Rotavirus gastroenteritis can be unpredictable in its course and severity and can lead to rapid deterioration.8,11 The severity of rotavirus infection ranges from asymptomatic infection to severe dehydrating gastroenteritis, which can lead to hospitalization in some cases.8 There are no reliable predictors to determine whether any given child is at risk for serious disease.11
Rotavirus is typically associated with the following symptoms:3,11
The incubation period of rotavirus gastroenteritis (RGE) is approximately 2 to 4 days.6,30 Onset of illness usually begins with vomiting and fever (often >102°F), which can continue for 2 to 3 days and is followed by diarrhea which may be profuse (10 to 20 bowel movements per day), and can last for 4 to 5 days.3,11
Results of laboratory analyses from children hospitalized with RGE demonstrated isotonic dehydration and include a high urine specific gravity and metabolic acidosis. RGE is usually not associated with leukocytosis but may be accompanied by a mild elevation in transaminases and uric acid levels. Stool samples from children with rotavirus diarrhea generally do not contain blood or fecal leukocytes, although fecal leukocytes can occasionally be encountered.3
Symptoms of rotavirus infections generally are more severe than are those caused by other viral gastrointestinal pathogens6,12
The combination of vomiting, fever and diarrhea caused by rotavirus can result in severe dehydration, which may lead to hospitalization in some cases.3,8
Rotavirus disease surveillance conducted in 862 children aged 15 days through four years presenting with common rotavirus symptoms (diarrhea, vomiting, fever) between November 1997 and June 1998 in three US hospitals31
In this study, rotavirus was detected almost 20 times more frequently (56%; 147/262) in children presenting with a combination of diarrhea, vomiting, and fever than in children presenting with diarrhea alone (3%; 1/38).31
This Venn diagram shows the presenting symptoms of 234 hospitalized patients who tested positive for rotavirus gastroenteritis. Among these children, the most frequent clinical presentation was the combination of diarrhea, vomiting, and fever (63%; 147/234).31
(n=234 children who
tested positive for rotavirus)
Adapted from Staat MA et al31
Eighty-four percent (195/234) of those children who were rotavirus-positive experienced both diarrhea and vomiting with or without fever.31