Rotavirus is the leading cause of viral gastroenteritis in children worldwide. Symptoms include severe dehydrating diarrhea, vomiting, and fever. Over 600,000 deaths occur annually and mostly in developing countries, due to dehydration caused by the infection.
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Rotavirus is one of nine genera in the family Reoviridae and it is subdivided into seven serogroups (A to G) on the basis of its antigenic and genetic properties. The members of each serogroup share a common group antigen located on the major inner capsid protein, VP6, which is also the most prevalent protein in the rotavirus particle and is highly immunogenic. Only rotaviruses in groups A to C have been associated with disease in humans.
Group A rotaviruses are the major cause of gastroenteritis in children worldwide, with a peak incidence among children between 6 months and 2 years of age. Rotavirus can produce a spectrum of illnesses ranging from subclinical infection to severe occasionally fatal dehydration. Typically, the clinical presentation after a 3-day incubation period is 3 days of vomiting and 5 days of watery diarrhea with moderate fever. Although only discovered as a human pathogen 32 years ago, the role of the virus as a diarrheal disease in developed and developing countries was quickly identified.
Diagnosis for rotavirus was originally performed using electron microscopy, which is still occasionally used in laboratories where it is available. Routine diagnosis now most commonly relies on antigen detection using commercially available rapid assays, latex particle agglutination and enzyme immunoassays (EIA). Since rotavirus is shed in such high concentrations in stool, fecal specimens are preferred for diagnosis. As nearly all rotavirus strains infecting humans belong to group A, the standard antigen detection in routine clinical use detects only group A (VP6 antigen). Serologic tests, although less commonly used due to high seropositivity, can detect a rise in serum IgG and IgA antibodies for recent infections. Serum IgA has also been the most widely used marker for rotavirus infection in vaccine trials and it is the best serologic indicator of reinfection. There are no commercial kits available to measure rotavirus antibodies.
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