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Pathophys and Cause ⬇

Pathophys:Small bowel invasion; immunity develops w recurrent infections (Nejm 1996;335:1022)

Epidemiology ⬆ ⬇

Episodic in individuals, esp infants <2 yr in 3rd world; 20 deaths and 50 000 hospitalizations annually in US; nearly 1 million die annually worldwide in 3rd-world countries

Signs and Symptoms ⬆ ⬇

Sx:Incubation period

Si:May have fever, no fecal leukocytes present

Lab and Xray ⬆ ⬇

Lab:Stool ELISA antigen test

Treatment ⬆

Rx:

Live vaccine; 1st versions caused intussceptions in 1/5000-10 000 (Nejm 2001;344:564) so pulled from US market 10/99; but 2 subsequent types (Rotarix, Rotateg) are safe and effective. 2-3 doses q1month (Nejm 2006;354:11, 23, 75). Reduces childhood diarrheal diease deaths in developing countries by almost ½ (Nejm 2010;362:289, 299, 358)

Rehydration and supportive care