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ROTA VIRUS:
Epidemiology: It is a major cause of diarrhea related morbidity & mortality in children. Disease burden : global annual mortality is more than 5,27,000 infant deaths. India more than 120000 annually.
Seasonal variation:
Increase incidence in winter and spring. Temperate v/s tropical countries incidence.
Transmission :
By close person to person contact. By faeco oral route. By fomites.
Etiology:
Agent : rota virus. Structure: Icosahedral double stranded RNA virus. Seven sero groups A-G. Group A causes human disease.
Pathogenesis:
Pathology:
Biopsy shows Atrophy of villi in SI.
Clinical features:
Age: under 3years. Incubation period: 2-3 days. Presents with vomiting and diarrhea. Dehydration depends on severity. Symptoms of respiratory tract infection.
Diagnosis:
Stool culture and microscopy. Serum electrolyte. Blood gas analysis. Serology: -latex agglutination. -ELISA. -Electron microscopy. -Reverse transcriptase PCR. Virus Culture
Treatment:
Supportive treatment: -IV fluids. -ORS. Prevention: -vaccine
Complications:
Dehydration. Malnutrition. Growth retardation.
Rotavirus vaccine:
Types: Live attenuated oral vaccine. -Human monovalent live vaccine. -Human bovine pentavalent live vaccine.
Dose:
1ml orally
Schedule:
2 dose schedule at 2 &4 months. 1st dose at 6weeks not later than 12 weeks.
5 reassortant rota viruses developed from human & bovine parent rota viruses. Dose :2ml orally. Schedule: 3 oral doses at 2, 4, 6months. 1st dose- b/w 6-8weeks. All 3doses should be completed within 32 weeks.
Storage:
2-8 degree.
Efficacy:
Immunity :
Confers life long immunity. Herd immunity is seen.
Side Effects
Milder problems: irritable , mild temporary diarrhoea and vomiting , fever. Serious problems: intussuception. kawasaki disease.
Contraindication:
Severe allergic reaction after previous dose of rota virus vaccine. Severe combined immunodeficiency state
Special situation:
Regurgitation of vaccine. Interchangibility of rotavirus vaccine. Missed oppurtunity.