Rotavirus

About rotavirus

Rotavirus is a common cause of viral gastroenteritis for Australian babies and preschool children, but can affect people of all ages.

Prior to the introduction of rotavirus vaccines in Australia, the best available estimates suggest that it accounted for about 10,000 hospitalisations and 115,000 doctor visits every year for children under 5 years of age.

Since the introduction of the rotavirus vaccines onto the National Immunisation Program in 2007, hospital presentations due to rotavirus in children under 5 have declined by more than 70%.

Rotavirus immunisation is available free of charge to all Victorian babies. See your GP or local council immunisation service provider for more information.

Symptoms of rotavirus

The symptoms and signs of rotavirus gastroenteritis range from mild to potentially life threatening, and may include:

• vomiting
• sudden onset of diarrhoea
• fever
• dehydration
• drowsiness.

Spread of rotavirus

In Victoria and other temperate regions of Australia, rotavirus gastroenteritis had previously been reported to be more common during winter. In recent years, however, peaks of rotavirus infections in Victoria have occurred during late spring and early summer.

Infection is spread by person-to-person contact and touching contaminated hands, faeces (faecal-oral transmission) and vomit. Rotavirus is highly infectious.

The onset of symptoms occurs one to 3 days after infection. An infected person's faeces usually remains infectious for approximately 10 days but can remain infectious for up to 2 months.

Rotavirus infection can occur several times

It is possible to be infected with rotavirus several times.

The first infection is usually the most severe. After an initial infection, the risk of being infected again is reduced by approximately 40%. Children who do get infected multiple times generally have less severe symptoms with each infection.

High-risk groups for rotavirus

Certain people are at increased risk of severe or even life-threatening symptoms. High-risk groups include:

• Aboriginal children
• children or adults with immune system problems
• organ transplant recipients
• people with gastrointestinal problems such as short gut syndrome.

Treatment for rotavirus

Treatment for rotavirus depends on the severity of symptoms.

Most children have a mild illness that can be treated at home and resolves within a few days to one week. The main treatment is generally to ensure your child keeps drinking fluids often (depending on the child’s age, this may include water, breastmilk, formula, diluted apple juice or oral rehydration drinks), and gets plenty of rest.

See your doctor immediately or go to the emergency department of your nearest hospital if your child refuses to drink or has worrying symptoms, for example, very frequent diarrhoea or vomiting, drowsiness, severe stomach pain, blood in their faeces, or green vomit. Children under 6 months old should always be seen by a doctor if they have gastroenteritis.

In severe cases, children may need to be admitted to hospital to get fluids through a tube in their nose or through a vein.

Prevention of rotavirus

Immunisation can dramatically reduce the risk of infection, but general tips to prevent spreading the disease if someone is infected include:

• Wash your hands thoroughly, especially after changing a nappy.
• Use disposable nappies while the child is sick – the elasticised leg bands help to prevent leakage of contaminated faeces.
• Dispose of nappies and used tissues carefully.
• Wash and disinfect the change table often.
• Wash and disinfect toys and other shared items regularly.
• Keep sick babies and children at home – rotavirus gastroenteritis can spread quickly through a crèche or kindergarten.
• Wash your hands before handling, preparing or eating food or drink.

Immunisation for rotavirus

In Victoria, a free rotavirus vaccine is available for all babies.

The vaccine contains a weakened form of rotavirus and works by prompting the body to make antibodies. In most cases, immunised children are protected against infection. Immunised children who do still become infected are less likely to become seriously unwell compared to children who are not immunised.

Rotavirus vaccination started in Australia in 2007. It is estimated that the introduction of this vaccination has prevented more than 7,000 hospital admissions each year in children under 5.

From 1 July 2017 Victoria switched brands of rotavirus vaccine, resulting in babies receiving a two-dose course, rather than the previous three-dose course. This change occurred in all states and territories of Australia that were using a three-dose course.

Rotavirus vaccine

The rotavirus vaccine is delivered by mouth and is made up of 2 separate doses given at 2 and 4 months of age. To ensure effectiveness, it is important that the vaccine is given as close to these ages as possible. The first dose can be given from 6 weeks of age.

If a baby has not received the first dose by 14 weeks and 6 days of age, they should not receive any doses of the vaccine. A baby who started but has not finished the rotavirus vaccine and is older than 24 weeks and 6 days should not have any further doses.

The oral rotavirus vaccine is given at the same time as other free vaccines in the National Immunisation Program. No special diet or dietary restrictions are required before or after vaccination.

Giving the rotavirus vaccine to older children (‘catch-up’ vaccination) is not recommended because the safety and effectiveness of the oral rotavirus vaccine has not been confirmed in older children.

Before rotavirus immunisation

Before receiving the vaccine, make sure that you tell your doctor or nurse if your baby:

• is older than the recommended age ranges for the first or second dose
• is unwell (temperature over 38.5°C)
• has had a serious reaction to any vaccine
• has had a severe allergic reaction to anything
• has a history of a chronic gastrointestinal disease
• has had intussusception or a congenital abnormality that may lead to intussusception (bowel blockage)
• is taking steroid medication
• has received a blood transfusion or blood products
• has lowered immunity due to immune deficiency, abnormal blood conditions or disorders, cancer, HIV or certain medications
• lives in a household with someone who has lowered immunity.

Side effects of the rotavirus vaccine

The oral rotavirus vaccine is generally effective and safe, although all medication can have unwanted side effects.

See your doctor for further information if you are worried about your baby.

Rare side effects of the rotavirus vaccine

There is a very small risk of a serious allergic reaction called anaphylaxis, to any vaccine. This is why you are advised to keep your child at the clinic for at least 15 minutes following immunisation, in case further treatment is required.

There is a very small risk of intussusception (bowel blockage caused by one portion of bowel sliding into the next like a telescope) that can rarely occur, mainly in the first one to 7 days following the first or second dose of rotavirus vaccine. Take your baby to your doctor or to the hospital if they:

• have repeated, sudden bouts of crying
• are pulling their legs up to their stomach
• look pale
• develop vomiting
• pass blood in their stools (poo).

A baby who has already had intussusception in the past should not be given the rotavirus vaccine.

Where to get help

• In an emergency, always call triple zero (000)
• Your GP (doctor)
• Emergency department of your nearest hospital
• Local council immunisation service
• NURSE-ON-CALL. Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Immunisation Unit, Department of Health, Victorian Government Email: immunisation@health.vic.gov.au
• Maternal and Child Health Line Tel. 132 229 (24 hours, 7 days)
• National Immunisation Information Line Tel. 1800 671 811
• SAEFVIC Tel: 1300 882 924