Rotavirus Infection in Children

Rotavirus is a virus that infects the small intestines. Rotavirus infection often occurs in the winter and spring months (December through June). It's very common and is the leading cause of diarrhea in children. It's also very contagious and is mostly spread by hands, toys, food, and water. Only a few tiny germs are needed to pass on the infection. It takes almost 48 hours for the symptoms to appear, and the illness can last up to 8 days. Most rotavirus infections are not serious and last only a few days. But they put children at risk for dehydration, a loss of water from the body.

 Common symptoms of rotavirus infection

• Fever

• Watery diarrhea

• Stomach pain or cramping

• Nausea and vomiting

Treatment

Most cases of rotavirus get better without treatment. There is no specific medicine or antibiotic that can treat a rotavirus infection. The goal of treatment is to make the child comfortable and to prevent dehydration. These tips can help:

• Don't give your child over-the-counter medicines to stop the diarrhea. These can be dangerous.

• Be sure your child gets plenty of rest.

• Have an older child sip water or suck on ice chips, if possible.

• If your older child seems dehydrated, give 1 to 2 teaspoons of an oral rehydration solution. Do this every 10 minutes until vomiting stops and your child is able to keep down larger amounts of liquid. You can buy an oral rehydration solution at the grocery store or pharmacy. Ask your child's healthcare provider which types of solutions are best for your child.

• Don't give your child sports drinks. They don’t have the right mix of water, sugar, and mineral salts, and may make symptoms worse. Don’t give diluted juice.

• Don't give your child food until they have not vomited for several hours. When your child is able to eat, return to their regular diet, as tolerated. Restricting food or limiting the diet may cause the diarrhea to last longer than expected.

• If your baby is bottle-fed, you can give an oral rehydration solution for 4 to 6 hours and then resume formula. You may need to feed your baby more often to make sure they get enough fluids. You can also give an oral rehydration solution if your baby is urinating less often. Or the urine is dark in color.

• If your baby is breastfeeding you may need to feed more often. You can also give an oral rehydration solution if your baby is urinating less often. Or the urine is dark in color. 

• Don't give your child any medicines unless they have been recommended by your child's healthcare provider.

• Some children may develop a short-term (temporary) intolerance to dairy products after a diarrheal illness. If dairy seems to make your child's symptoms worse, you may need to stay away from them temporarily.

Preventing rotavirus infection

Frequent handwashing can help prevent rotovirus.

These steps may help lessen the chances that you or your child will get or pass on a rotavirus infection:

• Make sure your child gets a rotavirus vaccine. Two rotavirus vaccines are currently licensed for use in infants in the U.S. Ask your child’s healthcare provider which vaccine is best for your child.

• Wash your hands with clean, running water and soap often, especially after going to the bathroom, diapering your child, and before preparing, serving, or eating food.

• Wash soiled clothing right away.

• Disinfect any areas that may have become contaminated with a chlorine bleach-based cleanser.

• Use diapers with waterproof outer covers or use plastic pants.

• Keep your sick child home from childcare or school. Discuss this with your child's healthcare provider.

• Prevent contact between your child and those who are sick.

• Keep food preparation areas clean.

• Have your child wash their hands often, especially before eating.

When to call the healthcare provider

Call your child’s healthcare provider right away if any of the following occur:

• Your child has a fever (see Fever and children, below)

• Your child has had a seizure caused by the fever

• Has been vomiting for more than 6 hours.

• Has bloody diarrhea

• Is lethargic

• Has severe stomach pain

• Can’t keep even small amounts of liquid down

• Shows signs of dehydration, such as very dark or very little urine, crying with few or no tears, excessive thirst, dry mouth, unusual sleepiness or fussiness, or dizziness

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider