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29-Rotavirus Enteritis and Vaccines

                  Up-dates on Rotavirus Enteritis and Rotavirus Vaccines 

Rotavirus is called ‘ democratic virus’ because it can affect both poor and rich; developed or under developed countries.But the country’ s capacity to perform rotavirus vaccine makes the difference on the damage that the virus makes on community.
 
Since the whole world knows much more about viruses due to Covid 19 pandemic,the information I report here about rotavirus and its vaccines will be more familiar to you than before corona virus pandemic.
 
Rotavirus gives much more damage to human health in underdeveloped countries where it is not easy to reach clean water,sanitation and health care services.Infants and elder people lose their lives in these countries because of rotavirus.On the contrary , in developed countries especially if the rotavirus vaccines are performed by health care providers, rotavirus doesnt cause severe illness.
 
One third of elder people infected with rotavirus should be admitted to hospitals and one third of these die.Nevertheless if it is easy to access health care providers, death toll rate decreases.
 
In the first four years of life rotavirus is the main virus that cause severe diarrhea.Between 5-12 years of age Noravirus is the common cause. The main reason to apply to hospitals in developed countries is rotavirus. 10-100 rotaviruses are enough to make disease in human.This virus just like SarsCov 2 holds to human cell thightly and multiply rapidly in the cell by the help of spike protein.They are thrown in huge amounts in to intestines.In 1 ml of stool there can be detected 100000000000 rotaviruses.
 
Symtoms usually begin in 3-5 days after exposure to the virus.The patient begins to throw rotavirus with stool in 3 days after the exposure and in day 5 this reaches the maximum.Diarrhea and virus discharge with stool may continue for 10 days.
 
Fever is present in one third of the cases.
 
Rotavirus is the main reason of diarrhea that cause hospital admissions in infants,small children and elder people.The main presentation is dehydration .Disinfectants do not affect rotavirus,but bleach does.
 
Rotavirus can be transmitted via upper airway but rarely.The most common way of transmission is the fecal-oral way that is the hand is infected with the virus and the human takes it via mouth.This shows us the importance of hand washing again.
 
The virus may spread 6 metres away.If the toilet seat cover is open while you are flushing the siphon,the tooth brush near the sink may be contaminated.
 
Rotavirus vaccines are effective and safe.Effiency of the rotavirus vaccines are about %98.Rotavirus vaccine decreases hospital admittance by %84.Side-effects are very rare.Mild diarrhea and nausea and vomiting sometimes.
 
There are two brands: Rotateq and Rotarix.For both of them,the proper time for the first dose is when the baby is 6 weeks to 15 weeks of age. Rotarix is given in two doses and Rotateq is given in three doses.Both of them are safe and efficient.
 
There should be at least four weeks between two rotavirus doses.
 
If you begin with Rotateq,you should continue with Rotateq, if you begin with Rotarix you should continue with Rotarix.
 
The time for the last dose is until 24 weeks of age for Rotarix and 20-22 weeks of age for Rotateq but if necessary for Rotateq it may be as long as until 32 weeks of age.( if there is no other solution).
 
Premature babies born after 25 weeks of gestation can be given rotavirus vaccine from 6 weeks of life.If the baby stays in hospital until 6 weeks ,rotavirus vaccine can be performed before discharge. Baby’s doctor will decide for the time of the vaccine but in my opinion for Rotarix 3 and 5 months are good.For Rotateq vaccine 2,4,6 months or 3,5,7 months or 3,5,6 months are good.They can be given simultaneously with the other vaccines. Rotavirus vaccines are given orally.No need for injections is nice.If the baby is neither hungry nor full when brought to vaccination ,she or he will swallow it easily. Babies can be fed after the vaccine.If the baby usually vomits after feeding it is better to wait for some time after the vaccination. If the baby vomits after rotavirus vaccine is given, repeat doses are not advised, because it sticks to the surface of the gastrointestinal system immediately. Mild diarrhea is not a contraindication for rotavirus vaccine but when moderate to severe diarrhea exists , rotavirus vaccine should not be given. Babies with short bowel syndrome or who had serious bowel problems can not have rotavirus vaccine. If there is a pregnant woman in the household ,rotavirus vaccine can be given.If there is an immunosupressed person in the household,he or she should not change baby’ s diapers for some weeks. Since we have understood the importance of vaccines due to Covid 19 pandemic,we know admire the vaccines more than ever. My daughter had had rotavirus diarrhea when she was only ten months old.Those days rotavirus vaccine had not been invented.Her diarrhea was so serious that we had thought it was cholera and we were so much afraid that we would lose her.I had learned that rotavirus test was possible in a private laboratory and by this test we had learned that she ha rotavirus diarrhea.I think nowadays babies are very lucky to have this vaccine.

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