Rotavirus Infection in India: A Major Cause of Childhood Gastroenteritis

Rotaviruses are genetically highly variable, non-enveloped viruses with a double-stranded, segmented ribonucleic acid genome. It is the single most important cause of severe, dehydrating gastroenteritis in infants and young children worldwide. Rotavirus gastroenteritis is associated with high morbidity in developed countries and significant mortality in developing countries. In children aged less than 5?years, they are the most frequent agent of severe acute diarrheal illnesses. Typically, symptomatic rotavirus diseases in infants (<5?years) and the elderly (>70?years) arise with sudden onset of watery diarrhoea with high risk of dehydration, accompanied by vomiting. Fecal-oral transmission is the most likely route of virus spread. Group A serotype strains G1 through G4 account for more than 90% of rotavirus gastroenteritis in humans, with G1 being the predominant serotype. The virus preferentially infects the mature small-intestinal enterocytes. Treatment of rotavirus diarrhoea is usually symptomatic and comprises a sufficient fluid and electrolyte substitution. Although nitazoxanide and some other drugs show high efficacy against rotavirus in vitro and in vivo, there is currently no recommended specific antiviral therapy. In India, two efficient and secure live vaccines against rotaviruses have been approved. Rotarix (GSK) vaccine is derived from single attenuated human rotavirus G1P[8], whereas RotaTeq (Merck) is a pentavalent mixture of naturally attenuated bovine/human rotavirus reassortants. Though these vaccines have already dramatically decreased the morbidity associated with rotavirus in countries where they are widely used, the third generation of vaccines, based on inactivated viruses or recombinant virus like particles are already in pipeline. For prophylaxis, special attention should be paid to adequate hygienic rules. Because of the high stability of rotaviruses to changing environmental conditions, disinfection should be performed applying disinfectants with proven activity against rotaviruses.