Primer

Rotavirus infection

  • Nature Reviews Disease Primers 3, Article number: 17083 (2017)
  • doi:10.1038/nrdp.2017.83
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Abstract

Rotavirus infections are a leading cause of severe, dehydrating gastroenteritis in children <5 years of age. Despite the global introduction of vaccinations for rotavirus over a decade ago, rotavirus infections still result in >200,000 deaths annually, mostly in low-income countries. 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. Reinfections with rotavirus are common throughout life, although the disease severity is reduced with repeat infections. The immune correlates of protection against rotavirus reinfection and recovery from infection are poorly understood, although rotavirus-specific immunoglobulin A has a role in both aspects. The management of rotavirus infection focuses on the prevention and treatment of dehydration, although the use of antiviral and anti-emetic drugs can be indicated in some cases.

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Acknowledgements

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention (CDC).

Author information

Affiliations

  1. Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, MS: BCM-385, Houston, Texas 77030, USA.

    • Sue E. Crawford
    • , Sasirekha Ramani
    •  & Mary K. Estes
  2. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

    • Jacqueline E. Tate
    •  & Umesh D. Parashar
  3. Division of Molecular Virology, Medical Faculty, Linköping University, Linköping, Sweden.

    • Lennart Svensson
    •  & Marie Hagbom
  4. Department of Medicine, Karolinska Institute, Stockholm, Sweden.

    • Lennart Svensson
  5. Instituto de Genetica Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.

    • Manuel A. Franco
  6. Department of Microbiology and Immunology, Stanford University, Stanford, California, USA.

    • Harry B. Greenberg
  7. Microbiology and Mycology Program, Institute of Biomedical Sciences, and Millennium Institute of Immunology and Immunotherapy, Faculty of Medicine, Universidad de Chile, Santiago, Chile.

    • Miguel O'Ryan
  8. Translational Health and Science Technology Institute, Faridabad, India.

    • Gagandeep Kang
  9. Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.

    • Gagandeep Kang
  10. Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.

    • Ulrich Desselberger

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Contributions

Introduction (S.E.C. and S.R.); Epidemiology (J.E.T. and U.D.P.); Mechanisms/pathophysiology (L.S. and M.H.); Diagnosis, screening and prevention (M.A.F. and H.B.G.); Management (M.O.); Quality of life (G.K.); Outlook (U.D. and M.K.E.); Overview of Primer (S.E.C., S.R. and M.K.E.).

Competing interests

The authors declare no competing interests.

Corresponding author

Correspondence to Mary K. Estes.