

lSigns and symptoms of dehydration including dry mouth, crying without tears, little or no urination, unusual sleepiness or unresponsiveness.

Risk factors

Rotavirus infections are common in the following:

lChildren between three and 60 months of age.

lOlder adults and adults caring for young children.

lDuring winter and spring.

Prevention

To reduce the spread of the rotavirus, you should observe the following measures:

lWash your hands thoroughly and often, especially after you use the toilet, change your child’s diaper or help your child use the toilet.

lYou make use of available vaccines:

Rotatrix: This vaccine is a liquid given in two doses to infants at about two and four months.

RotaTeq: This vaccine is given by mouth in three doses, often at ages two months, four months and six months. The vaccine is not approved for use in older children or adults.

Rotavac: Naturally occurring bovine-human reassortant neonatal G9P.

RotaSiil

Diagnosis

lRotavirus diagnosis is usually based on symptoms and physical examination.

lA stool sample may be analysed in a laboratory to confirm the diagnosis.

Treatment

There is no specific treatment for rotavirus infection. Antibiotics are not of great help in the infection. Usually the infection resolves within three to seven days.

Preventing dehydration is the biggest concern. To prevent dehydration while the virus runs its course take the following:

lTake plenty of fluids.

lTake salt/sugar solutions.

lTake oral rehydration fluids such as Pedialyte or Enfalyte.

lIn moderate to serious cases, intravenous fluids should be administered. This would mean hospital admission and putting patients on drips. Do not delay to visit medical institutions.

lDr Johannes Marisa is a medical practitioner, a public health practitioner and educationist who can be accessed on: doctormarisa@gmail.com

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