Everything You Need to Know About Rotavirus

Medically Reviewed By Michaela Murphy, PA-C
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Rotavirus is a cause of viral gastroenteritis, which people commonly call “the stomach flu.” Rotavirus is not a flu virus at all, but it is highly contagious. Symptoms of rotavirus infection include fever, vomiting, and watery diarrhea. Symptoms of rotavirus infection in infants and children are generally more pronounced than in adults. Since rotavirus is a virus, antibiotics cannot treat it. Instead, treatment relies on steps to prevent dehydration.

This article covers rotavirus infection, including its symptoms, causes, and treatment. You will also learn ways to prevent it, including by receiving the rotavirus vaccine.

What is rotavirus?

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Rotavirus is actually a group of 10 virus species. You can find these viruses anywhere in the world. In fact, rotaviruses are the most common cause of severe diarrhea in young children worldwide. Nearly all children have either had the infection or been immunized against rotavirus by the time they are 3–5 years old.

Rotavirus is highly contagious. It spreads through the fecal-oral route — either by direct contact with feces or by contact with contaminated objects, food, or water. The highest rate of infection takes place in the winter months, November through March. In tropical climates, rotavirus is more constant. 

Particularly in children, especially those with compromised immune systems, rotavirus infection can cause severe diarrhea and dehydration that can lead to death.

There is a rotavirus vaccine and it is very effective. Although many developing countries do not have a routine vaccination program, the vaccine has significantly reduced the number of people who develop severe gastroenteritis and die, according to the World Health Organization (WHO).  

What are the symptoms of rotavirus infection?

Rotavirus symptoms appear about 1–3 days after exposure. They start suddenly, can last up to a week, and include:

Contact your doctor right away if your baby is 3 months old or younger and has diarrhea, has a fever higher than 100.4°F (38°C), has a dry diaper for 2–3 hours, or is listless.

For older infants and children, check with your doctor for diarrhea accompanied by:

  • fever for more than 24–48 hours
  • bloody or blood-streaked diarrhea
  • distended abdomen
  • severe abdominal pain
  • lethargy
  • lack of eating or drinking
  • rash or jaundice, which is yellowing of the skin or eyes
  • vomiting for more than 12 hours or throwing up bloody, green, or coffee ground-like material

You should also find prompt medical care for signs of dehydration, including:

  • dry mouth and tongue
  • fewer wet diapers than normal
  • fussiness
  • increased thirst
  • listlessness
  • no tears when crying
  • sunken eyes, cheeks, or soft spots
  • weight loss

Rotavirus in adults generally causes milder symptoms, says the Centers for Disease Control and Prevention (CDC). This is due to either having received the vaccine or already having experienced natural infection.

Learn more about when to take a child to the doctor for diarrhea here.

How does rotavirus spread?

Rotavirus is a highly contagious virus. Infected people shed the virus in their stool. It spreads through contact with these infected feces. It can also spread through contaminated objects, food, or water. 

Unvaccinated infants and young children are at highest risk for contracting rotavirus and getting sick from it. Family members and close contacts can get the virus from being around them.

How can you prevent rotavirus infection?

It is not always possible to prevent rotavirus infection. The virus is highly contagious and you can get it more than once. However, you can help prevent severe disease by getting the rotavirus vaccine.

The vaccine protects about 90% of children from getting severe disease. About 70% of children who get the vaccine will not get sick at all from a rotavirus infection. Keep in mind that the vaccines approved for use in the United States — Rotarix and RotaTeq — help prevent rotavirus illness caused by most, but not all, types of rotavirus.

Doctors give the first vaccine dose at 2 months of age. Repeat doses are due at 4 months and sometimes 6 months. Rotavirus vaccine side effects are usually mild and include:

According to the CDC, good hygiene is not enough to prevent rotavirus disease. However, handwashing and hygiene can help prevent the spread of many other diarrheal and respiratory diseases.

In addition, natural first infections do not necessarily protect against a severe second infection, so children who have had rotavirus illness before should still get the vaccine. You are less likely to get sick from rotavirus if you get the vaccine.

Learn about vaccines required for U.S. children here.

How do you diagnose rotavirus infection?

Rotavirus is usually a clinical diagnosis, meaning that your doctor uses your symptoms, an exam, and your history to make a diagnosis. Stool testing can confirm the diagnosis. However, doctors typically do not order testing unless symptoms are severe or persistent.

If your healthcare professional wants a stool test, you will need to bring in a stool sample. The clinic will check it for rotavirus and potentially other germs that can cause diarrhea.

What is the treatment for rotavirus?

There is no specific treatment for rotavirus. Antibiotics will not work because it is a virus, not a bacterium. So, the aim of treatment is to prevent dehydration. This includes drinking plenty of fluids.

Oral rehydration solutions are most helpful. Avoid apple juice and sodas, as they are high in sugar and can make diarrhea worse. Do not use antidiarrheal medicines unless your doctor recommends them.

If dehydration becomes severe, hospitalization for IV fluids, which are given through a vein, may be necessary.

Learn what foods to avoid when you have diarrhea.

Outlook

Rotavirus is usually a self-limiting disease. In most cases, symptoms resolve within a week or so. The main complication is dehydration. Severe dehydration can be fatal. Other possible but rare complications include:

Discover the dangers of dehydration here.

Other frequently asked questions

Here are other questions that people ask about rotavirus.

What are the first symptoms of rotavirus infection?

Rotavirus symptoms tend to start suddenly. The main symptoms are watery diarrhea, vomiting, abdominal pain, and fever.

How long does rotavirus last?

Rotavirus symptoms typically last 3–8 days.

What does rotavirus do to humans?

Rotavirus damages the cells that line the small intestine. This impairs the cells’ ability to absorb nutrients and electrolytes. In turn, this leads to problems with water absorption in the large intestine. The result is watery diarrhea.

Is rotavirus contagious to adults?

Yes, adults can get rotavirus. However, the disease tends to be milder in adults than in children.

Summary

Rotavirus is a very common and highly contagious diarrheal disease. The virus spreads through contact with an infected person’s feces or contaminated objects, food, or water.

Infants and young children are at highest risk of the disease. A vaccine is available. It will not always prevent symptoms, but it can help your child avoid severe disease.

Treatment mainly involves preventing dehydration with extra fluids until the virus runs its course or symptoms subside. This takes about a week. 

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Medical Reviewer: Michaela Murphy, PA-C
Last Review Date: 2022 May 11
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