Rotavirus is a type of infection that’s most common in children under the age of 5. It’s highly contagious and easily transmittable. While it occurs most often in young children, adults can also get the infection, although it’s usually less severe. Rotaviruses are the most common cause of severe diarrhoeal disease in young children throughout the world. According to WHO estimates in 2013 about 215 000 children aged under 5 years die each year from vaccine-preventable rotavirus infections; the vast majority of these children live in low-income countries.
As the babies are highly prone to dehydration, as they have an undeveloped immune system and weak body compared to adults, diarrhoea can be fatal in them if not managed on time. In very small babies, diagnosis and treatment are more difficult due to lack of verbal communication. Though doctors & hospital care are crucial, parent’s attention to the baby is equally important.
SIGNS AND SYMPTOMS
Following symptoms usually start about 2 days after a person is exposed to rotavirus:
- Severe watery diarrhoea
- vomiting
- fever
- abdominal pain
Vomiting and watery diarrhoea can last from 3 to 8 days. Additional symptoms may include loss of appetite and dehydration (loss of body fluids), which can be especially dangerous for infants and young children.
Symptoms of dehydration include:
- decreased urination
- dry mouth and throat
- feeling dizzy when standing up
- crying with few or no tears and
- unusual sleepiness or fussiness
Rotavirus disease is most common in infants and young children. However, older children and adults also can get sick from rotavirus. Adults who get rotavirus disease tend to have milder symptoms.
PATHOPHYSIOLOGY
Rotavirus primarily infects enterocytes and induces diarrhoea through the destruction of absorptive enterocytes (leading to malabsorption), intestinal secretion stimulated by rotavirus non-structural protein 4 and activation of the enteric nervous system. In addition, rotavirus infections can lead to antigenaemia (which is associated with more severe manifestations of acute gastroenteritis) and viraemia, and rotavirus can replicate in systemic sites, although this is limited.
DIAGNOSIS
It is tough to diagnose in an acute & severe case. Clinically, rotavirus infections are often more severe than diarrhoeal diseases caused by other infectious agents. In addition, the seasonality of infection can indicate rotavirus as the causative agent in some regions; for example, in non-equatorial countries, rotavirus or norovirus infection is suggested if a child presents with diarrhoea in winter.
In a laboratory setting, rotavirus antigen can be detected in stools using enzyme-linked immunosorbent assay (ELISA) or immunochromatography. In vaccine and epidemiological studies, these assays are often complemented by the use of reverse transcription PCR (RT-PCR)-based assays
TREATMENTS
There is no specific medicine to treat rotavirus infection.
As in any other viral infection, symptomatic treatment can be given. Since rotavirus disease can cause severe vomiting and diarrhoea, it can lead to dehydration (loss of body fluids). The best way to protect against dehydration is to drink plenty of liquids. Oral and intravenous rehydration solutions are often helpful.
PROGNOSIS
Rotavirus infection is a self-limited disease that resolves after three to nine days of symptoms.
COMPLICATIONS
dehydration
metabolic acidosis
fever
Afebrile and febrile seizures
transient reduced consciousness
encephalopathy.
DISEASE AND AYURVEDA
Atisaara
NIDANA
Excess water intake
Intake of dry meat & meat of emaciated animal
Food which is not habitual or suitable to body
Sesame (dry, grinded and oil removed)
Sprouts
Alcohol
Dry food intake
Excess food intake
Haemorrhoids
Faulty routine during ghee intake (as a treatment)
Intestinal parasites
Suppression of natural urges
PURVARUPA
Pricking pain in chest, rectum and abdomen
Weakness of body
Constipation
Distended abdomen
Indigestion
SAMPRAPTI
Due to the causative factors, Vaata dosha vitiates and brings the water content in the body into the koshtha and expels through anus. With this excess water in koshtha, reduces the Agni (digestive fire), damages the gastrointestinal tract along with faecal matter and causes loose stools. It makes the stool watery and the disease diarrhoea gets manifested especially in people who eat unwholesome diet.
LAKSHANA
Vaathika
Watery, more frequent stools with obstruction
Defaecation with pain & abnormal sounds
Dry, frothy/clear or hardened stools
Resembles over-cooked jaggery
Sticky stools passed with severe tearing pain
Dryness of mouth
Rectal prolapse
Horripilation
Groaning
Paittika
Yellow, black, green like grass,
With blood
Foul smelling,
Excess thirst
Fainting/giddiness
Excess sweating
Burning sensation
Abdominal pain
Heat and inflammation of rectum & anus
Kaphaja
Heavy, sticky, with thread-like structures, white in colour, oily & sticky, faeces with particles of undigested food
Irregular & interrupted flow containing only a little faecal matter in one vega with mucous &foul smell,
With flatulence
Pain
Excess sleep
Lazy
Aversion to food
Horripilation
Feeling that not completely voided faeces after defaecation
Sannipatajam
All three doshalakshanas are present
Bhayajam and Shokajam
(Resembles Vaata-Pitta akshanas)
Very hot and liquified stools
Very light & floating
Divisions
6 types
- Vaatika
- Paittika
- Kaphaja
- Thridoshaja or sannipaatika
- Bhayajam (due to fear/anxiety)
- Sokajam (due to grief)
2 types
Saamam – with indigestion
Niraamam – without indigestion
2 types
Saraktam – with bleeding
Araktam – without bleeding
Prognosis
Kricchrasadhya in healthy individuals without any complications & dhatudushti.
Asaadhya in children, old persons and with complications.
Chikithsa
Ayurveda treatment for atisaara includes fasting as an important method in adults. It can not be done in small babies & children as they are asampoornadhatu (not completely developed body tissues). In children, proper hydration and nourishment is ensured during the treatment.
Samana
Langhana – fasting (only in adults)
Upekshaa – Leaving the body to expel out the excess doshas by atisaara(only in adults)
Aamapachana
Agnideepana
Sodhana
No sodhana is done in children unless fatal & emergency condition.
Therapies done in adults for sodhana include:
Vamana – In atisaara with severe abdominal pain & distension
Snehavasti
Kashayavasti-Picchavasti
Commonly used medicines
Kutajarishtam
Pippallyasavam
Brands available
AVS Kottakal
AVP Coimbatore
SNA Oushadhasala
Home remedies
Taking Oral Rehydration Therapy: Mix one glass of boiled water with one teaspoon of sugar & one pinch of salt. Take it sip by sip for 3-4 hours. This is the simplest method of rehydration which can be done at home.
Moderate fasting on solid foods till feeling better & hungry.(only in adults)
Fenugreek seeds boiled in water for drinking
Carminatives like cumin seeds help correct the indigestion
Buttermilk boiled with turmeric, curry leaves, ginger, etc.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
carbonated drinks – makes the stomach more acidic and disturbed digestion
refrigerated and frozen foods – causes weak and sluggish digestion by weakening agni (digestive fire)
curd – causes vidaaha and thereby many other diseases
- To be added
Drink only boiled water
Light meals and easily digestible foods
Green gram, soups, buttermilk boiled with turmeric, ginger and curry leaves
freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Better to avoid exposure to excessive sunlight wind rain or dust.
Avoid lifting heavy weights and other vigorous physical activities.
Maintain a regular food and sleep schedule.
Avoid sitting continuously for a long time and avoid squatting.
Yoga
Yoga is not advised in children with Rotavirus infection. Complete bedrest is advised for even an adult patient with loose stools. After regaining normal health, following a daily exercise routine will help the person to improve digestion & health.
Stretching exercises and specific yoga asanas like pavanamuktasana, vajrasana, bhujangasana etc are recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within and with surroundings.
Pavanamuktasana
Vajrasana
Bhujangasana
Exercises for Low backache
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
RESEARCH ARTICLES
DOI: 10.3945/jn.116.246090
In the study, the effect of specific and abundant milk oligosaccharides on the infectivity of 2 globally dominant human rotavirus strains was determined. Four milk oligosaccharides-2′-fucosyllactose (2’FL), 3′-sialyllactose (3’SL), 6′-sialyllactose (6’SL), and galacto-oligosaccharides-were tested for their effects on the infectivity of human rotaviruses G1P and G2P through fluorescent focus assays on African green monkey kidney epithelial cells (MA104 cells). It was concluded that milk oligosaccharides reduce the infectivity of human rotaviruses in MA104 cells, primarily through an effect on the virus.
DOI: 10.1128/AEM.00027-15
To learn how temperature and solar treatments inactivate the virus on a molecular level, an approach was made to correlate rotavirus inactivation with the inhibition of portions of the virus life cycle as a means to identify the mechanisms of solar or heat inactivation. Specifically, the integrity of the rotavirus NSP3 gene, virus-host cell interaction, and viral RNA synthesis were examined after heat (57°C) or solar treatment of rotavirus. Only the inhibition of viral RNA synthesis positively correlated with a loss of rotavirus infectivity; 57°C treatment of rotavirus resulted in a decrease of rotavirus RNA synthesis at the same rate as rotavirus infectivity. These data suggest that heat treatment neutralized rotaviruses primarily by targeting viral transcription functions. In contrast, when using solar disinfection, the decrease in RNA synthesis was responsible for approximately one-half of the decrease in infectivity, suggesting that other mechanisms, including posttranslational, contribute to inactivation. Nevertheless, both solar and heat inactivation of rotaviruses disrupted viral RNA synthesis as a mechanism for inactivation.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
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