RotavirusRotavirus

Crystal DenmonCrystal Denmon

Allen ChiuAllen Chiu

Anthony BonillaAnthony Bonilla

Background InformationBackground Information

Family – ReoviridaeFamily – Reoviridae Have 10-12 DS RNA segmentsHave 10-12 DS RNA segments Double icosadehral capsid, 60 nmDouble icosadehral capsid, 60 nm Outer capsid + short spikesOuter capsid + short spikes

Rotavirus SerotypesRotavirus Serotypes

2 Types of Surface 2 Types of Surface Proteins Proteins G (glycoprotein) G (glycoprotein) P (protease-P (protease-

sensitive protein)sensitive protein) 11 G 11 G

serotypes and 12 P serotypes and 12 P types types

Rotavirus Life CycleRotavirus Life Cycle

How Rotavirus AffectsHow Rotavirus Affects Host Cell Transcription Host Cell Transcription

Case StudyCase Study

A A 6 month-old6 month-old child was seen in the child was seen in the emergency in emergency in JanuaryJanuary after two days of after two days of persistent watery persistent watery diarrheadiarrhea and and vomitingvomiting accompanied by low grade accompanied by low grade feverfever and mild and mild cough. The infant appeared dehydrated cough. The infant appeared dehydrated and required hospitalization. The patient and required hospitalization. The patient attended a attended a day-care centerday-care center..

Diarrhea Caused by Diarrhea Caused by Cellular ApoptosisCellular Apoptosis

SymptomsSymptoms

VomitingVomitingWatery Watery

diarrhea for 3-8 diarrhea for 3-8 daysdays

FeverFever

Similar Viral AgentsSimilar Viral Agents Traveller’s DiarrheaTraveller’s Diarrhea

Get it shortly after you return home or while traveling. More common with Get it shortly after you return home or while traveling. More common with young adults age 20-29. young adults age 20-29.

CholeraCholera Not likely to spread directly from one person to another; therefore, casual Not likely to spread directly from one person to another; therefore, casual

contact with an infected person is not a risk for becoming ill. Symptoms contact with an infected person is not a risk for becoming ill. Symptoms include leg cramps include leg cramps

SalmonellaSalmonella Usually from coming in contact with surfaces that had raw meat on themUsually from coming in contact with surfaces that had raw meat on them

CampylobacterCampylobacter Associated with handling raw poultry or eating raw or undercooked poultry Associated with handling raw poultry or eating raw or undercooked poultry

meat. Diarrhea may be bloodymeat. Diarrhea may be bloody

Similar Viral AgentsSimilar Viral Agents Common ColdCommon Cold

Not just limited to infants. Diahrrea and vomiting are not primary Not just limited to infants. Diahrrea and vomiting are not primary symptoms.symptoms.

ShigellosisShigellosis Diarrhea, often bloody, is the most common sign of shigellosis.Diarrhea, often bloody, is the most common sign of shigellosis.

DiptheriaDiptheria Toxin usually attacks the tonsils first and causes fever, red sore throat, Toxin usually attacks the tonsils first and causes fever, red sore throat,

weakness, and headache. The toxin destroys the normal throat tissue, causing weakness, and headache. The toxin destroys the normal throat tissue, causing the throat to swell. the throat to swell.

NorwalkvirusNorwalkvirus General lethargy, weakness, muscle aches, headache, and low-grade fever General lethargy, weakness, muscle aches, headache, and low-grade fever

may occur.may occur. CoxsakievirusCoxsakievirus

Hand, foot, and mouth disease, a type of coxsackievirus syndrome, Hand, foot, and mouth disease, a type of coxsackievirus syndrome, causes painful red blisters in the throat and on the tongue, gums, hard causes painful red blisters in the throat and on the tongue, gums, hard palate, inside of the cheeks, and the palms of hands and soles of the palate, inside of the cheeks, and the palms of hands and soles of the feet.feet.

DiagnosisDiagnosis

Tests Confirming Rotavirus:Tests Confirming Rotavirus: Rapid Antigen detection of rotavirus in stool.Rapid Antigen detection of rotavirus in stool. Further characterization by: Further characterization by:

Enzyme immunoassay or ELISAEnzyme immunoassay or ELISA Reverse transcriptase polymerase chain reactionReverse transcriptase polymerase chain reaction

Polyacrylamide gel electrophoresis (PAGE)Polyacrylamide gel electrophoresis (PAGE) Electron Microscopy (EM)Electron Microscopy (EM) ImmunochromatographyImmunochromatography

Enzyme ImmunoassayEnzyme Immunoassay

TransmissionTransmission

Fecal-Oral (primary)Fecal-Oral (primary)Contact with Contact with

Contaminated surfacesContaminated surfacesFoodFoodWaterWaterFomite Fomite

(ie. toys, table (ie. toys, table tops,solid surfaces)tops,solid surfaces)

Respiratory tract fluidsRespiratory tract fluids

EpidemiologyEpidemiology

Incubation time: 2 - 4 daysIncubation time: 2 - 4 days Patients show symptoms 3 to 8 days after incubation. Patients show symptoms 3 to 8 days after incubation. Contagious for 2 days before showing symptoms and 2 days Contagious for 2 days before showing symptoms and 2 days

after recovery.after recovery.

Who’s At Risk?Who’s At Risk?

When Are You At Risk?When Are You At Risk?

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http://rotavirusinfo.com/hcp/rotavirus_infection.htmlhttp://rotavirusinfo.com/hcp/rotavirus_infection.html

TreatmentTreatment

Oral Rehydration Therapy (ORT)Oral Rehydration Therapy (ORT) replaces fluids and electrolytes lost via replaces fluids and electrolytes lost via

diarrhea and vomiting, is usually given in 2 diarrhea and vomiting, is usually given in 2 phases:phases:Rehydration: to quickly replace water and Rehydration: to quickly replace water and

electrolyte loss.electrolyte loss.Maintenance: continued to replace fluid loss and Maintenance: continued to replace fluid loss and

provide adequate caloric intake.provide adequate caloric intake.

Vaccine and PreventionVaccine and Prevention

Live oral vaccine Live oral vaccine (RotaTeq) for use in (RotaTeq) for use in children children (FDA approved February (FDA approved February

of 2006)of 2006)Prevention:Prevention:

Good Hygiene and Good Hygiene and Sanitation. Sanitation.

Questions???Questions???

ReferencesReferences 1. 1. About RotavirusAbout Rotavirus. Retrieved November 4, 2007 from . Retrieved November 4, 2007 from http://http://www.cdc.govwww.cdc.gov/rotavirus//rotavirus/.. 2. Vergara F R, Navarrete MS, Núñez E, Escobar L, Navarro G S, Venegas E G, Schuffeneger 2. Vergara F R, Navarrete MS, Núñez E, Escobar L, Navarro G S, Venegas E G, Schuffeneger

P, O'Ryan M. P, O'Ryan M. Incidence of Severe Rotavirus Gastroenteritis Among Chilean Children Under Incidence of Severe Rotavirus Gastroenteritis Among Chilean Children Under Three Years Of AgeThree Years Of Age. Rev Med Chil. 2007 Aug;135(8):975-81. Epub 2007 Oct 25.. Rev Med Chil. 2007 Aug;135(8):975-81. Epub 2007 Oct 25.

3. Rotavirus3. Rotavirus. Retreived November 4, 2007 from . Retreived November 4, 2007 from http://http://www.who.int/biologicals/areas/vaccines/rotavirus/enwww.who.int/biologicals/areas/vaccines/rotavirus/en//..

4. MMWR. (3/19/99). 4. MMWR. (3/19/99). Vaccine for the Prevention of Rotavirus Gastroenteritis Among Children Vaccine for the Prevention of Rotavirus Gastroenteritis Among Children Recommendations of the Advisory Committee on Immunization Practices (ACIP).Recommendations of the Advisory Committee on Immunization Practices (ACIP). Retrieved Retrieved November 4, 2007 from (November 4, 2007 from (http://www.cdc.gov/MMWR/preview/mmwrhtml/00056669.htmhttp://www.cdc.gov/MMWR/preview/mmwrhtml/00056669.htm..

5. Merck & Co.5. Merck & Co. Information about Rotavirus. Information about Rotavirus. Retrieved November 5, 2007 from Retrieved November 5, 2007 from http://http://rotavirusinfo.com/hcp/information_on_rotavirus.htmlrotavirusinfo.com/hcp/information_on_rotavirus.html..

6. Mayo Clinic Staff (August 25, 2006). 6. Mayo Clinic Staff (August 25, 2006). Rotavirus: OverviewRotavirus: Overview. Retrieved November 5, 2007 from . Retrieved November 5, 2007 from http://www.mayoclinic.com/health/rotavirus/DS00783http://www.mayoclinic.com/health/rotavirus/DS00783..

7. Symptomchecker. Retrieved Novevember 7, 2007 from 7. Symptomchecker. Retrieved Novevember 7, 2007 from http://http://symptoms.webmd.com/default.htmsymptoms.webmd.com/default.htm..

8. Sandra Martin-Latil, Laurence Mousson, Arnaud Autret, Florence Colbère-Garapin, and Bruno 8. Sandra Martin-Latil, Laurence Mousson, Arnaud Autret, Florence Colbère-Garapin, and Bruno BlondelBlondel. . Bax Is Activated during Rotavirus-Induced Apoptosis through the Mitochondrial Bax Is Activated during Rotavirus-Induced Apoptosis through the Mitochondrial PathwayPathway. October 26 2006. Journal of Virology, May 2007, p. 4457-4464, Vol. 81, No. 9.. October 26 2006. Journal of Virology, May 2007, p. 4457-4464, Vol. 81, No. 9.

9. Gouvea, V., Glass, R.I., Woods, P., Taniguchi, K., Clark, H.F., Forrester, B., Fang. Z.Y, 9. Gouvea, V., Glass, R.I., Woods, P., Taniguchi, K., Clark, H.F., Forrester, B., Fang. Z.Y, Polymerase chain reaction amplification and typing of rotavirus nucleic acid from stool Polymerase chain reaction amplification and typing of rotavirus nucleic acid from stool specimens. specimens. November 3 1989. Journal of Clinical Microbiology, February 1990, p.267-282. Vol. November 3 1989. Journal of Clinical Microbiology, February 1990, p.267-282. Vol. 28, No.228, No.2