If you have been in contact with someone sick with rotavirus, how can you avoid getting infected?

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Daria Shirochina

Practitioner. She graduated with honors from Vitebsk State Medical University in 2012 with a degree in general medicine. She was awarded a certificate of honor for her achievements in her work.

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Rotavirus infection affects the gastrointestinal tract in people of any age, but is more common in the elderly, elderly and children. The prevalence of the microorganism usually increases in winter, when immunity is reduced and there is no full access to vitamins. To avoid becoming infected with rotavirus even in close contact with a patient, you must follow a few simple recommendations.

Main routes of transmission of rotavirus

Rotavirus is a microorganism that easily spreads and is picked up by humans in the environment. There are several mechanisms of infection:

• household - through objects located in the apartment (dishes, bed linen, personal hygiene items);
• food - you can become infected with food that has been touched by a carrier or a sick person (unwashed vegetables, fruits);
• aquatic - consuming liquids with rotavirus, swimming in open water during the warm season.

The possibility of becoming infected with rotavirus through airborne droplets is questionable. Some experts explain intestinal flu epidemics precisely by this method of spreading the virus.

Sometimes, when the immune system of the body decreases in adults and children, the disease is extremely severe. The patient complains of diarrhea, vomiting, fever, and abdominal pain. Sometimes rotavirus causes catarrhal symptoms: runny nose, cough, inflammation of the conjunctiva.

There are no vaccines or cures for rotavirus infection. How to protect yourself?

Among all acute intestinal infections, rotavirus gastroenteritis ranks second in its prevalence in the world and is more common in the cool season. Nevertheless, periodic outbreaks of this disease are recorded in the hot months. Why is this diagnosis called “family” and how to protect yourself from this insidious disease? We are talking with Inna Rashkevich, an epidemiologist at the Center for Hygiene and Epidemiology of the Pervomaisky District of Minsk.

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- Inna Ilyinichna, what is the peculiarity of rotavirus gastroenteritis compared to other intestinal infections? — Rotavirus infection is characterized by an acute course with fever, frequent vomiting and diarrhea.
The condition that a person experiences during illness is extremely exhausting and tiring, because, in addition to increasing weakness and fever, he is tormented by constant vomiting, abdominal pain, diarrhea and severe intoxication. To improve your well-being during this disease, it is extremely important to maintain a drinking regime to avoid dehydration. Another feature of RVI is that the virus very rarely “walks alone,” and the incidence is mainly always characterized by outbreaks within groups of children or adults, or intrafamily outbreaks. Often several people from the same family or team are admitted to the hospital at once.

The virus is very tenacious; most often, neither traditional disinfectants nor repeated freezing are able to kill it. This “endurance” is due to the specificity of its protein shell, which makes its owner absolutely resistant to the high acidity of gastric juice, as well as to the alkaline environment of bile located in the duodenum. In addition, rotaviruses have high genetic variability, resulting in a wide variety of serotypes circulating in nature.

— Can rotavirus be transmitted by airborne droplets?

— Researchers do not exclude this. Although the most common transmission mechanism is still fecal-oral. The infectious dose for humans is extremely small, and only 100 viral particles are enough to develop the disease.

From the moment of infection to the development of the first clinical symptoms, about 48 hours most often pass, while after recovery, those who have recovered can release the virus into the environment for about a month.

Rotavirus gastroenteritis with a pronounced clinical picture is suffered mainly by children aged 6 months to 3 years. Infants rarely get sick. It is assumed that this is due to the protective role of substances contained in breast milk.

There is a category of people who do not get sick themselves, but are a source of infection for others - these are the so-called healthy virus carriers, who pose an epidemiological danger because they can infect a large number of the population susceptible to RVI. Also, rotavirus infection is characterized by the “iceberg phenomenon”, in which the number of identified forms of the disease with symptoms of vomiting, diarrhea and fever is much less than the number of erased and asymptomatic forms of the disease.

— What happens in the human body during this disease?

— Entering the human body through the oral cavity, the virus easily reaches the intestines and begins to multiply in the cells of the duodenum and upper parts of the small intestine, causing inflammation of the mucous membrane with the development of the classic “triad of symptoms” — fever, vomiting and diarrhea. Within a few hours, intestinal cells begin to break down and “slough off.”

The development of diarrhea and vomiting is accompanied by impaired absorption of water and electrolytes by the intestines. This condition is extremely dangerous and can lead to uncontrolled fluid loss and dehydration. This condition is most dangerous for children (due to their anatomical and physiological characteristics and low weight).

Harbingers of a severe course of rotavirus gastroenteritis are severe weakness and pallor of the skin. For those who have had this infection, the likelihood of reinfection is high, but in this case the disease will go away easier.

— Are there any effective drugs or vaccines against RVI?

- Unfortunately no. In recent years, scientists have invented several vaccines against RVI, and some time ago the Belgian Rotarix vaccine was used in our country. However, unfortunately, supplies of this drug have been discontinued today. So far, the disease has to be content with only symptomatic treatment. At home, you need to drink plenty of small portions of various liquids: tea, alkaline non-carbonated mineral waters, raisin drinks, rice water, etc. If there is a large loss of fluid, it is necessary to drink special saline solutions for rehydration, which are sold at pharmacy kiosks. Taking enterosorbents, the surface of which binds and removes viral particles from the body and thus reduces intoxication, can be effective. However, if the condition quickly worsens, immediate hospitalization is necessary (especially if the patient is a child). Only in a hospital is adequate therapy possible in full with the parenteral administration of special solutions under the constant supervision of doctors.

To normalize the intestinal microflora during complex therapy of rotavirus infection, it is necessary to take probiotics and enzyme preparations, which will help restore the intestinal microflora and better digestibility of food.

During the acute period of development of the disease, it is necessary to exclude foods that increase intestinal motility and secretion - milk, fresh fruits, meat. 12 hours after vomiting and diarrhea have stopped, food begins with non-concentrated broth, salty cookies or crackers, and white bread is added. If symptoms do not return, add rice, baked potatoes, chicken broth with rice and homemade noodles, baked fish and poultry to the diet.

— Prevention of rotavirus infection means following basic hygiene rules?

- First of all. Rotavirus is unstable to high temperatures and is killed by boiling for 1-3 minutes. Drinking water and raw milk must be boiled for all family members and especially small children. It is not advisable to give children even unboiled milk.

Particular attention should be paid to fruits and vegetables from market stalls and shops, which must be thoroughly washed with running water and then rinsed with boiling water.

To prevent RVI in babies, it is necessary to use perfectly clean dishes for feeding the child, and when preparing infant formula, they should be diluted only with cooled boiled water and prepared exclusively for one feeding.

Older children, like adults, need to wash their hands with soap after coming in from outside, before eating, and additionally before preparing food for the whole family.

If symptoms of an acute intestinal infection appear, you should immediately isolate the patient from healthy family members and, first of all, from the child, and provide the sick person with separate dishes, linen, and a towel.

Rotavirus particles can be found on the surface of furniture, household appliances, toys, door handles, toilet flush valves, washbasin taps, clothing and other items, so you should thoroughly clean your living space.

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IN THE TOPIC
Rotavirus infection was first identified and registered in 1973 and got its name because of the shape of the viral particles, which reminded researchers of a wheel (“rota” from the Latin “wheel”). On the territory of modern Belarus, the disease has been officially registered since the beginning of 1991. When making a diagnosis, doctors rely on clinical manifestations, symptoms of the disease, and also confirm the presence of infection with laboratory tests.

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How long is a person contagious?

The carrier or patient is capable of spreading rotavirus intestinal infection throughout the entire time the microorganism is in the tissues and is excreted through feces and saliva.

After the rotavirus clinic subsides and the person stops complaining about deterioration in health, it is still necessary to follow preventive measures, as there is a risk of becoming infected. Therefore, you should not come into close contact with people who have recently been ill; you should continue to treat all surfaces and household items with disinfectant solutions.

How to protect yourself from rotavirus

When treating stomach flu at home without following recommendations to protect others, the entire family usually becomes infected. To prevent this from happening, you must follow the following rules:

• provide the sick person with a separate plate, mug, spoon and other utensils;
• provide individual towels for face, hands and body, if none were available;
• wash all household items touched by the patient with soap or antiseptic, you can pour boiling water over them;
• things need to be washed often and, if necessary, soaked in disinfectants in order to avoid infection;
• when communicating with someone who is infectious, wear a gauze mask for complete protection;
• Every day you need to wash the toilet and floors with the addition of chlorine compounds.

If your immune system is weak, it is advisable to take mineral and vitamin complexes and specialized medications. Before medicinal prophylaxis of rotavirus, you should consult a doctor for advice.

Symptoms of rotavirus infection

Rotavirus disease develops acutely, that is, symptoms appear suddenly and increase rapidly. From the moment of infection to the appearance of the first signs of intestinal flu, it usually takes from 14 hours to 4 days. In 90% of cases, all manifestations of the disease reach their peak within 24 hours. Much less often, rotavirus infection is sluggish, with a gradual increase in symptoms over 2-3 days. The average duration of the disease is 5-7 days.

Symptoms of a typical form of rotavirus gastroenteritis:

• temperature rise usually up to 37-38oC;
• signs of intoxication: weakness, general malaise, loss of appetite, headaches;
• vomiting from 2-4 times a day to 10-20 times in severe cases, usually appears before diarrhea;
• diarrhea (diarrhea) is characterized by the appearance of watery, foamy yellow stools, the frequency of bowel movements depends on the severity of the disease;
• pain in the upper abdomen of moderate intensity, sometimes cramping;
• rumbling in the intestines;
• the appearance of signs of a cold - pain when swallowing, runny nose, cough, redness of the throat - a variable sign, more common in children.

The severity of symptoms of rotavirus infection depends on many factors: the general condition of the body, the presence of concomitant diseases, and the strength of immunity to rotavirus.

Some children, and especially adults, suffer from intestinal flu in a mild form; sometimes the disease goes away almost unnoticed and does not require seeing a doctor. Less often, people become carriers of the virus: they themselves do not get sick, but they constantly excrete the virus in their feces and can be a source of infection for others.

Severe forms of the disease are usually observed in children under 3 years of age with immunodeficiency or low body weight, as well as in elderly people with serious chronic diseases. According to WHO, rotavirus kills 1-3 million children every year.

Severe rotavirus gastroenteritis is dangerous primarily due to the loss of fluid that accompanies repeated vomiting and diarrhea. Therefore, it is important to know how to avoid dehydration in children and adults. Often the fight against dehydration becomes a key part of the treatment of intestinal flu.

If a nursing mother gets sick

There are many misconceptions about treatment for women who are breastfeeding and contract rotavirus. Here are some recommendations from therapists and pediatricians:

• You cannot self-medicate; to make an accurate diagnosis, it is important to seek help from a doctor;
• rotavirus does not penetrate into breast milk, so switching to formula is not at all necessary to prevent the baby from becoming infected;
• feeding can and should be continued, but at the same time observe all hygiene rules (washing hands and chest, putting on a gauze mask, and so on);
• if there is a sharp deterioration in health, it is better to express milk and give it to the baby in a bottle;
• the use of mixtures is necessary if a secondary bacterial infection has occurred and antibiotics are required.

Natural feeding provides additional protection for the baby from viral inflammation, so the likelihood of becoming infected with rotavirus is significantly reduced. Switching to formula usually leads to the end of lactation, which does not have the best effect on the baby’s body.

Medicines: what to give your baby

Vaccines are widely used to prevent rotavirus. Other drugs do not have a targeted effect on rotavirus. A single medicine for prevention has not been invented, so doctors prescribe drugs, taking into account their general therapeutic effect on the body according to the symptoms that arise.

Enterol

The action of the drug is aimed at eliminating the symptoms of infection . Penetrating into the intestines, the medicine begins to secrete enzymes that accelerate the breakdown of protein foods, and also activates enzymes for the breakdown of milk carbohydrates.

Enterol helps cleanse the intestines of viral pathogens and toxins. Blood circulation in organs is normalized and the formation of immune cells is stimulated. In addition, the drug allows you to retain fluid and salts, preventing dehydration.

Children are usually prescribed Enterol in powder - it is sold in sachets with a dosage of 100 or 250 mg. The required amount of the drug is diluted in 100 g of warm water.

Recommended dosage:

• Children 1 year old take 1 sachet per day of Enterol-100 or 1 sachet of Enterol-250 divided into 2 doses per day. For severe diarrhea, use for up to 5 days;
• Children 2-5 years old take a sachet of Enterol-250 or 2 sachets of Enterol-100 twice a day. Duration of admission - similar to one year of age;
• Children 6 years and older - 2-3 doses of 2 sachets of Enterol-250 or 4 sachets of Enterol-100.

Polysorb

The medicine is an intestinal sorbent and has a large area of ​​action. The drug stops diarrhea and minimizes intoxication of the body.

In the intestines, “Polysorb” is not absorbed, but collects toxins and is eliminated along with them, freeing the body from viruses and the results of their vital activity. At the same time, its effect on beneficial substances is minimal.

The effectiveness of Polysorb is higher than that of activated carbon, it does not cause adverse reactions and is suitable even for children and pregnant women. The drug is sold in powder form in bags or jars.

The dosage depends on the person’s body weight:

• Children weighing up to 10 kg are recommended to take 0.5-1.5 teaspoons per day. The powder is diluted in 50 ml of water;
• For children weighing 11-30 kg, 1 teaspoon per day is recommended. To dissolve, you will need 50 ml of water;
• For children weighing 30-40 kg, 2 teaspoons per day are recommended. You need 100 ml of water.

Enterosgel

This is a sorbent with a spongy structure, thanks to which it absorbs toxins and pathogenic microorganisms and binds them. Harmful substances are removed from the body with the sorbent within 12 hours. The drug is available in the form:

• sweet paste,
• gel,
• gelatin capsules.

For children under 10 years of age, the first two forms of the drug are most suitable.

Dosage:

• Children under 0.5 years old are allowed to take 1/3 teaspoon of gel diluted with 2/3 teaspoon of water;
• Children 0.5-1 years old are given 0.5 teaspoon of gel;
• Children 1-5 years old are given 1 teaspoon of gel 2-3 times a day. You can mix it with water, tea, fruit puree;
• Children over 6 years of age are given the drug 1 dessert spoon 3 times a day.

What to do if you have been in contact with a sick person

The incubation period of the disease varies from 3–4 hours to seven days. At the same time, the person does not know that he is already infected and, perhaps, will feel worse in the near future. Due to the lack of symptoms and reluctance to go to the doctor, a diagnosis is not made. The patient comes into contact with everyone as usual and spreads the rotavirus further. Often, worries arise only at the moment when one of the family members suddenly begins to talk about severe nausea, chills and other signs of illness.

If a person is afraid of contracting inflammation of the gastrointestinal tract, it is recommended to take antiviral drugs. When rotavirus is most active:

• Arbidol,
• Anaferon,
• Viferon,
• Isoprinosine.

The concept of preventing intestinal flu may include vaccination, however, antibodies are not produced immediately, so it does not apply to methods of immediate protection after contact with an infected person.

How not to get infected and how not to get infected from a child

Prevention of rotavirus in children begins at home. If mom, dad or another family member is infected with the virus, you should follow some rules to protect your children from the disease:

• If possible, step away from caring for the baby for a while. If this is not possible, then you need to put on a gauze bandage and wash your hands before each contact with the child;
• clean the toilet and bathroom more often;
• wipe the surfaces of all objects and ventilate the room where children are;
• If a child is fed breast milk, it is better to transfer him to formula or to expressed and boiled milk during the period of illness.

Precautions in healthcare settings

In infectious diseases departments of hospitals, where they deal with the elimination of diseases caused by pathogenic microorganisms, there are rules for the prevention of rotavirus infection. They are aimed at reducing the risk of recurrent illness, so it is almost impossible to become infected with intestinal flu. The list of events includes:

• placement of patients in separate boxes, where they remain with an identical disease;
• restriction of movement around the hospital;
• quartzing, cleaning premises with disinfectants.

If the rules described above are ignored, the risk of further spread of rotavirus and infection of a larger number of the population sharply increases.

Basic preventive measures

To reduce overall morbidity, a list of measures has been created aimed at protecting the population and preventing the epidemic. The concept of rotavirus prevention includes:

• after using the toilet, going outside and visiting public places, wash your hands thoroughly with soap;
• do not open your mouth while swimming in pools and public bodies of water;
• do not drink from untested springs;
• exclude contact with the patient, transfer patients to the infectious diseases department;
• when preparing dishes, take into account the temperature regime, process ingredients well, give preference to home cooking;
• regularly process children's things and toys;
• wash vegetables and fruits and, if necessary, pour boiling water over the peels.

A vaccine against rotavirus has been created. It is not included in the National Vaccination Calendar as mandatory for all children, but can strengthen the baby’s immune defense. When administered, there is a possibility of infection, however, the pathology will be mild or asymptomatic.

How to avoid getting infected at sea

When coming to the sea, it is necessary to take a number of measures to prevent your baby from becoming infected with rotavirus. If a child goes on vacation alone, then the result of his prevention efforts largely depends on how to prevent him from becoming infected.

Before your trip, be sure to tell your child how to avoid infection and follow the simple rules yourself.:

• Since rotavirus is well tolerated in water, you should not bathe too much from the start of your vacation, since the body has not yet adapted to the new conditions. Gradually, the time of swimming in the sea can be increased;
• you need to let your baby drink bottled water and, preferably, baby water, since it is better purified in production than regular drinking water;
• On vacation, it is better to give your child familiar foods: cereals, purees, juices. Changes can cause stress in the gastrointestinal tract, which will lead to the intestines being vulnerable to all kinds of infections;
• food must be fresh and well-cooked;
• dairy products can be dangerous, so it is better to avoid them when traveling;
• It should be remembered that in places with large crowds of people there are many times more pathogenic bacteria;
• Hygiene standards must be strictly observed, that is, washing hands before eating should become a mandatory resort ritual;
• You should have in your first aid kit the necessary medications for an immediate response to the onset of the disease.