The weather turns cold to prevent children from being attacked by rotavirus
Recently, the weather turns cold, and it is the high incidence of children's autumn diarrhea. Autumn diarrhea is mainly an acute gastrointestinal infectious disease caused by rotavirus. Rotavirus belongs to the Reoviridae family and is the most common pathogen of pediatric diarrhea [1]. Because the virus particle looks like a wheel under the electron microscope, it is named "rotavirus" [1]. Rotavirus mainly invades the villi epithelial cells of the small intestine, causing cell damage and reduced villi absorption capacity, leading to diarrhea [2].
Children under the age of two are most susceptible to infections
There are about 1.7 billion cases of childhood diarrhea in the world every year [3], a 2014-2015 my country diarrhea surveillance study [4], a shows that rotavirus accounts for viral diarrhea The ratio exceeds 90%, and almost every child has been infected with rotavirus before 3 to 5 years old [2]. A surveillance study showed that the younger the infection, the more serious the condition may be [5],b. According to estimates by the World Health Organization[6], in 2013, about 220,000 children under the age of 5 died from rotavirus infection. An epidemiological study in my country [7], c showed that more than 60% of children with rotavirus diarrhea occurred before 1 year old, and more than 90% occurred before 2 years old.
rotavirus is mainly transmitted through the feces-oral route. The feces of infected children contain high concentrations of rotavirus. After being discharged through the feces, it may contaminate food, water or toys, causing transmission [8]. In addition, it can also be spread through respiratory droplets and close human-to-human contact [8]. Rotavirus infection is a self-limiting disease, with varying clinical manifestations, and may be asymptomatic, vomiting, fever, diarrhea, dehydration, electrolyte imbalance, and even death may also occur [1].
Rotavirus infection may be complicated by extra-intestinal infections[1], such as central nervous system infection (can be manifested as convulsions, viral encephalitis or meningitis, Reye syndrome, epilepsy, polio-like syndrome, etc.), respiratory tract Infection (the most common, may cause acute pharyngitis, bronchitis, pneumonia, etc.), hepatitis and kidney damage and other diseases.
has no specific medicine for the treatment of rotavirus infection, and prevention of dehydration is very important.
The 2013 WHO position paper pointed out [9]: There is currently no specific medicine for the treatment of rotavirus infection. The cornerstone of its treatment is fluid supplementation and zinc supplementation. Fluid supplementation is used to prevent dehydration, and zinc supplementation is used to reduce the severity of diarrhea and shorten the course of the disease. Other treatment measures include continued breastfeeding. After diarrhea occurs, you should pay attention to a reasonable match with your child's diet, mainly light. As long as the child does not experience frequent vomiting, the child should be encouraged to eat more, mainly liquid and semi-liquid foods, such as milk, rice soup, and porridge.
Parents should pay special attention to prevent the child from dehydration. Once there is a decrease in urine output, no tears when crying, dry mouth, sunken eye sockets, sunken fontanelle, reduced skin tone, lethargy, lethargy, weakness and other dehydration symptoms[10], they should seek medical attention immediately. , Otherwise it may endanger life.
In 2016, "Chinese Children's Acute Infectious Diarrheal Disease Clinical Practice Guidelines" pointed out [11]: At present, the commonly used method of rehydration in China is oral rehydration salts, and hypotonic oral rehydration salts are strongly recommended. The
rotavirus diarrhea is a category C infectious disease in my country [4] and is highly contagious [12]. A 2014-2015 my country Diarrhea Surveillance Study[4], a showed that more than 90% of the confirmed cases of infectious diarrhea* (infectious diarrhea other than cholera, dysentery, typhoid/paratyphoid) in the country were viral diarrhea , Bacterial diarrhea accounted for less than 10%; viral diarrhea, rotavirus infection accounted for more than 90%.
rotavirus can survive on the hands for several hours and on the surface of the toy for several days [13]. The US CDC pointed out that frequent hand washing and improved hygiene are important, but not enough to prevent rotavirus infection [14]. The World Health Organization recommends: Vaccination is the best way to prevent rotavirus infection[15]; Rotavirus vaccine should be vaccinated as soon as possible from the baby's 6 weeks of age (6 weeks of age ≈ 1.5 months of age), and the baby should be provided with corresponding measures before infection The protection of [9].
This article is provided by Merck China
If you want to learn more about disease knowledge and related information, please consult medical and health professionals
09-2022-CN-ROT-00508
References:
[1] Fang Hesong. Pediatric Diarrhea. Beijing: People's Medical Publishing House. 2009.12.
[2] World Health Organization.Rotavirus vaccines.WHO position paper–January 2013.Wkly Epidemiol Rec.2013;88(5):49-646.
[4] Zhang Ping, Zhang Jing. my country 2014-2015 Analysis of the status of surveillance of other infectious diarrhea. Chinese Journal of Epidemiology. 2017;38(4):424-430
a Research design: Collection of other infectious diarrhea reported cases and public health emergencies from the China Disease Control Information System from 2014 to 2015 The event data, including children and adults, are analyzed by descriptive epidemiology for their epidemiological and pathogenic information.
*Other infectious diarrhea refers to infectious diarrhea other than cholera, dysentery, typhoid fever/paratyphoid fever, and is a Class C infectious disease specified in the "People's Republic of China Law on Prevention and Control of Infectious Diseases". The pathogens mainly include bacteria, viruses, parasites and so on.
[5] Mathew A, Rao PS, Sowmyanarayanan TV, et al. Severity of rotavirus gastroenteritis in an Indian population: report from a 3 year surveillance study.Vaccine.2014;32 Suppl 1:A45-8.
b Research Design: One A three-year surveillance study conducted in the Indian population included
hospitalizations of acute gastroenteritis in a tertiary hospital in India from December 2005 to November 2008. It was found that severe dehydration, acidosis and hospitalization time of ≥7 days occurred at the age of 0-5 months The proportion is significantly higher than 6-23 months old.
[6] Tate JE, Burton AH, Boschi-Pinto C, et al. Global, Regional, and National Estimates of Rotavirus Mortality in Children
[7] Zeng Mei, Chen Jie, Gong Sitang, etc. Chinese Journal of Pediatrics. 2010; 48( 8): 564-570
c Study design: A total of 5,091 stool specimens of children with acute non-bacterial dysentery-like diarrhea were randomly collected from children with acute diarrhea in outpatient clinics in Shanghai, Hangzhou, Guangzhou, Chongqing and Tianjin from 2008 to 2009. Such as the clinical epidemic characteristics of virus and rotavirus diarrhea. The results of the
study showed that the detection rate of rotavirus was 30.7%, and the detection rate of norovirus in rotavirus-negative specimens was 29.7%. Children with rotavirus diarrhea are between 1 month and 11.3 years old, 92.5% of children are ≤2 years old, and children with norovirus diarrhea are between 1 month and 14 years old, and 91.8% are ≤2 years old. The peak of rotavirus epidemic is from October to February of the following year, and the norovirus epidemic season varies from region to region.
[8] Diao Liandong, Tang Fenyang, Wu Jiang, etc. Progress in the prevention of rotavirus infectious diarrhea in China. China Vaccines and Immunity. 2018;24(4):492-498
[9] World Health Organization.Rotavirus vaccines. WHO position paper--January 2013.Wkly Epidemiol Rec.2013;88(5):49-64.
[10] Fang Hesong. Diagnosis and treatment of pediatric diarrhea. Journal of Practical Pediatrics. 2011;26(19):1537- 1540
[11] Digestive Science Group, Pediatrics Branch of Chinese Medical Association. Clinical Practice Guidelines for Acute Infectious Diarrhea in Children in China. Chinese Journal of Pediatrics. 2016;54(7):483-488
[12] Chen SC,et al.Rotavirus infection and the current status of rotavirus vaccines.J Formos Med Assoc.2012;111(4):183-93.
[13] Liu Chonghai, Wei Yushu. Clinical Journal of Practical Hospital. 2005;2(3):18-20
[14] CDC.Rotavirus.https://www.cdc.gov /rotavirus/vaccination.html
[15] WHO.Rotavirus vaccines in routine immunization.Pocket Guide.2012.
