Rotavirus Flashcards
True or false: rotavirus is nationally notifiable?
True - routine.
Which organism causes rotavirus?
Rotavirus.
Group A common, Group B rare.
How is rotavirus transmitted?
Person-person: faecal-oral
Contaminated water, food, surfaces (environmentally stable).
Resp transmission possible - detected in secretions.
What are the clinical features of rotavirus?
- Watery to severe dehydrating diarrhoea
- Fever
- Vomiting
- Abdominal pain
- Shock
Sx lasts 3-7 days usually.
Which groups are high-risk for rotavirus?
- First Nations children
- Immunocompromised
- Short gut syndrome
What are the case definitions for rotavirus?
Confirmed:
* Wild-type detected by PCR OR
* Unclear type AND >= 8mo OR no vaccine last 4 weeeks
Probable:
* Ag assay
* PCR (but not distinguish wild vs. vaccine type)
* EM
* Isolation
How is rotavirus diagnosed?
PCR usually.
False positives post-vaccination. PCR can distinguish wild from vaccine type.
What is the incubation period for rotavirus?
24-72 hours.
What is the infectious period for rotavirus?
While shedding continues.
Usually 4-8 days but up to 30 days.
What is the outbreak definition of rotavirus?
Per gastroenteritis guidelines.
2+ cases of D+/-V in a 24 hour period
OR
2+ cases of D+/-V in a defned time frame in a setting that is prone to outbreaks such as hospitals or ACFs.
How are outbreaks of rotavirus managed?
How is rotavirus prevented?
Vaccination
* NIPS for all infants
* Rotarix 2, 4yo (oral vaccine)
Hygiene - personal, food, cleaning
Note to be given >6mo or history of intusussception. 80% shed virus after first dose. 30% after 2nd dose.
What type of vaccine is the Rotavirus vaccine?
Oral live-attenuated.
Which vaccines are available against rotavirus?
Rotarix - a human monovalent vaccine (given in a 2-dose schedule at 2 and 4 months of age)
RotaTeq - pentavalent human bovine reassortant vaccine (given in a 3-dose schedule at 2, 4 and 6 months of age).
What resources are available for public health management of rotavirus?
No SoNG.
DH protocol and gastro outbreak guidelines.
How are cases of rotavirus managed?
No routine case follow-up.
- Interview: ascertain vaccination status
- Treatment: supportive
- Isolate/exclude - no isolation; exclude from primary/ECEC 24hrs post diarrhoea; food handlers and HCW until 48hr after diarrhoea
- Educate: hygiene, no food preparation, cleaning
Most cases notified are age 1-2 months and vaccine-related (very limited typing in Victoria to distinguish vaccine/wild-type strain).
How are contacts of rotavirus managed?
Nil routine.
What environmental management is required for rotavirus?
None specific.
Case to pay close attention to cleaning at home to prevent further transmission.
What is the public health follow-up of rotavirus?
Limited to outbreak scenarios using standard gastro outbreak guidelines (mainly childcare cluster).
Australian Rotavirus Surveillance Program (ARSP) characterises rotavirus genotypes causing severe disease in children ≤ 5 years old.
True or False: rotavirus is the leading cause of infant viral gastroenteritis worldwide?
True
Which groups do rotavirus infections mostly occur in?
- Unvaccinated infants and young children (mainly < 2yo)
Adults can be infected but usually mild.
During which season are rotavirus infections most common?
Winter
By what percentage has the rotavirus vaccine reduced rotavirus morbidity and mortality in Australia?
70%
10,000 admissions per year in kids < 5yo in Aus before vaccination.
