Rotaviruses

-Most common cause of infantile gastroenteritis around the world -Resemble Reoviruses in terms of morphology and strategy of replication.

Classification
Classified into 5 species (A to E) plus two tentative species (F and G), based on antigenic epitopes on the internal structure VP6. Detected by Immunofluorescence, ELISA, and immune electron microscopy (IEM) Group A Rotaviruses most frequent human pathogens.

Propagation in cell culture

Fastidious agents to culture Most group A can be cultivated if pretreated with trypsin, and if low levels of trypsin are included in culture medium.

Pathogenesis
Infect cells in the villi of small intestine Multiply in cytoplasm of enterocytes and damage their transport mechanisms. Damaged cells may slough off into the lumen of the intestine and release large quantities of virus, which appear in the stool. 2-12 days healthy people

Clinical findings & Diagnosis

Cause major portion of diarrheal illness in children and infants, but not in adults. Incubation 1-3 days. Typical symptoms include: watery diarrhea, fever, abdominal pain, and vomiting, leading to dehydration. Viral excretion may persist for up to 50 days after onset of diarrhea.

EIA or IEM EIA > IEM PCR is most sensitive detection method ELISA can be used to detect antibody titer rise

Epidemiology

3 billion 5 billion annual diarrheal episodes in children <5 years in Africa, Asia, Latin America, with 1 million deaths. 50% of acute gastroenteritis of hospitalized children is by Rotavirus. Fecal-oral route transmission.

Frequent nosocomial infections.

Treatment and Control

Correct water loss by replacement of fluids and restoration of electrolytes(intravenously or orally).

Wastewater treatment and sanitation.

In, 1998 vaccine reports of intussusception