Download Probability of rotavirus infection Age (months)

Rotavirus – in 4 parts
Dr Gaurav Gupta
Charak Clinics
www.charakclinics.com
DCH, DNB, MAAP, MIAP
What are we talking about ?
• A disease that affects ALL
children before the age of 5
years
• Responsible for 5 % deaths
of all children less than 5
years.
Rotavirus Virology – Part 1
• Rota – means wheel-like in greek
• Double-stranded RNA virus
Rotavirus – this is how it looks!
Are these multiple serotypes important ?
NOT REALLY !
Because Natural RV infection attenuates
severity of subsequent infections, regardless
of serotype
Cumulative probability of rotavirus infection in 200
Mexican infants during the 1st 2 years of life
Probability of rotavirus infection
1.0
1st infection
0.9
0.8
2nd infection
0.7
*
0.6
0.5
3rd infection
0.4
0.3
4th infection
0.2
0.1
5th infection
1
2
3
4
*Complete protection against
moderate-to-severe diarrhoea
5
6
7
8
9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Age (months)
NEJM 1996; 335: 1022
Scary Statistics– Part 2
• Diarrhoea is third largest
cause of death in under 5
• Rotavirus are the single
most important cause of
diarrhoea worldwide.
• Annually rotaviruses
cause
– 5% of all deaths in
children
– 527,000 deaths
• 80% of deaths are
in infancy
• > 100,000 in India
– 39% of childhood
hospitalisations for
diarrhea
Lancet Infect Dis 2007; 7: 56 Wkly Epidemiol Rec 2007; 82: 285 JID
2005; 192(Suppl 1) S1 EID 2006;12: 304
Part 3 - Can we clinically diagnose
Rotavirus gastroenteritis (RVGE)?
• High fever and vomiting in a 6 month
to 2 year child
• Severe vomiting resistant to antiemetics
• Followed by explosive diarrhea,
severe with significant peri-anal
excoriation
• The diarrhea can be mild to severe
and generally lasts 3-9 days. Illness
usually begins 3 days after exposure.
Part 4 – Preventing rotavirus
• Democratic Virus – affects the
entire world equally, without
differentiating the rich & poor –
almost 40 % of hospital
admissions worldwide due to
diarrhea are due to RVGE.
• Hand-washing and sanitation.