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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 OF 
ROTAVIRUS 
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 
surrounding RNA
 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 
childs 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 
antiemetics 
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
Rotavirus
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
Rotavirus
THANKYOU

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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 OF ROTAVIRUS 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 surrounding RNA
  • 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 childs 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 antiemetics 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
  • 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