Rotavirus and Other Viral Diarrhoea

Rotavirus, norovirus, sapovirus, enteric adenovirus, and astrovirus are established etiologic agents of acute gastroenteritis. Rotavirus is the single most important pathogen associated with severe dehydrating gastroenteritis in infants and young children worldwide. Four live, oral, attenuated rotavirus vaccines are available for use globally and have been introduced into the national immunization programs in over 100 countries. Substantial declines in rotavirus disease burden have been observed in countries that have introduced rotavirus vaccine. Norovirus causes sporadic and epidemic cases of acute gastroenteritis in all age groups but children and the elderly have the highest burden. Sapovirus, enteric adenovirus, and astrovirus account for a smaller proportion of the viral gastroenteritis disease burden. All gastroenteritis viruses infect the epithelial cells of the intestinal mucosa causing acute, non-inflammatory watery diarrhea that is usually self-limiting and of less than one week duration. Diagnosis of these viruses requires detection of either specific antigens of each virus with immunologic assays or the presence of the viral genome with molecular assays. Treatment is primarily supportive and consists of rehydration and restoration of electrolyte balance. Only rotavirus is vaccine-preventable.