A FRIGHTENING ENCOUNTER WITH ROTAVIRUS

It was Monday, and two-year-old Mira was having a fever. Soon, she started vomiting profusely and developed watery green and foul-smelling diarrhoea[1]. Dad, Yusuf, decided to take her to the hospital while Liza, the mum, stayed behind to look after their eight-month-old son, Halim.

Mira was pale and exhausted from all the vomiting and diarrhoea, which showed no signs of abating. After a close examination by the doctor, Mira was also found to be severely dehydrated; sunken eyes and falling in and out of consciousness[1].

“The doctor ordered a stool test, and it came back positive for rotavirus”

Mira was quickly admitted and immediately placed on an IV drip[1]. Oral rehydration therapy was also given but she was too weak to ingest any liquid and she would have simply vomited everything out[1]. The doctor ordered a stool test, and it came back positive for rotavirus.

But Mira’s situation was far less dramatic than what was about to happen to Halim, her baby brother. On Wednesday, Halim started having fever, vomiting and soon after that, diarrhoea. The parents were worried he had contracted rotavirus from Mira, and they were right. By the time the doctor saw Halim, he had lost so much fluid he was lethargic and cried without tears[1]. So, he was placed on an IV drip immediately. Halim was placed in the same room as Mira so Liza and Yusuf could be with the both of them. He was in so much discomfort he cried whenever he was awake, his parents could only do their best to calm him down.

“…regretted not vaccinating their kids when they had the chance, as all this could’ve been avoided”

Since both siblings had epidemiological links, the doctor needed to contact the Local Health Department (PKD) immediately, so he decided to investigate further. Both parents too were curious as to how Mira had contracted the virus. Liza stated that she had started sending Mira to a day-care centre. The doctor explained to them how rotavirus is found in the stool of those who are infected[2]. It was possible that the virus spread to Mira when she touched an object contaminated with the stool, and unwittingly put her hand into her mouth[2]. Also, the virus can thrive for weeks on surfaces[3], especially if the centre is not properly cleaned or sanitised. With the information the doctor gathered, he contacted the health department immediately.

Both Liza and Yusuf regretted not vaccinating their kids when they had the chance, as all this could’ve been avoided. At that time, they thought since it was just an optional vaccine, it was not worth the expense. Rotavirus vaccine is an additional recommended vaccine that can be obtained only if requested.By Thursday, Mira was well enough to be discharged, but Halim was still having diarrhoea. He only started to get better on Sunday and was finally discharged on Monday. Yusuf said their encounter with rotavirus was very stressful and traumatising for the family.

After the siblings were discharged, the doctor kept an eye out for any more rotavirus admissions, especially for those that may have been attending the same day-care centre as Mira. Luckily there weren’t any more cases.

“…there is no specific treatment for rotavirus”

According to Datuk Dr Zulkifli Ismail, a consultant paediatrician and Immunise4Life Technical Committee Chairman, the above scenario is quite common. He explained that rotavirus is the most common and potentially lethal virus affecting infants and young children. Symptoms may include fever, nausea, vomiting and watery diarrhoea, which appear within two days of exposure to the virus.

He said, “Almost every child would have an episode of rotavirus gastroenteritis by the age of five years. But unlike some diseases, there is no specific treatment for rotavirus. So when it happens, we can only try and manage the symptoms as best as we can.”

“…all these deaths could have been prevented with a vaccine given by mouth”

“Currently, the rotavirus vaccine is one of the ways to protect children against the disease. While clean water initiatives, personal and environmental hygiene may help reduce virus transmission, these measures are not enough,” added Datuk Zulkifli.

Rotavirus gastroenteritis kills roughly 215,000 children under five around the world every year[4]. The tragedy of this is that all these deaths could have been prevented with a vaccine given by mouth[4].

Currently in Malaysia, rotavirus vaccines are only available in private clinics. Click here to find your nearest clinic and talk to a paediatrician about rotavirus prevention for your child.

Rotavirus and children

 

Article courtesy of the Immunise4Life programme by Ministry of Health Malaysia, Malaysian Paediatric Association & Malaysian Society of Infectious Diseases & Chemotherapy, supported by Merck Sharp & Dohme.

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References:
[1]NFID. n.d. Frequently Asked Questions About Rotavirus. http://www.nfid.org/idinfo/rotavirus/faqs.html (Accessed on March 11, 2019)
[2]CDC. 2018. Epidemiology and Prevention of Vaccine-Preventable Diseases. Retrieved from https://www.cdc.gov/vaccines/pubs/pinkbook/rota.html (Accessed on March 15, 2019)
[3]WebMD. n.d. What is Rotavirus? https://www.webmd.com/children/guide/what-is-rotavirus#1 (Accessed on March 13, 2019).
[4]WHO. 2018. Immunization, Vaccines and Biologicals. Retrieved from https://www.who.int/immunization/diseases/rotavirus/en/ (Accessed on March 15, 2019)
[5]5. WHO. 2013. WHO Position Paper. Retrieved from https://www.who.int/wer/2013/wer8805.pdf?ua=1 (Accessed on March 15, 2019)
[6]6. Mayo Clinic. 2019. Rotavirus. https://www.mayoclinic.org/diseases-conditions/rotavirus/symptoms-causes/syc-20351300 (Accessed on March 15, 2019)
[7]7. CDC. 2016. Vaccines and Preventable Diseases. https://www.cdc.gov/vaccines/vpd/rotavirus/index.html (Accessed on March 15, 2019)