Clinical presentation, diagnosis, and management

Most rotavirus infections are not associated with symptomatic disease. Clinical cases present after an incubation period of 1–3 days with a rapid onset of fever, malaise, vomiting, and watery diarrhea. The illness typically lasts 3–8 days. A mild elevation of blood urea nitrogen and metabolic acidosis are common. Stools are watery but devoid of red or white blood cells. A number of diagnostic assays have been developed to detect rotavirus infection. Solid-phase immunoassays have sensitivities and specificities higher than 90%. Nucleic acid hybridization assays are also available, as are reverse transcriptase–polymerase chain reaction (PCR) assays; however, both are generally more expensive than solid-phase immunoassays. Electrophoretic analysis of stool RNA is both sensitive and inexpensive. Culture of the virus from fecal specimens is also feasible.

Therapy for rotaviral diarrhea is supportive. Oral rehydration therapy is the cornerstone of treatment; no effective antiviral medication is available. Several live, attenuated, rotavirus vaccines are being tested.