Rotavirus

Rotavirus Factsheet

What is rotavirus?

Rotavirus is the most common cause of diarrhoeal disease among infants and young children worldwide. Infants and young children in crèches and children's hospitals are particularly vulnerable to infection. Susceptibility is greatest between 6 and 24 months of age. Usually by five years of age, most children will have been infected and have acquired immunity to the virus.

The virus is also a common cause of diarrhoea in the elderly living in long-term care facilities and homes for older adults. In 2016, rotavirus remained the leading cause of diarrheal deaths among children globally, contributing to around 129,000 deaths in children under the age of five.

How is rotavirus spread?

Rotavirus is highly contagious and is primarily transmitted via the faecal-oral route. Infection can also spread through airborne droplets, contaminated water and contaminated objects such as toys, doorhandles, toilet seats, nappies and water taps.

The virus is shed in the faeces of infected individuals during the acute stages of illness, when they are symptomatic, and for the first three days after recovery. In healthy children, this shedding can last up to a week, but in immunocompromised individuals it may persist for up to a month, significantly increasing the risk of spreading the infection.

What are the symptoms of infection?

Symptoms generally appear within 1-2 days after infection and include vomiting, severe watery diarrhoea, stomach pain, cramps and low-grade fever. Vomiting and diarrhoea typically last 3 to 8 days. Asymptomatic carriers are common. With severe vomiting and diarrhoea, a child may become dehydrated from acute loss of fluids and electrolytes and require hospitalisation for rehydration therapy. If left untreated dehydration could lead to shock, cardiac arrhythmia and death.

How is rotavirus diagnosed?

Diagnosis is typically made through rapid antigen detection of rotavirus in stool specimens. Strains may be further characterized by enzyme immunoassays, immunochromatographic rapid tests, electron microscopy or genome-detecting assays (polymerase chain reaction).

How is rotavirus infection treated?

For most cases in healthy individuals, the illness is self-limiting lasting only a few days. The treatment focuses on maintaining fluid balance to prevent dehydration. Drinking enough water or other fluids is very important to avoid dehydration. For breastfed infants, breastfeeding should continue. For bottle fed infants, milk and oral rehydration fluids are recommended. Sugary drinks should be avoided. In cases of severe dehydration, hospitalisation for intravenous rehydration may be required.

How do you prevent rotavirus infection?

Thorough hand washing is the best preventive measure.

• Wash your hands thoroughly with warm soapy water after using the toilet, changing nappies, and before and after preparing or serving food.
• Wash your hands upon entering and leaving a healthcare facility or day-care setting.
• People ill with rotavirus-like symptoms should avoid handling food or caring for others until they are symptom free for at least 48 hours.
• Infected children should be excluded from daycare facilities until 48 hours after symptoms have resolved.
• Keep the belongings of infected children separate from others and sanitise them.

Is there a vaccine?

Yes, the rotavirus vaccine is now part of the childhood immunisation schedule. All babies born on or after 1 October 2016 will be offered oral drops of the rotavirus vaccine at 2 months or 4 months of age. Two doses are required and must be delivered at least four weeks apart. The vaccine is not given to babies aged 8 months or older.

Sources

NHS Wales. Available at: https://111.wales.nhs.uk/pdfs/34390_English_leaflet%20WEB.PDF

NHS England. Available at: https://www.nhsborders.scot.nhs.uk/media/197851/Rotavirus-June-2014.pdf

ECDC. Available at: https://www.ecdc.europa.eu/en/rotavirus-infection/facts

CDC. Available at: https://www.cdc.gov/rotavirus/about/index.html

Children’s Health Ireland. Available at: https://media.childrenshealthireland.ie/documents/Immunisation-Rotavirus-Guideline-.pdf

Public Health Scotland. Available at: https://publichealthscotland.scot/population-health/health-protection/infectious-diseases/rotavirus/overview/

Healthline. Available at: https://www.healthline.com/health/rotavirus-death-rate#worldwide

Updated: 07 February 2025