Pediatrician Cui Yutao: Rotavirus Diarrhea Does Not Need Antibiotics

Editor’s Note:

What is rotavirus

There is a virus that mainly invades infants and young children. After being invaded by it, infants and young children develop mild upper respiratory tract symptoms in the early stage, which will soon cause vomiting and acute diarrhea, and often dehydration. Because the virus looks like a wheel under an electron microscope, it is called [rotavirus].

Rotavirus can invade people of any age, often affecting children under 6 years old, and children under 1 year old are high-risk groups. The younger the age, the more severe the symptoms. Symptoms are characterized by acute watery stool, so it is especially easy to cause dehydration.

In the early stage of rotavirus diarrhea, liquid containing certain electrolytes, such as oral rehydration salts, should be supplemented in time. Later, due to lactose intolerance, breast milk + lactase can be adhered to or lactose-free formula powder can be selected. Probiotics also have a certain effect on shortening the course of the disease.

In case of diarrhea in children, stool specimens can be taken for direct rotavirus antigen detection, and the accuracy of detection methods is relatively high. Because rotavirus is divided into several types, theoretically rotavirus can be infected many times, but in fact, few infants can suffer from more than two times.

Rotavirus gastroenteritis

Gastroenteritis caused by rotavirus often occurs in autumn and winter (October-February of the following year), so it used to be called “autumn diarrhea”. Although rotavirus gastroenteritis does not only occur in autumn, it is still a high incidence season. The incidence age of rotavirus gastroenteritis is 6 months to 2 years old, and it is relatively rare for infants over 4 years old.

1. How confirmed that the child suffered from rotavirus gastroenteritis?

Through stool rotavirus antigen detection, rotavirus infection can be rapidly determined.

The test requires parents to leave stool specimens in clean plastic bottles or plastic wrap after their children have diarrhea, and send them to the hospital laboratory for testing within 2 hours after infants defecate.

2. What are the manifestations of rotavirus gastroenteritis?

When suffering from rotavirus gastroenteritis, children will have fever, vomiting and dilute stool, which can also be described as [egg flower soup].

Rotavirus gastroenteritis in the early stage, children with fever and vomiting, vomiting, eating liquid is more difficult, often is to drink 10 milliliters of water, vomiting out 20 milliliters. At this time, parents should keep their children in a quiet state as much as possible, as much as possible to reduce the number of vomiting.

At the same time, inducing defecation is also an effective way to stop vomiting. Early discharge of gastrointestinal toxins is also conducive to early recovery of diseases.

In addition, rotavirus gastroenteritis still conforms to the manifestations of infectious gastroenteritis-fever and vomiting first, followed by diarrhea, mainly watery stool. Infants are very prone to dehydration and should be actively treated.

Is rotavirus gastroenteritis serious?

The course of rotavirus gastroenteritis is 5-7 days, and the main harm to children is dehydration. Prevention and treatment of dehydration are especially important. In addition, children can heal themselves within 5-7 days after taking probiotics to assist and supported by breast milk + lactase or lactose-free formula milk.

The Biggest Harm of Rotavirus-Dehydration

The harm caused by rotavirus gastroenteritis to infants is dehydration after vomiting and diarrhea. Dehydration refers to not only water loss, but also electrolyte loss.

1. How serious is the problem?

Rotavirus gastroenteritis is ferocious, It damages the small intestinal mucosa very quickly, which can obviously reduce the absorption of water by the small intestinal mucosa, at the same time lead to lactose digestion disorder, increase the osmotic pressure in the intestine, cause a large amount of water in the body to enter the intestinal tract, and finally lead to the rapid loss of a large amount of water containing electrolyte, resulting in dehydration. Severe dehydration can cause brain and other organs damage, and even endanger life.

2. What should parents do?

During diarrhea, parents should give their children rice soup, apple juice and other mixed liquids containing sugar, salt and water.

According to strict standards, the electrolyte-containing [oral rehydration salt] available in pharmacies is the best choice. Glucose, sodium, potassium and water contained in the liquid can effectively prevent and treat mild dehydration.

When in use, according to the dilution method in the instruction manual, a small amount is fed for many times, which can not only prevent dehydration, but also treat mild to moderate dehydration.

In addition, in family treatment, if the child still does not urinate within 4 hours under the condition of entering water as much as possible, or even suffers from less tears and dry mouth when crying, he should go to the hospital to correct dehydration through intravenous infusion.

Do I need antibiotics for rotavirus infection?

Some parents give their children antibiotics as soon as they hear that their children have “autumn diarrhea” or “rotavirus gastroenteritis”. But in fact, rotavirus gastroenteritis is a typical viral infection and antibiotics are not necessary in theory.

Rotavirus can invade small intestinal mucosa and cause mucosal damage. Therefore, routine stool examination may find a small number of white blood cells and red blood cells (< 10/high power field) in addition to positive rotavirus antigen.

Do not use antibiotics just because a small amount of white blood cells and red blood cells are found in stool, so as not to cause antibiotic-related diarrhea on the basis of rotavirus infection and prolong the course of the disease.

I once received a 11-month-old baby girl. The day before, she began to feel uncomfortable. She had fever in the middle of the night. The next morning, she began to vomit. By evening, she vomited eight times. During this period, parents gave her child cefixime and traditional Chinese medicine. Stool tests showed rotavirus gastroenteritis. When asked why parents chose antibiotics, the parents’ answer was very simple: [to diminish inflammation.]

The parents’ ideas and practices are very representative, but antibiotics are only aimed at bacteria or some special microbial infections and can never kill the virus.

A large number and frequent application of antibiotics will lead to the destruction of normal flora in children’s intestinal tract and damage the integrity of intestinal barrier. Dear parents, don’t love antibiotics too much!

The article was reprinted by Clove Garden authorized by the author.