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Rotavirus is the most common cause of severe diarrhea among children. The infection is characterized by vomiting and watery diarrhea lasting 3 to 8 days, commonly accompanied by fever and abdominal pain.
In the United States and other countries with a temperate climate, the disease has a winter seasonal pattern, with annual epidemics occurring from November to April. The illness occurs most often in infants and young children; most children in the United States are infected by age 2. Rotavirus is responsible for the hospitalization of about 55,000 children each year in the United States.
The primary mode of rotavirus transmission is the fecal-oral route, although low virus titers have been reported in respiratory tract secretions and other body fluids. Because the virus endures in the environment, transmission may also occur through ingestion of contaminated water or food or through contact with contaminated surfaces.
Billions of rotavirus microorganisms are passed in the stool of the infected individual. Small numbers of rotavirus particles may lead to infection if a baby puts fingers or other objects contaminated with the virus into the mouth. Young children can pass it on to siblings and parents.
Rotavirus is the most common diagnosis for young children who have acute diarrhea, but other causes may include bacteria (Salmonella, Shigella, and Campylobacter are the most common), parasites (Giardia and Cryptosporidium are the most common), localized infection elsewhere in the body, antibiotic-associated adverse effects (such as those related to treatment for Clostridium difficile), and food poisoning. Noninfectious causes include overfeeding (particularly of fruit juices), irritable bowel syndrome, celiac disease, milk protein intolerance, lactose intolerance, cystic fibrosis, and inflammatory bowel syndrome.
Immunity after infection is incomplete, but recurrent infections tend to be less severe than the original infection.
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