Clinical Information

Clinical Features

Rotavirus disease is characterized by vomiting and watery diarrhea for three to eight days. Fever and abdominal pain also are common. Additional symptoms include loss of appetite and dehydration.

Symptoms of dehydration include

  • decreased urination
  • dry mouth and throat
  • feeling dizzy when standing up
  • crying with few or no tears and
  • unusual sleepiness or fussiness.

The incubation period for rotavirus disease is approximately two days.

Children may develop rotavirus disease more than once because neither vaccine nor natural infection provide full immunity from future infections. A child’s first infection with rotavirus tends to cause the most severe symptoms.

The Virus

Rotavirus has a characteristic wheel-like appearance when viewed by an electron microscope. See photos. The name rotavirus is derived from the Latin word rota, meaning “wheel.” Rotaviruses are non-enveloped, possess a triple-layered capsid, and have a segmented RNA genome. The virus is stable in the environment.

Epidemiologic Features

The primary mode of transmission is the fecal-oral route, usually through direct contact between people. Because the virus is stable in the environment, transmission also can occur through ingestion of contaminated water or food and contact with contaminated surfaces or objects. In the United States and other countries with a temperate climate, the disease has a winter and spring seasonal pattern, with annual epidemics occurring from January through June. The highest rates of illness occur among infants and children age 5 and under. Adults can get rotavirus, though disease tends to be milder.


Conduct nucleic acid detection PCR assays (for rotavirus alone or in multipathogen panels) or antigen-detection immunoassays on stool specimens to rapidly detect rotavirus RNA or antigens and make a diagnosis. You can further characterize strains by nucleic acid sequencing, but such tests are usually carried out only by laboratories engaged in surveillance testing or research.


For people with healthy immune systems, rotavirus disease is self-limited, lasting only a few days. Treatment is nonspecific and consists primarily of oral rehydration therapy to prevent dehydration.


The two rotavirus vaccines approved for use in infants in the United States are safe and effective. During the first year of an infant’s life, rotavirus vaccine provides 85% to 98% protection against severe rotavirus illness and against hospitalization from rotavirus illness, and 74% to 87% protection against rotavirus illness of any severity.

The CDC recommends routine vaccination of infants with either of the two available vaccines:

  • RotaTeq® licensed in 2006, is given in three doses at ages 2 months, 4 months, and 6 months
  • Rotarix® licensed in 2008, is given in two doses at ages 2 months and 4 months

The vaccines differ in how they are made and the number of doses, but both are given orally.

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