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SAURABH WANI
PGDPM 10
GARWARE COLLEGE

ROTAVIRUS
INTRODUCTION
Rotaviruses are the major cause of diarrheal illness in

human infants in the world
Adults also get infected because of rotavirus
Young animals like calves and piglets are also
infected
Rotavirus infection spread easily and outbreaks
usually occur in the winter and early spring between
about November and April
Rotavirus infections often spread in settings where
many children's are together, such as daycare
centers
“TRANSMISSION
ROTAVIRUS”

OF

Primary mode of rotavirus transmission is fecal to oral
Highly communicable and transmissible disease

Close person to person contact and environmental

surfaces are common vectors of transmission
Incubation period is 1-3 days
Large quantities of virus are shed in stool from just prior
to onset of symptoms until about 10 days after onset
Amount of virus shed in stool [10-100 billion virion/gram
of stool]infection
Amount of ingested virus required to cause infection as
few as 10 infective virions
ROTAVIRUS
• First recognized in
1973, rotavirus belongs
to viral family
Reoviridae
• Rotavirus has
characteristic wheel
like appearance when
viewed under electron
microscope

• Rotavirus is triple
layered capsule
• The Rotavirus genome consist of 11 double stranded
RNA segments each encoding one viral proteins
• Scientist have describe seven Rotavirus group [A to
G]
• Only groups A, B AND C infect humans
• Group A which has multiple strains cause majority of
childhood infections
• Vaccine candidates are designed to protect against
group A Rotaviruses
• The G type and P type define the serotype
• They are critical to a vaccine development because
they are the vaccine for stimulating a protective
immune response
“ SEROTYPES”
Serotypes are described as variations within species of

bacteria or viruses or among immune cells of different
individuals
G1P[8] is the most common serotype worldwide and
accounts for over two thirds of rotavirus infections
worldwide
Infections with G1,G2,G3,G4 AND G9 together
comprise almost 95% of rotavirus serotype observed
Because the two gene segments that encode these
protein can segregate independently, A typing system
which consist of both G and P type is used i.e.
G1P[8],G2P[4],G3P[8],G4P[8],G9P[8] and G9P[6]
STEPS IN VIRAL REPLICATION
1. Receptor mediated
endocytosis leading to
formation of endosome
2. Viral RNA dependent RNA
polymerase creates m RNA
transcript of double stranded
viral genome
3. Viral genome is in the core of
two layered protein shell called
as double layered particle
VIRAL REPLICATION
4.

Third layer is disrupted

5. By remaining in the core, the viral RNA evades innate host immune
responses called RNA interference that are triggered by the presence of
double-stranded RNA

6. Viroplasm is formed around the cell nucleus as early as two hours
after virus infection, and consists of viral factories thought to be made by two
viral nonstructural proteins: NSP5 and NSP2
7. In this viroplasm RNA is replicated and the DLPs are assembled
8. The DLPs migrate to the endoplasmic reticulum where they obtain their

third, outer layer

9. Progeny viruses are released from the cell by lysis
WHY ROTAVIRUS INFECTION CAUSES DIARRHEA
Infection of villus epithelial cells causes cell destruction, decreased

absorption of salt and water and decreased dissachridase activity leading
to osmotic load in the gut lumen
 The osmotic load in the gut and increased fluid secretion leads to
diarrhea and without fluid replacement it will ultimately lead to
dehydration and acidosis
 Rotavirus induced gastroenteritis in children with immunodeficiency may
cause persistent infections lasting weeks or months
DIAGNOSIS OF ROTAVIRUS INFECTION
Diagnosis of infection with Rotavirus follows diagnosis of gastroenteritis of
severe diarrhea
Most children's are admitted to hospital with gastroenteritis are tested for
Rotavirus A
Specific diagnosis of infection with rotavirus A is made by finding the virus in
child’s stool by enzyme immunoassay

Children with immunodeficiency disorders may be treated with specific
rotavirus immunoglobulin preparation
DIAGNOSIS OF ROTAVIRUS
Laboratory diagnosis

Electron microscopy is used in the detection of
Virus in the stools which helps in early detection
Of disease
OTHER DIAGNOSIS METHOD INCLUDE
• ELISA
RAPID ANTIGEN DETECTION BY ELISA OF
ROTAVIRUS IN STOOL SAMPLES
• GENOTYPING
TREATMENT FOR ROTAVIRUS DIARRHEA
Therapy for rotavirus induced diarrhea involves replacement of fluid and

electrolyte loss during infection
ORAL REHYDRATION THERAPY is recommended in children with mild
or moderate dehydration
Fruit juices and soft drinks are not recommended due to there high
glucose content low sodium content and high osmolarity
 Antibiotics, antisecretory drugs, antimotility drugs, absorbents and
antiemetic’s
Do not clear acute infection but it prevents reinfection and reduce fluid
losses during rotavirus induced gastroenteritis and hence do not play role
in treatment
INFECTION CONTROL
Home and daycare facilities
1.HAND WASHING AREAS
2.Food preparation areas
3.Diaper changing surfaces
4.Diaper disposable containers
5.Toys
Hospital areas and clinics
1.HAND WASHING AREAS
2.Medication preparation areas
3.Equipment
4.Patient care areas
Rotavirus vaccine - Two oral,live,attenuated rotavirus
vaccines
INDIA UNVEILS FIRST INDIGENOUS ROTAVIRUS
VACCINE

Rotavirus responsible for approximately 4,53,000 child deaths due to

diarrhea globally each year
The Phase-III clinical trial of low cost Indian-made rotavirus vaccine

Rotavac has demonstrated strong efficacy and excellent safety
profile and if approved by the Drugs Controller General of India, it
would be available at Rs. 54 per dose.
Clinical study has demonstrated for the first time that Rotavac is

efficacious in preventing severe rotavirus diarrhea in low-resource
settings in India, and developing countries in Asia and Africa. Strain
diversity, too, has not apparently affected its efficacy.
Rotavirus is responsible for approximately 4,53,000 child deaths due to
diarrhea globally each year. It is particularly threatening in India where —
according to a recent study — around 1,00,000 children die each year
from severe diarrhea and dehydration caused by rotavirus.
India accounts for 22 per cent of the estimated global deaths from
diarrhea-causing rotavirus.
Rotavac is an oral vaccine and is administered to infants in a three-dose
course at the ages of 6, 10 and 14 weeks.

It is given alongside routine immunizations' in the Universal Immunization
Programed (UIP) vaccines recommended at these ages.
The randomized, double-blind, placebo-controlled phase-III clinical
trial enrolled 6,799 infants in India (aged six to seven weeks at the time
of enrolment) at three sites — the Centre for Health Research and
Development, Society for Applied Sciences, in New Delhi; Shirdi Sai
Baba Rural Hospital, KEM Hospital Research Centre in Vadu; and
Christian Medical College in Vellore.
Infants received Rotavac and the UIP vaccines, including the oral polio
vaccine (OPV).
Result showed that infants receiving OPV at the same time as Rotavac
generated comparable immune responses to all three polio serotypes
as the infants receiving OPV without Rotavac, supporting the
concurrent administration of OPV and Rotavac.
VACCINATING KIDS AGAINST ROTAVIRUS MAY
REDUCE RISK OF SEIZURES
The researchers found that children who were fully vaccinated

against rotavirus had an approximately 20 percent reduced risk of
seizure-related hospitalizations and emergency department visits
during the year following vaccination, compared to unvaccinated
children
Latest study estimated that rotavirus vaccination could potentially

save more than $7 million in U.S. health care costs each year by
preventing approximately 1,000 hospitalizations and 5,000 emergency
room visits for seizures among young children. "Caring for children
who have seizures can be expensive and emotionally taxing for
families," Dr. Payne said. "Seizures sometimes lead to painful
procedures, medication regimens, trips to the emergency room, or
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Rotavirus

  • 1. SAURABH WANI PGDPM 10 GARWARE COLLEGE ROTAVIRUS
  • 2. INTRODUCTION Rotaviruses are the major cause of diarrheal illness in human infants in the world Adults also get infected because of rotavirus Young animals like calves and piglets are also infected Rotavirus infection spread easily and outbreaks usually occur in the winter and early spring between about November and April Rotavirus infections often spread in settings where many children's are together, such as daycare centers
  • 3. “TRANSMISSION ROTAVIRUS” OF Primary mode of rotavirus transmission is fecal to oral Highly communicable and transmissible disease Close person to person contact and environmental surfaces are common vectors of transmission Incubation period is 1-3 days Large quantities of virus are shed in stool from just prior to onset of symptoms until about 10 days after onset Amount of virus shed in stool [10-100 billion virion/gram of stool]infection Amount of ingested virus required to cause infection as few as 10 infective virions
  • 4. ROTAVIRUS • First recognized in 1973, rotavirus belongs to viral family Reoviridae • Rotavirus has characteristic wheel like appearance when viewed under electron microscope • Rotavirus is triple layered capsule
  • 5. • The Rotavirus genome consist of 11 double stranded RNA segments each encoding one viral proteins • Scientist have describe seven Rotavirus group [A to G] • Only groups A, B AND C infect humans • Group A which has multiple strains cause majority of childhood infections • Vaccine candidates are designed to protect against group A Rotaviruses • The G type and P type define the serotype • They are critical to a vaccine development because they are the vaccine for stimulating a protective immune response
  • 6. “ SEROTYPES” Serotypes are described as variations within species of bacteria or viruses or among immune cells of different individuals G1P[8] is the most common serotype worldwide and accounts for over two thirds of rotavirus infections worldwide Infections with G1,G2,G3,G4 AND G9 together comprise almost 95% of rotavirus serotype observed Because the two gene segments that encode these protein can segregate independently, A typing system which consist of both G and P type is used i.e. G1P[8],G2P[4],G3P[8],G4P[8],G9P[8] and G9P[6]
  • 7. STEPS IN VIRAL REPLICATION 1. Receptor mediated endocytosis leading to formation of endosome 2. Viral RNA dependent RNA polymerase creates m RNA transcript of double stranded viral genome 3. Viral genome is in the core of two layered protein shell called as double layered particle
  • 8. VIRAL REPLICATION 4. Third layer is disrupted 5. By remaining in the core, the viral RNA evades innate host immune responses called RNA interference that are triggered by the presence of double-stranded RNA 6. Viroplasm is formed around the cell nucleus as early as two hours after virus infection, and consists of viral factories thought to be made by two viral nonstructural proteins: NSP5 and NSP2
  • 9. 7. In this viroplasm RNA is replicated and the DLPs are assembled 8. The DLPs migrate to the endoplasmic reticulum where they obtain their third, outer layer 9. Progeny viruses are released from the cell by lysis
  • 10. WHY ROTAVIRUS INFECTION CAUSES DIARRHEA Infection of villus epithelial cells causes cell destruction, decreased absorption of salt and water and decreased dissachridase activity leading to osmotic load in the gut lumen  The osmotic load in the gut and increased fluid secretion leads to diarrhea and without fluid replacement it will ultimately lead to dehydration and acidosis  Rotavirus induced gastroenteritis in children with immunodeficiency may cause persistent infections lasting weeks or months
  • 11. DIAGNOSIS OF ROTAVIRUS INFECTION Diagnosis of infection with Rotavirus follows diagnosis of gastroenteritis of severe diarrhea Most children's are admitted to hospital with gastroenteritis are tested for Rotavirus A Specific diagnosis of infection with rotavirus A is made by finding the virus in child’s stool by enzyme immunoassay Children with immunodeficiency disorders may be treated with specific rotavirus immunoglobulin preparation
  • 12. DIAGNOSIS OF ROTAVIRUS Laboratory diagnosis Electron microscopy is used in the detection of Virus in the stools which helps in early detection Of disease OTHER DIAGNOSIS METHOD INCLUDE • ELISA RAPID ANTIGEN DETECTION BY ELISA OF ROTAVIRUS IN STOOL SAMPLES • GENOTYPING
  • 13. TREATMENT FOR ROTAVIRUS DIARRHEA Therapy for rotavirus induced diarrhea involves replacement of fluid and electrolyte loss during infection ORAL REHYDRATION THERAPY is recommended in children with mild or moderate dehydration Fruit juices and soft drinks are not recommended due to there high glucose content low sodium content and high osmolarity  Antibiotics, antisecretory drugs, antimotility drugs, absorbents and antiemetic’s Do not clear acute infection but it prevents reinfection and reduce fluid losses during rotavirus induced gastroenteritis and hence do not play role in treatment
  • 14. INFECTION CONTROL Home and daycare facilities 1.HAND WASHING AREAS 2.Food preparation areas 3.Diaper changing surfaces 4.Diaper disposable containers 5.Toys Hospital areas and clinics 1.HAND WASHING AREAS 2.Medication preparation areas 3.Equipment 4.Patient care areas
  • 15. Rotavirus vaccine - Two oral,live,attenuated rotavirus vaccines
  • 16.
  • 17. INDIA UNVEILS FIRST INDIGENOUS ROTAVIRUS VACCINE Rotavirus responsible for approximately 4,53,000 child deaths due to diarrhea globally each year The Phase-III clinical trial of low cost Indian-made rotavirus vaccine Rotavac has demonstrated strong efficacy and excellent safety profile and if approved by the Drugs Controller General of India, it would be available at Rs. 54 per dose. Clinical study has demonstrated for the first time that Rotavac is efficacious in preventing severe rotavirus diarrhea in low-resource settings in India, and developing countries in Asia and Africa. Strain diversity, too, has not apparently affected its efficacy.
  • 18. Rotavirus is responsible for approximately 4,53,000 child deaths due to diarrhea globally each year. It is particularly threatening in India where — according to a recent study — around 1,00,000 children die each year from severe diarrhea and dehydration caused by rotavirus. India accounts for 22 per cent of the estimated global deaths from diarrhea-causing rotavirus. Rotavac is an oral vaccine and is administered to infants in a three-dose course at the ages of 6, 10 and 14 weeks. It is given alongside routine immunizations' in the Universal Immunization Programed (UIP) vaccines recommended at these ages.
  • 19. The randomized, double-blind, placebo-controlled phase-III clinical trial enrolled 6,799 infants in India (aged six to seven weeks at the time of enrolment) at three sites — the Centre for Health Research and Development, Society for Applied Sciences, in New Delhi; Shirdi Sai Baba Rural Hospital, KEM Hospital Research Centre in Vadu; and Christian Medical College in Vellore. Infants received Rotavac and the UIP vaccines, including the oral polio vaccine (OPV). Result showed that infants receiving OPV at the same time as Rotavac generated comparable immune responses to all three polio serotypes as the infants receiving OPV without Rotavac, supporting the concurrent administration of OPV and Rotavac.
  • 20. VACCINATING KIDS AGAINST ROTAVIRUS MAY REDUCE RISK OF SEIZURES The researchers found that children who were fully vaccinated against rotavirus had an approximately 20 percent reduced risk of seizure-related hospitalizations and emergency department visits during the year following vaccination, compared to unvaccinated children Latest study estimated that rotavirus vaccination could potentially save more than $7 million in U.S. health care costs each year by preventing approximately 1,000 hospitalizations and 5,000 emergency room visits for seizures among young children. "Caring for children who have seizures can be expensive and emotionally taxing for families," Dr. Payne said. "Seizures sometimes lead to painful procedures, medication regimens, trips to the emergency room, or
  • 21.