Rotavirus. Symptoms in adults, symptoms and treatment of infection, the incubation period

Rotavirus is mainly prevalent among children. In adults, it occurs much less frequently, and signs of the disease are erased character. This pathology refers to the "disease of dirty hands" category, which is the cause of failure to comply with basic hygiene rules.

pathogen transmission path

The main method of spread of infection is food - through unwashed hands or products.

There are other ways of transmission:

Airborne	Like influenza virus, these microorganisms are able to spread in aerosol form (e.g., a human patient sneezes or ingestion of dust particles infected pathogens).
transplacental	Medical studies show that rotavirus can penetrate into the amniotic fluid of pregnant women and transmitted to the child.
Water	The risk of contracting an infection increases during the spring flood, when they can get runoff from the land surface in the water network. Viruses are also found in many natural waters. Infection occurs not only in the use of contaminated water, but also while washing it in vegetables, fruits, dishes and hands.
Contact-household	These infections less, and they are rare. Infection is through contact with contaminated objects with subsequent release of virions into the esophagus.

There is also evidence that rotavirus animals can infect humans or direct transfer, or by altering the human genome of the virus. The main source of infection - people who are carriers of the infection, as well as patients with obvious clinical symptoms. Rotaviruses in a large amount excreted with the faeces, with the concentration being highest during the first 3 days.

A feature of rotavirus is that it has a high resistance to adverse conditions. Thus, its viability after freezing persists for several months, and a multilayer shell particles makes it immune to acid contained in the stomach. It is also difficult to remove from everyday items using ordinary soap and other detergents.

The causes of disease development

Children's groups - the main source of infection for adults. The level of virus infection in them up to 9%. Also recorded a large number of cases of nosocomial infection, reaches a value of 32% of all patients hospitalized with this diagnosis.

Infection in a hospital environment can occur within hours and is primarily associated with the hidden course of the disease among staff and patients, failure to comply with sanitary regime.

Infection in children's hospitals and nursing homes due to the fact that in these patients significantly reduced immunity. When deterioration of the body's defenses decreases threshold infectious dose, i.e. for the development of the disease sufficiently small amount falling virulent microorganisms.

Another reason for the high prevalence of this disease is that the virus for a long time stand out along with the feces. So, in some patients it occurs throughout the year in the absence of any signs of pathology.

The average duration of the period is 10 days. Individuals with asymptomatic form of support activity of the epidemic process, contributing to the infection of others. Rotavirus, symptoms in adults who are very similar to those of children with repeated infection has less effect on the human body.

When this activation occurs antibodies in blood, but the highest level of protection is formed in the case, if the disease was postponed for at least 3 times. This is due to the presence of multiple serotypes, which is the causative agent of the disease.

Often, large outbreaks of rotavirus infection occur during a flu epidemic (mix) infection, so people also called "intestinal flu". For disease also is characterized by seasonality - the largest number of cases is observed in winter, spring and autumn, when the air temperature below 0˚ C. In countries with hot climates outbreaks are maximum in the rainy season.

Characteristics of the disease in adults

In adults, the immune system is stronger, so the symptoms of rotavirus have a lighter character. Impact and better adapted the gastrointestinal tract. The high acidity of gastric contents and the active development of immunoglobulin A help suppress pathogens.

The minimum dose of virions for children - 10 pieces, and for older persons -. 10³ PC. But as this infection is very contagious, in the presence in the house at least one carrier in one form or another sick and other family members.

The disease in adults is often asymptomatic, but the person is infectious all the time. Recovery is faster (about 5 days) and the number of complications is minimal, in contrast to the high mortality rate which is fixed in children.

However, there are strains of rotavirus, dangerous for adults, especially in poor health. Thus, Rotavirus B (or in other words, adult rotavirus diarrhea) caused the spread of a serious epidemic among people of all ages in China and in India in 1998

Symptomatology rotavirus in adults

Rotavirus, symptoms in adults are very similar to gastroenetrit (up to 70% of all hospitalized patients), can be manifested in two forms.

When acute course of the disease symptoms occur all at once on the first day of the disease, and in subacute - first observed abdominal pain and intoxication, and in 2-3 days - diarrhea and fever. The peculiarity of infection - this constancy of symptoms in all age groups.

Respiratory syndrome, characteristic of early childhood, there is less. In some cases, the "common cold" symptoms precede diarrhea. Patients themselves symptoms of the gastrointestinal tract is seen as an easy, temporary indigestion ( "ate something wrong"). And since most no nausea and vomiting, then seek medical advice a few.

Diarrhea

Diarrhea - one of the most typical symptoms of rotavirus infection. Most often it was he who serves as a diagnostic criterion in determining the disease.

It is characterized by the following features:

• profusion;
• watery, mushy consistency;
• stench;
• the presence of foam;
• yellow or yellow-green color;
• in some cases - sour smell;
• It may appear transparent in a small amount of mucus.

The number of bowel movements per day is usually no more than 4-5 episodes. 2-3 days a chair can become glinoobraznym and acquire a grayish hue. In some cases, a darkening of the urine, which resembles the symptoms of hepatitis.

The emergence of this feature due to the fact that the multiplication of the virus occurs mainly in the intestine. At the same time there are structural changes in its epithelium.

And functional disorders occur - malabsorption syndrome (impaired nutrient absorption process) deterioration reuptake process water, reduced secretory reflexes formation lactase failure.

Lesion area was small intestinal mucosa, in severe cases can reach 75%. The deterioration process of cleavage of organic substances also intestinal microflora results in increased gassing.

hyperthermia

Rotavirus, symptoms in adults is associated primarily with the diarrheal syndrome, can also lead to an increase in body temperature. Its value depends on the severity of the disease. In most cases it does not exceed 38,5 ° C, and fever passes after 2-4 days of onset.

With the development of the infection was moderate temperature may rise up to 39,5 ° C. While also having the symptoms of intoxication. If the disease is a severe form (in debilitated patients), its value can reach 40 ° C or more. This is accompanied by an increase dehydration symptoms that is an alarm signal, requiring immediate treatment to the doctor.

general intoxication

Rotavirus, symptoms in adults which can occur with severe intoxication, causes the following symptoms:

• general weakness, malaise;
• chills;
• flaccid state;
• appetite loss, nausea;
• headache and muscle pain;
• dizziness.

Usually, these effects are mild in nature and quickly pass.

In addition, 20-30% of patients there are signs of "a cold" disease:

• nasal congestion;
• redness and sore throat, pain when swallowing;
• rare dry cough;
• "Granularity" of the posterior pharyngeal wall.

Soreness in the peritoneal cavity

Abdominal pain in adults with rotavirus infection is observed in the acute phase of the disease. It may have a different intensity. The soreness is felt in the upper abdomen or is diffuse in nature. Sometimes patients are cramping episodes.

After passes diarrhea, and pain disappears. It may take up to several days, depending on the severity of gastrointestinal lesions.

exsicosis

Dehydration as a result of rotavirus associated with fluid loss due to diarrhea. Since the adult chair in this disease is rare, it usually does not exceed exsicosis I severity. In this blood pressure may rise a little.

To restore the balance of fluids and electrolytes, the patient should drink more water. If diarrhea episodes than 10 per day, it is required to carry out additional measures of rehydration therapy.

How long is the incubation period

The incubation period during which the progression of the disease without any visible symptoms of the rotavirus infection ranges from 12 h - 3-5 days. Most often, it lasts no more than 2 days.

As with most infectious diseases, rotavirus infection characterized by a cyclic flow in which distinguish several periods:

• hidden (or incubation);
• sharp - 3-7 days or more in the case of a severe form of disease;
• recovery stage - 5 days.

Complications of rotavirus gastroenteritis

The prognosis for adults with adequate treatment - good. Unlike children who have produced strong immunity after the first previous infection, for older people are at risk recurrence of disease symptoms.

In elderly patients aged over 60 years, the disease can take place in a severe form. Going pronounced dehydration that often leads to the development of toxic nephropathy. It manifests itself in a deterioration of renal function filter, which is caused by exposure to toxins and metabolic disorders.

Distinguish the following symptoms of nephropathy:

• pain in the lumbar region;
• swelling;
• reduction in urine excretion, which is then followed by a reverse process due to violation of the absorption process of water in the renal tubules;
• multiorgan failure - disrupt several functional systems of the organism, which can lead eventually to death.

In persons of middle age there is the easiest course of the disease.

diagnosis of the disease

The diagnosis of rotavirus infection in rare cases of disease is established on the basis of studies of feces, which can be in several ways:

• ELISA (enzyme-linked immunosorbent assay). This is the most common method. There are rapid tests based on ELISA, allowing to identify the causative agent in the shortest possible time.
• PCR and RT-PCR.
• Microscopic examination.

The last 2 methods are used mainly in research laboratories. If the disease is epidemiological in nature, that is widespread in the group foci, the diagnosis by doctors is based on the collection of patient history and data inspection.

Treatment of rotavirus intestinal infection

Specific medicament for the treatment of rotavirus infection, there is no medicine.

Treatment of symptomatic and the main activities are:

• normalization of water-salt balance, impaired due to diarrhea or vomiting;
• prevention of secondary bacterial infections;
• elimination of toxicity and associated abnormalities in the cardiovascular and urinary systems.

If pronounced signs of infection are absent, the treatment for adults is required. It is recommended to refrain from contact with children in order to keep from infecting them. Generally, treatment of adult outpatient, home.

But in some cases may require hospitalization:

• in severe forms of pathology;
• patients older than 60 years over the average degree of severity of the disease;
• patients who have concomitant chronic disease that can lead to complications.

Medicines for rotavirus

The following groups of drugs and treatment methods are used for the treatment of rotavirus infection:

• Absorbent and antidiarrheal agents: Activated charcoal (white and black), Polysorb, Enterodez, enterosorbent, Attapulgite, Filtrum-Ste, Polyphepanum, Entegnin; Smecta, diosmectite, neosmectin, loperamide, diphenoxylate, Alosetron.
• Rehydration therapy: excessive drinking, oral preparations (Normogidron, tours, and other Regidron), in severe cases - by intravenous infusion or injection of fluid through the probe.
• antibiotics to prevent secondary bacterial infections: Ftalazol, Enterofuril, furazolidone and others.
• Drugs used in the enzymatic deficiency: Creon, pantsitrat, Pancreatin, Mezim forte.
• Antispasmodics: No-spa, Drotaverinum, Spazmol and others.
• Antipyretic drugs: Ibuprofen, Paracetamol, Diclofenac and others.

At present, medical science is studied the efficacy of antiviral drugs to treat the disease. As they can be used Arbidol, instrumentation, TSikloferon, Anaferon.

Preparations for the recovery of the microflora

Acceptance of probiotics and prebiotics, not only contributes to the normalization of intestinal microflora, but also significantly reduces the duration of diarrhea syndrome for 1-2 days.

Among the drugs used in this case are the following:

• Enterol;
• Linex;
• baktisubtil;
• Atsipol;
• atsilakt;
• Bifidumbacterin;
• Hilak forte and others.

It is recommended to use those medicaments which include Lactobacillus rhamnosus bacteria and Saccharomyces boulardii, since they have the most pronounced positive effect.

diet therapy

During the period of treatment and recovery, you need to stick to a diet. It is recommended to exclude from the diet of dairy products, since they contribute to the reproduction of the virus, as well as all types of food, and digestive tract mucous membrane irritant having sokogonnym action (acute, salty, roasted, fat; carbonated and caffeinated beverages), raw fruits and vegetables (except bananas), juices.

Meals should be gentle, puree and boiled with a predominance of products: mucous cereal (oats, rice), lean meat and fish, bouillons. At the same time, the food should be nutritious enough to make up the energy stored during the illness.

Folk remedies

As the dehydrating agent used in the home 6 h the sugar solution. l. and salts ½ hours. l. in 1 L of cooled boiled water.

Rotavirus infection in folk medicine to treat the following means:

• Predried pomegranate rind grind into powder, 1 tbsp. l. which pour 1 tbsp. of boiling water and infuse for half an hour. Serving unstrained solution of ¼ art. 3-4 times a day.
• Pine buds in the amount of '10 It pours 1 tbsp. boiling water, then afterwards in a water bath for half an hour. After straining drink for ½ st. several times a day until complete recovery.
• Rose hips, linden flowers, chamomile, willow bark taken in equal quantities, mix. 5 g collection brew 1 tbsp. boiling water and keep on a low heat for 10 minutes. Strain. Take 1 glass a few times a day.
• 10 g elderberry fruit pour 1 tbsp. boiling water, hold water bath for 10 min. Cool, then strain, put 1 tbsp. l. honey, mix well. Consumed 50 grams 3 times per day.

To stop diarrhea apply such traditional recipes, such as:

• 1 tbsp. l. potato starch was dissolved in 1 tbsp. boiled water. Drink entire gulp solution. If necessary, repeat 1-2 times during the day.
• Chop the stalks of chicory. ½ st. dry raw pour boiling water and allow to cool infusion. Consume immediately the entire amount for 1 time.
• Green walnuts grind in a meat grinder, squeeze the juice into a glass bottle. At 1 hr. l. with boiled water to drip out of the pipette and 5-7 drops to drink. Means to store corked in the refrigerator.

Do I need a vaccination against rotavirus, when to do?

One of the most effective preventive measures against rotavirus is vaccination. However, adults and children over 1 year of immunization is not carried out. Currently clinically tested 2 types of vaccines - Rotarix and RotaTeq. They are administered orally (in the oral cavity) in the form of droplets and contain attenuated live microorganisms.

In Russia, the vaccination against rotavirus is held for children on the schedule of 2, 3 and 4.5 months. This measure is to protect the child from the disease over the next 5 years, when especially high risk of complications due to infection.

Rotavirus infection in adults does not require special treatment. Signs of the disease is often mistaken for a short-term indigestion. If the disease is in a severe form, accompanied by frequent diarrhea and fever, you should seek medical help.

Author: Baimurzina Regina

Registration of the article: Mila Friedan

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