The severity of rotavirus infection ranges from asymptomatic infection to severe dehydrating gastroenteritis, which can lead to hospitalization in some cases.8 Rotavirus is the leading cause of severe, dehydrating gastroenteritis in children younger than 5 years of age.3,9 In two studies conducted in Canada, rotavirus was responsible for up to 78% of gastroenteritis hospitalizations.1,16,*,**
The clinical consequences include dehydration, metabolic acidosis, and potassium depletion. Dehydration can be significant and lead to hypovolemia, circulatory collapse, and possibly death in some cases if not adequately managed.3,24,25
Chronic diarrhea and extraintestinal infections can occur in immunosuppressed children with rotavirus infection.3
Dehydration of at least mild severity occurs in 80% of patients. However, the combination of profuse diarrhea, vomiting and fever may lead to moderate-to-severe dehydration, metabolic acidosis, and/or potassium depletion.8,25
A recent study also indicated that rotavirus antigen and RNA were present in the serum of the majority of children with acute rotavirus infection.26,*** Further studies are needed to establish the importance of extraintestinal spread with rotavirus pathogenesis and the relationship it may serve with the severity of the disease and potentially additional sequelae.26
*This study tested stool samples from 565 children <5 years of age hospitalized for gastroenteritis between December 1999 and May 2000 in seven community and specialized hospitals in Quebec.
** Data from the Pediatric Rotavirus Epidemiology Study for Immunization (PRESI) study, a prospective, multisite cohort study. Data were collected between November 1997 and June 1998 in 18 hospitals serving the Toronto region. Hospitalization data obtained from 1638 children <5 years of age who were hospitalized for diarrhea, and prospective, centralized testing of their stools was performed.
*** Data obtained from serum samples of 33 immunocompetent children aged 1-36 months, presenting with acute gastroenteritis confirmed by EIA. 22 of 33 children (67%) had detectable serum rotavirus antigen, and viral RNA was detected in 3 of 6 (50%) children available for viral RNA testing.