Rotavirus infection in a child: how to feed, signs of dehydration and treatment in Tashkent

How do you get infected and why is it so easy?

Rotavirus enters the body through the mouth: from hands, toys, surfaces, dishes, and less often with water and food. A sick child excretes a colossal amount of viral particles in his stool, and a very small dose is enough to become infected. The virus is stable in the external environment, persists for weeks on toys and door handles and is difficult to respond to ordinary detergents.

• The peak incidence occurs in the cool season, but you can get sick all year round
• In kindergartens and nurseries, the infection spreads in a matter of days, often the entire group gets sick
• Adults also become infected, but their disease is often mild and is mistaken for poisoning.
• The child is contagious a day or two before symptoms appear and remains contagious for about a week after recovery.
• Past infection does not provide lifelong immunity: repeated episodes occur, but are milder

How does the disease progress by day?

The classic picture is recognizable: first vomiting and fever, then profuse watery diarrhea. This sequence helps distinguish rotavirus from food poisoning, which usually does not have a high fever for several days.

1. Инкубационный период — от 12 часов до 3 суток. Ребёнок выглядит здоровым, но уже заразен.
2. Первые сутки: внезапная рвота, часто многократная, подъём температуры, вялость, отказ от еды. Понос может ещё отсутствовать, и родители думают об отравлении.
3. Вторые-третьи сутки: рвота обычно стихает, зато появляется обильный водянистый стул — жёлтый или желтовато-зелёный, с резким кислым запахом, до 10–15 раз в сутки. Часто беспокоит вздутие и урчание в животе.
4. Третьи-пятые сутки: температура нормализуется, стул постепенно густеет, возвращается аппетит. Это перелом болезни.
5. Пятые-седьмые сутки: самочувствие восстанавливается, но неустойчивый стул может сохраняться ещё около недели — это нормальное восстановление слизистой кишечника.

Some children simultaneously develop a runny nose, red throat and coughing - hence the popular name “intestinal flu”. The infection has nothing to do with real flu, but the combination of catarrhal and intestinal symptoms is indeed characteristic and often confuses parents.

Dehydration: how to recognize it in time

This is the key section. A young child loses fluid much faster than an adult, and his reserves are smaller. What needs to be assessed is not how many times there were loose stools, but the child’s condition and the volume of urine.

• Mild degree: the child is thirsty, slightly restless, urinates a little less often than usual, the mucous membranes are moist. Cope at home by soldering
• Moderate degree: noticeable thirst or, conversely, lethargy, dry lips and tongue, urination is rare, urine is dark and concentrated, there are few tears when crying, the skin, when compressed into a fold, straightens out more slowly than usual
• Severe: severe lethargy or drowsiness, sunken eyes and fontanel, lack of urine for many hours, cold hands and feet, rapid breathing, weak rapid pulse. This condition requires intravenous fluid replacement
• A separate alarm signal: the child has stopped asking to drink and refuses to drink - with dehydration, thirst intensifies, and its disappearance against the background of lethargy indicates an increase in severity

How to desolder correctly: a technique that solves everything

Oral rehydration is the main treatment for rotavirus infection and is done at home. The mistake of most parents is not that they do not give food, but that they give too much at one time: the stomach is irritated with viral gastroenteritis, a large volume immediately provokes new vomiting, the parents get scared and stop feeding altogether. The correct approach is exactly the opposite - very small portions, but very often.

1. Используйте готовый регидратационный раствор of аптеки — состав солей и сахара в нём подобран так, чтобы жидкость всасывалась максимально эффективно. Разводите строго по инструкции на упаковке, не «на глаз» и не крепче.
2. Давайте по чайной ложке или по 5–10 миллилитров of шприца без иглы каждые 3–5 минут. Такой объём успевает всосаться и не растягивает желудок.
3. После каждого эпизода рвоты сделайте паузу на 10–15 минут, затем возобновите выпаивание в том же режиме, начав с ещё меньших порций.
4. Ориентир по объёму: примерно 50–100 миллилитров раствора на каждый килограмм веса в сутки при умеренных потерях, плюс возмещение после каждого жидкого стула. Точный объём подскажет врач по состоянию ребёнка.
5. Грудного ребёнка продолжайте кормить грудью — прикладывайте чаще, но на меньшее время. Грудное молоко при кишечной инфекции не отменяют.
6. Раствор комнатной температуры переносится лучше, чем холодный или горячий. Многие дети охотнее пьют его слегка охлаждённым.
7. Если ребёнок наотрез отказывается от солёного вкуса, лучше дать что-то другое, чем не дать ничего: слабый компот of сухофруктов без сахара, рисовый отвар, слабый чай. Полный отказ от питья опаснее неидеального напитка.
8. Замороженный раствор в виде маленьких кусочков льда или фруктового льда домашнего приготовления часто спасает ситуацию у детей, отказывающихся пить.

What is treated and what is not necessary to treat

There is no specific medicine that kills rotavirus, and it is not required: the immune system copes on its own within a few days. The goal of treatment is to support the child while this happens.

• Rehydration is the basics, everything else is secondary
• Antipyretic for high fever and poor health - according to age and weight, as prescribed by a doctor
• Sorbents are used limitedly and on the recommendation of a doctor; they should be taken separately from other medications and drinks
• Zinc preparations for prolonged diarrhea in young children are prescribed by a doctor
• Some probiotic strains can reduce the duration of diarrhea by about a day, but they are not a replacement for drinking water
• Antibiotics are not prescribed for rotavirus: the virus is insensitive to them, and disruption of the microflora prolongs recovery
• Drugs that stop intestinal motility are not given to children with acute intestinal infections - they trap the virus and toxins in the intestines and are dangerous
• Enzymes, choleretic, “antiviral” nasal drops and suppositories of unknown effect do not affect the course of the disease

It’s worth mentioning separately about a common situation: a child is prescribed an antibiotic “just in case it’s E. coli.” If watery stool without blood, with vomiting and high fever in a child under five years of age, the likelihood of a viral nature is very high, and the decision on the need for an antibiotic is made by the doctor based on specific symptoms, and not as a precaution. It is worth asking the doctor what kind of finding makes you think about a bacterial infection.

Nutrition during illness and after

1. Голодные паузы больше не рекомендуются. Раннее возвращение к еде ускоряет восстановление слизистой кишечника, а голодание её замедляет.
2. Кормите по аппетиту, маленькими порциями и чаще обычного. Не заставляйте есть насильно, но и не ждите, пока «всё пройдёт».
3. Подойдут отварной рис, гречка, картофельное пюре на воде, подсушенный хлеб, банан, печёное яблоко, нежирное отварное мясо, овощной суп.
4. На несколько дней ограничьте цельное молоко, жирное, жареное, сладкое, свежие соки, бобовые, сырые овощи и виноград — они усиливают брожение и вздутие.
5. Грудное вскармливание не прерывают. Ребёнку на смеси менять её обычно не требуется; временный перевод на низколактозную смесь решает врач, если понос затягивается.
6. Возвращайте привычный рацион постепенно, в течение 3–5 дней после нормализации стула.

Prevention: vaccination and hygiene

It is almost impossible to avoid infection with rotavirus through hygiene alone - the virus is too contagious and the infectious dose is too small. The only truly effective way to protect a child from severe disease is vaccination.

• The vaccine against rotavirus is given not by injection, but in the form of drops in the mouth
• The course begins in the first months of life: the terms are strictly limited by age, and being late means losing the opportunity to get vaccinated
• Vaccination does not guarantee that the child will not get sick at all, but it sharply reduces the likelihood of severe illness and hospitalization due to dehydration
• In a family with a sick person: separate dishes and towels, thorough hand washing after changing a diaper and before eating, cleaning the potty and surfaces
• The child returns to kindergarten after stool normalization and with the doctor’s permission
• It is better to wash the sick person’s linen and clothing separately and at high temperature.

A common misconception is that rotavirus only occurs in dirty conditions and in “careless” parents. This is not true: the infection spreads equally well in the most prosperous families and in the best kindergartens, because the virus is stable and the infectious dose is minimal. Parents have nothing to blame themselves for; The only thing that matters is how well the desoldering is organized.