Rotavirus Follow-up

Updated: Sep 13, 2015
  • Author: David D Nguyen, MD, FACEP; Chief Editor: Kirsten A Bechtel, MD  more...
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Follow-up

Further Outpatient Care

Follow-up with the patient's primary physician is recommended to ensure patient improvement. The caretaker should also be instructed on clinical warning signs and the need to seek further care if the patient's symptoms worsen.

Breastfeeding can continue regularly before and after the patient receives the rotavirus vaccine. [27]

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Further Inpatient Care

Inpatient care is usually not needed for rotavirus infection unless the child is dehydrated, cannot tolerate oral liquids, has a poor social network, or appears toxic.

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Inpatient & Outpatient Medications

Antiemetics have been used with some success in prevention of vomiting for gastroenteritis. [24, 25] Risk versus benefit of the medications must be determined by the treating clinician.

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Transfer

Transfer may be indicated for the dehydrated child who requires admission to a pediatric inpatient or ICU bed.

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Deterrence/Prevention

Rotavirus is contagious. Parents who have more than one young child or who help care for several small children should be cautioned about good hand-washing technique. Children who are asymptomatic should not play with children who are symptomatic during the diarrheal phase of the illness.

Daycare centers should keep symptomatic children together and separated from those who are not symptomatic. Ideally, the staff should be segregated as well, so that some staff members care for only the symptomatic children, and some staff members care for the others. Fomites should also be disinfected, as viral spread from these objects has also been demonstrated. [68]  Use of an alcohol-based hand sanitizer has been shown to reduce transfer of viruses to hands as well as to commonly contacted household surfaces. [69] Hand sanitizing wipes has also been shown to reduce infection risks of rhinovirus and rotavirus by 30-89%. [70]

Health care workers can be vectors for this illness. Extra vigilance with regard to hand washing, stethoscope cleaning, and housekeeping is warranted during rotavirus outbreaks.

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Complications

The most important complication of rotavirus infection is dehydration.

Multisystem organ failure is possible when dehydration leads to shock and even death.

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Prognosis

The prognosis for rotavirus infection is excellent as long as adequate hydration is maintained.

Most children recover within a week of symptom onset.

Rotavirus enteritis has virtually no important long-term sequelae.

Reinfection is a common phenomenon.

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Patient Education

Parents should be taught the signs and symptoms associated with dehydration and should be instructed to seek care immediately upon noticing any of these signs or symptoms in a child.

Parents must know which fluids should and should not be given and how to administer these fluids to young children who are vomiting.

Parents should be informed about early refeeding with a soy-based infant formula and a bland, general diet, which may include lactose-free milk for toddlers.

Diarrhea can last for 5-7 days.

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