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Rotaviral gastroenteritis
Page content: Victorian statutory requirement | Infectious agent | Identification | Incubation period | Public health significance & occurrence | Reservoir | Mode of transmission | Period of communicability | Susceptibility & resistance | Control measures | Outbreak measures
Victorian statutory requirement
Isolated cases are not notifiable.
School exclusion: exclude from school or child care centre until at least 48 hours after symptoms have ceased.
Infectious agent
Rotavirus, predominantly Group A, is the causative agent.
Identification
Clinical features
The disease is characterised by vomiting and watery diarrhoea lasting for three to eight days. Fever and abdominal pain occur frequently. Treatment is symptomatic. Maintenance of hydration is the most important measure.
Method of diagnosis
Diagnosis may be made by rapid antigen detection of rotavirus in stool specimens. Strains may be further characterised by enzyme immunoassay or reverse transcriptase polymerase chain reaction. Stools for these tests should be collected in the acute phase of illness.
Incubation period
The incubation period is approximately 24–72 hours.
Public health significance & occurrence
Disease usually occurs in infants and young children, particularly under two years of age. Adults can also be infected although their resultant disease tends to be mild. In temperate climates it is more common in the winter months. Rotavirus gastroenteritis is the leading cause of infant viral gastroenteritis worldwide. The cost of managing rotavirus disease in Australia is estimated at $26 million annually.
Reservoir
Humans.
Mode of transmission
Rotavirus is transmitted predominantly via the faecal-oral route. Rotavirus has been detected in respiratory secretions. Because the virus is stable in the environment transmission can occur through ingestion of contaminated water or food and contact with contaminated surfaces.
Period of communicability
Rotavirus is communicable during the acute stage of disease and while viral shedding continues. Excretion of virus for greater than 30 days has been documented.
Susceptibility & resistance
Everyone is susceptible to infection. Immunity after infection is incomplete, but repeat infections tend to be less severe than the original infection.
Control measures
Preventive measures
Prevention is primarily through good personal, food and home hygiene.
Control of case
Provide advice regarding personal hygiene, exclusion from work or school or child care and attempt to identify source of infection. Health care workers and food handlers should be excluded from work until at least 48 hours after diarrhoea has ceased.
Control of contacts
Identify whether any contacts are ill. Provide advice about strict personal, food and home hygiene.
Control of environment
Rigorous attention to clean-up procedures and personal and home hygiene is essential to prevent further transmission.
Outbreak measures
An outbreak is defined as two or more related cases of gastroenteritis. The primary aim is to prevent further disease by identifying the source, cleaning contaminated environments and isolating cases.
Special settings
Specific protocols for the management of outbreaks in special settings are available from the Communicable Diseases Section of the Department of Health, phone 1300 651 160.
