By Robin Stevenson
If you just found yourself saying “rota-what?” you’re not alone. But chances are if you have children under the age of five, you’ve already felt the effects of this highly contagious virus in your home — probably marked by several days of soothing a child wracked with severe vomiting and diarrhea.
In fact, according to one study, rotavirus accounts for about one in five bouts of gastroenteritis (stomach flu). It’s the most common cause of acute diarrhea in babies and young children between the ages of six months and two years, and almost all children get rotavirus at least once by age five. According to the Canadian Paediatric Society (CPS), up to 600 children afflicted with the virus — a leading cause of illness and death in developing countries — are hospitalized in Canada each year.
The virus is generally spread from person to person by hand or when children put their fingers in their mouths after having contact with something touched by someone who has rotavirus. Symptoms start within one to three days of being exposed and usually begin with a high fever (40Â°C/104Â°F), nausea and vomiting, followed by abdominal cramps and profuse watery diarrhea. Symptoms can persist for three to seven days.
While this is a common childhood virus, dehydration is a real concern for infants, explains Dr. Mitchell Zelman, head of pediatric and newborn medicine at Queen Elizabeth Hospital in Charlottetown. Babies showing symptoms such as dry mouth, sunken eyes, an absence of tears, decreased urine output or lethargy, should be seen by a doctor immediately. They may require intravenous rehydration and even a hospital stay.
The most important goal is to maintain hydration, says Dr. Joan Robinson, a member of the CPS’s infectious disease and immunization committee. “Breastfeeding should continue, but if a bottle-fed infant has significant vomiting, we normally recommend just clear fluids. If there’s diarrhea and no vomiting, I would suggest staying on as normal a diet as possible.” Drugs that suppress diarrhea should not be used with infants, she says, and daycare and playgroups should be avoided until symptoms are gone for 24 hours. Frequent handwashing by all family members is essential to limit the virus’s spread.
In October the CPS issued a statement urging parents to vaccinate infants against rotavirus with one of the two vaccines approved for sale in Canada: Rotarix and RotaTeq. Both are liquid oral vaccinations given at two, four and, in the case of RotaTeq, six months. In late September the U.S. Food and Drug Administration updated the label on Rotarix after a study linked it to an increase in the risk of intussusceptions, a serious intestinal condition. “The maximum cases were four per 100,000 vaccinated children,” says Dr. Robinson. “The same risk may occur with RotaTeq. But this is a very slight risk, and it is many-fold lower than the risk that a child will end up in hospital with severe dehydration if he or she is not vaccinated.”
Parents need to consider the benefit of prevention, states Dr. Robinson. “The vaccine is really almost 100 percent effective in terms of preventing severe disease,” she says. “The reason the provinces have not jumped to add this vaccine is because of the costs.” Parents can expect to pay about $200″“$250, but some health insurance plans do cover the expense.
In December Prince Edward Island became the first province to offer a rotavirus vaccine as part of its immunization schedule. “We know that many parents feel that if the vaccine is not provided by the province, maybe it’s not important,” says Dr. Zelman, who is also the province’s deputy chief health officer. “That’s why we decided to take this on.” He also cites the use of the vaccine in the United States as an example — hospitalization rates for rotavirus there have been drastically cut since 2006.
In the end, the choice of whether or not to vaccinate must be made by parents. Shannon Quinn-Hill of Savage Harbour, P.E.I., decided to vaccinate her now three-month-old son after much deliberation. “As parents, we need to be well informed about what we put into our children’s bodies,” says Quinn-Hill. “This vaccine was in my child’s best interest.”