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Rotavirus. Crystal Denmon Allen Chiu Anthony Bonilla. Background Information. Family – Reoviridae Have 10-12 DS RNA segments Double icosadehral capsid, 60 nm Outer capsid + short spikes. Rotavirus Serotypes. 2 Types of Surface Proteins G (glycoprotein)
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Rotavirus Crystal Denmon Allen Chiu Anthony Bonilla
Background Information • Family – Reoviridae • Have 10-12 DS RNA segments • Double icosadehral capsid, 60 nm • Outer capsid + short spikes
Rotavirus Serotypes • 2 Types of Surface Proteins • G (glycoprotein) • P (protease-sensitive protein) • 11 G serotypes and 12 P types
Case Study • A 6 month-old child was seen in the emergency in January after two days of persistent watery diarrhea and vomiting accompanied by low grade fever and mild cough. The infant appeared dehydrated and required hospitalization. The patient attended a day-care center.
Symptoms • Vomiting • Watery diarrhea for 3-8 days • Fever
Similar Viral Agents • Traveller’s Diarrhea • Get it shortly after you return home or while traveling. More common with young adults age 20-29. • Cholera • Not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill. Symptoms include leg cramps • Salmonella • Usually from coming in contact with surfaces that had raw meat on them • Campylobacter • Associated with handling raw poultry or eating raw or undercooked poultry meat. Diarrhea may be bloody
Similar Viral Agents • Common Cold • Not just limited to infants. Diahrrea and vomiting are not primary symptoms. • Shigellosis • Diarrhea, often bloody, is the most common sign of shigellosis. • Diptheria • Toxin usually attacks the tonsils first and causes fever, red sore throat, weakness, and headache. The toxin destroys the normal throat tissue, causing the throat to swell. • Norwalkvirus • General lethargy, weakness, muscle aches, headache, and low-grade fever may occur. • Coxsakievirus • Hand, foot, and mouth disease, a type of coxsackievirus syndrome, causes painful red blisters in the throat and on the tongue, gums, hard palate, inside of the cheeks, and the palms of hands and soles of the feet.
Diagnosis • Tests Confirming Rotavirus: • Rapid Antigen detection of rotavirus in stool. • Further characterization by: • Enzyme immunoassay or ELISA • Reverse transcriptase polymerase chain reaction • Polyacrylamide gel electrophoresis (PAGE) • Electron Microscopy (EM) • Immunochromatography
Transmission • Fecal-Oral (primary) • Contact with Contaminated surfaces • Food • Water • Fomite • (ie. toys, table tops,solid surfaces) • Respiratory tract fluids
Epidemiology • Incubation time: 2 - 4 days • Patients show symptoms 3 to 8 days after incubation. • Contagious for 2 days before showing symptoms and 2 days after recovery.
When Are You At Risk? • o • http://rotavirusinfo.com/hcp/rotavirus_infection.html
Treatment • Oral Rehydration Therapy (ORT) • replaces fluids and electrolytes lost via diarrhea and vomiting, is usually given in 2 phases: • Rehydration: to quickly replace water and electrolyte loss. • Maintenance: continued to replace fluid loss and provide adequate caloric intake.
Vaccine and Prevention • Live oral vaccine (RotaTeq) for use in children • (FDA approved February of 2006) • Prevention: • Good Hygiene and Sanitation.
References • 1. About Rotavirus. Retrieved November 4, 2007 from http://www.cdc.gov/rotavirus/. • 2. Vergara F R, Navarrete MS, Núñez E, Escobar L, Navarro G S, Venegas E G, Schuffeneger P, O'Ryan M. Incidence of Severe Rotavirus Gastroenteritis Among Chilean Children Under Three Years Of Age. Rev Med Chil. 2007 Aug;135(8):975-81. Epub 2007 Oct 25. • 3. Rotavirus. Retreived November 4, 2007 from http://www.who.int/biologicals/areas/vaccines/rotavirus/en/. • 4. MMWR. (3/19/99). Vaccine for the Prevention of Rotavirus Gastroenteritis Among Children Recommendations of the Advisory Committee on Immunization Practices (ACIP). Retrieved November 4, 2007 from (http://www.cdc.gov/MMWR/preview/mmwrhtml/00056669.htm. • 5. Merck & Co. Information about Rotavirus. Retrieved November 5, 2007 from http://rotavirusinfo.com/hcp/information_on_rotavirus.html. • 6. Mayo Clinic Staff (August 25, 2006). Rotavirus: Overview. Retrieved November 5, 2007 from http://www.mayoclinic.com/health/rotavirus/DS00783. • 7. Symptomchecker. Retrieved Novevember 7, 2007 from http://symptoms.webmd.com/default.htm. • 8. Sandra Martin-Latil, Laurence Mousson, Arnaud Autret, Florence Colbère-Garapin, and Bruno Blondel. Bax Is Activated during Rotavirus-Induced Apoptosis through the Mitochondrial Pathway. October 26 2006. Journal of Virology, May 2007, p. 4457-4464, Vol. 81, No. 9. • 9. Gouvea, V., Glass, R.I., Woods, P., Taniguchi, K., Clark, H.F., Forrester, B., Fang. Z.Y, Polymerase chain reaction amplification and typing of rotavirus nucleic acid from stool specimens. November 3 1989. Journal of Clinical Microbiology, February 1990, p.267-282. Vol. 28, No.2