Rotavirus is the leading cause of gastroenteritis in infants and young children. Symptoms may include fever, abdominal pain, vomiting, diarrhea, and dehydration. Due to an infant’s small body mass, dehydration can be life threatening.

Rotavirus is a highly transmissible virus that causes viral gastroenteritis or inflammation of the stomach and intestines. It can result in abdominal pain, vomiting, and diarrhea.

Rotavirus can affect people of any age. However, in the United States, it is most common in children under 5 years.

The virus resolves on its own in about a week. Treatment focuses on managing the symptoms — particularly preventing and treating dehydration.

This article discusses diagnosing and treating rotavirus in infants, ways to prevent it, when to call a doctor, and more.

Learn about rotavirus transmission.

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Usually, symptoms begin about 2 days after exposure to rotavirus.

The most common symptoms of rotavirus are severe watery diarrhea and vomiting, which may last 3–8 days.

Other symptoms include:

Of those,dehydration is the most serious symptom. It is especially dangerous for infants because they have much less body mass than adults.

The World Health Organization (WHO) reports that 2 million children are hospitalized each year with dehydration due to rotavirus.

Symptoms of dehydration in infants include:

  • no wet diapers in 3 hours
  • dry or sticky mouth
  • cracked lips
  • sunken eyes
  • sunken fontanel, the soft spot on a young baby’s skull
  • few or no tears when crying
  • decreased activity
  • extreme fussiness or sleepiness
  • lethargy
  • rapid breathing
  • rapid heartbeat

Caregivers must seek medical help right away if an infant shows signs of dehydration.

Learn about the signs of dehydration in toddlers.

Typically, the presence of fever, vomiting, and watery diarrhea is enough for a doctor to diagnose gastroenteritis but not to identify rotavirus as the cause. Determining the specific cause of uncomplicated gastroenteritis in babies is usually unnecessary.

If a doctor recommends finding the cause, laboratory testing is the only way to confirm a rotavirus diagnosis. This is because rotavirus shares similar clinical features as other diarrheal diseases.

A caregiver or healthcare professional will collect a stool sample from the infant’s diaper. Once the lab receives the sample, a technician will analyze the stool for a rotavirus antigen.

In some circumstances, doctors may recommend testing for rotavirus, but it is not usual practice.

There is no specific medication to cure rotavirus infection. Treatment aims to reduce the symptoms.

The most effective treatment for dehydration is to take in more fluids. For infants, that means more breastmilk or formula more often than usual.

A doctor may recommend an oral rehydration solution (ORS) if an infant is still dehydrated. An ORS is a liquid that replenishes the body’s water, carbohydrates, and electrolytes.

These rehydration drinks are available over the counter, or a doctor may recommend an at-home mix of:

  • 1 liter of water
  • 6 teaspoons of sugar
  • half a teaspoon of salt

In cases of severe dehydration or if the infant cannot keep liquids down due to excessive vomiting, treatment with IV fluids in the hospital may be necessary.

Preventing diaper rash is another way to help infants with rotavirus rest and stay comfortable. The American Academy of Dermatology (AAD) recommends:

  • changing a diaper as soon as it becomes soiled, even if it is just wet
  • being extra gentle when cleaning the diaper area and avoiding products containing alcohol and fragrances
  • using a diaper cream with zinc oxide

Aside from severe diarrhea and dehydration, complications of rotavirus in infants may include:

Infants with compromised immune systems may experience more severe and prolonged rotavirus infection and develop abnormalities in certain organ systems, such as the liver and kidneys.

While good hygiene is important, it is not enough to prevent rotavirus infection.

According to the Centers for Disease Control Prevention (CDC), the rotavirus vaccine is the best way to protect against severe rotavirus in infants.

In the U.S., there are currently two rotavirus vaccines for infants:

  • Rotarix: 2-dose series at 2 and 4 months old
  • RotaTeq: 3-dose series at 2, 4, and 6 months old

Children should receive the first dose of either vaccine between 6 and 15 weeks of age and the final dose before they turn 8 months.

Both are oral vaccines, meaning a healthcare professional places liquid drops in the infant’s mouth. The rotavirus vaccine prevents 40,000–50,000 hospitalizations in the U.S. yearly, and infection is much less common than in the prevaccine era.

However, neither vaccine completely eliminates the risk of rotavirus, and it is still possible to contract the virus after vaccination. Typically, subsequent rotavirus infections are not as severe.

Some researchers are working to develop an injectable rotavirus vaccine, which may prove more effective for infants in low income countries.

Caregivers should contact a doctor if an infant:

  • appears dehydrated
  • has a fever
  • cries nonstop
  • cannot keep fluids down long enough to rehydrate
  • has excessive vomiting or diarrhea — severe cases may result in as many as 20 episodes in 24 hours

Call 911 or go to the nearest emergency room if the infant:

  • becomes weak or lethargic
  • has difficulty breathing or can barely cry
  • appears severely dehydrated
  • has difficulty waking up or cannot wake up

Rotavirus mainly affects children under 5 years of age and can cause fever, abdominal pain, vomiting, diarrhea, and dehydration.

It is a highly transmissible virus. However, the rotavirus vaccine prevents 40,000–50,000 hospitalizations yearly, and infection is much less common than in the prevaccine era.

Doctors can diagnose an infection during a physical exam and recommend ways to treat the symptoms and prevent serious complications, such as dehydration.

While there is no cure for rotavirus, addressing the symptoms as soon as possible can help lessen the severity of the illness until it runs its course.

Caregivers should seek immediate medical attention if an infant with rotavirus shows signs of dehydration.