Disease
Rotavirus causes an acute gastroenteritis in infants and young children and is associated with profuse watery diarrhoea, projectile vomiting and fever. Rapid dehydration can occur, especially in very young infants, requiring rehydration therapy. The virus is transmitted via the faecal–oral route and by direct personto- person spread, although a respiratory mode of transmission has been proposed also. It replicates in the enterocytes of the small intestine, causing extensive damage to the microvilli that results in malabsorption and loss of fl uids and electrolytes.
Occurrence
Rotavirus is found worldwide. The virus is ubiquitous, infecting a large proportion of young children by their second or third birthday. Re-infection of older children and adults is common, although the infection is usually sub-clinical.
Risk for travellers
The potential risk for travellers is extremely limited since most individuals will have good immunity through repeated exposures early in life.
Vaccine
Two live, attenuated, oral rotavirus vaccines are internationally licensed and routine childhood vaccination has been initiated in a number of countries. To date, the clinical effi cacy of the rotavirus vaccines has been demonstrated mainly in the Americas and in Europe. WHO recommends the inclusion of rotavirus vaccination into the national immunization programmes of regions where vaccine effi cacy data suggest a signifi cant public health impact. Vaccination is not currently recommended for travellers or older children outside the routine childhood immunization schedule.