Gastroenteritis with rotavirus, methods of prevention and treatment

Acute gastroenteritis is generally defined as a decrease in the consistency of the chairs (liquid or semi-liquid) and / or an increase in the frequency of discharges typically 3 24-hour chairs with or without fever or. However, a change in the consistency of the previous seats is more significant for diarrhea than the number of seats, especially in the first months of life. Acute diarrhea usually lasts between 7 and 14 days. Gastroenteritis with rotavirus is caused by rotavirus that infects the stomach and intestine, being frequent in the small baby. Children under 5, especially between 6 months and 3 years, are more vulnerable to the disease. Rotavirus infection is primarily transmitted by faecal-oral, person-to-person or contact with contaminated objects such as, generally, the target group being children under 5 years of age.

After infecting contact, incubation takes about 24-72 hours, followed by 3-8 days of vomiting, diarrhea, and abdominal pain lasting up to 3 weeks. The person infected with Rotavirus excretes a large number of viruses (which resist the external environment for 30 days), so that the disease reaches the patient's family quickly but also in the community in which he lives. Infants and young children with diarrhea caused by rotavirus are susceptible to severe symptoms and are more accentuated than patients with diarrhea of ​​other aetiology. Clinical symptomatology begins relatively suddenly after 1-3 days of incubation through: - fever - frequent vomiting - - asthenia - abdominal cramps - low consistency diarrhea -. Diarrhea occurs almost constantly after vomiting.

The disease lasts for an average of 5 to 8 days. During the period of vomiting, the frequency is reduced or disappeared, it is moderate and the number of seats oscillates between 3-10 per day. The chairs are aqueous, yellow-green or white acolic (sometimes), with mucositis and very rare muco-blood. Muscle and maculo-papular pain may be associated. Dehydration is moderate in most cases, only in 10-20% of cases is severe.

It is done in the clinical stage, taking into account the anamnesis, the diarrhea chair's particularity, the consequences on the body and the laboratory data required for the certainty of the etiological diagnosis. Rotavirus gastroenteritis is preceded by vomiting that lasts for 8-12 hours and only then diarrhea. The general condition is not severely influenced and the epidemiological context of \. In most cases, the usual analysis suggests an aspect of viral infection with minimal changes in the absence of inflammatory syndrome. Quite frequently encountered are hydroelectrolytic disorders requiring careful monitoring and correction.

Etiological diagnosis of gastroenteritis with rotavirus is performed through several investigations: coprocultures, viral cultures or direct examination by microscopy. The treatment of acute gastroenteritis without dehydration is carried out in the following stages: Hygiene-dietetic treatment The stages of hygienic-dietary treatment: • The first stage is digestive rest (temporary suppression of food) and is done by initiating a water diet for the loss-. The duration of digestive rest is not to be prolonged because it is deficient in protein and it is calorie or hypocaloric. If gastric tolerance is good and if the form of the disease is not severe, some pediatricians give up the dietary diet and start dietary treatment with the transition diet. • The second stage of dietary treatment is, which can not be longer than 24 hours.

Anti-diarrheal herbs are administered in an amount of 150 ml / kg body weight. • The third stage of dietary treatment is refueling and can begin as soon as hydroelectrolyte losses have been replaced. Rapid and early refueling lowers the number and volume of the seats. As a principle in refueling is the qualitative replacement of the previous diet with a lactose-free or low-lactose diet to respect the temporary decrease of intestinal activity. Refueling consists of: - gradually reaching a normal diet as it returns, - progressive introduction of the milk that the infant received prior to contacting the virus, in consideration of the age, weight, presence and degree of dystrophy.

The naturally fed baby will be put on the breast after the first 24 hours. In mixed-fed infants, mother's milk is also introduced and supplemented with transition food. • The fourth stage of dietetic treatment consists of passing or progressively returning to the full nutrition corresponding to age and to digestive tolerance. The principle of progressivity is the progressive introduction of new food, daily or 2 days, by replacing the same amount of refueling food. It will take into account digestive tolerance, age and disease form.

Increasing the amount of food will also take into account the appearance of the stool, the general condition and the age of the child. If after the gradual introduction of dairy food, the stool becomes less consistent or softer, there is no justification for a new return to the pre-treatment regimen for the gut. Drug treatment There is no specific drug treatment for the treatment of rotavirus infection, but the doctor may recommend medication for symptomatic treatment. Antidiabetic medication should be regarded as a symptomatic remedy and is recommended after 2-3 years of age and in cases of excessive and prolonged diarrhea. Treatment is not indicated in rotavirus gastroenteritis.

General prophylactic measuresThe rotavirus gastroenteritis is a contagious disease. The most effective way to prevent viral gastroenteritis is to adhere to hygiene rules, especially in children's collectives (nurseries, kindergartens, hospitals): - in children's care centers, symptomatic children will be separated from asymptomatic children, - caregivers . Because lack of access to treatment is one of the major causes of childhood mortality due to rotavirus infection, immunization prevention is an approach to reducing the impact of this infection. The most important goal of immunization against rotavirus is to prevent the onset of acute dehydration syndrome of over 10%. Thus, an effective vaccine does not necessarily have to completely protect against all or even against mild gastroenteritis.

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