1. SAURABH WANIPGDPM 10GARWARE COLLEGEROTAVIRUS

2. INTRODUCTIONRotaviruses are the major cause of diarrheal illness inhuman infants in the worldAdults also get infected because of rotavirusYoung animals like calves and piglets are alsoinfectedRotavirus infection spread easily and outbreaksusually occur in the winter and early spring betweenabout November and AprilRotavirus infections often spread in settings wheremany children's are together, such as daycarecenters 3. TRANSMISSION OFROTAVIRUSPrimary mode of rotavirus transmission is fecal to oralHighly communicable and transmissible diseaseClose person to person contact and environmentalsurfaces are common vectors of transmissionIncubation period is 1-3 daysLarge quantities of virus are shed in stool from just priorto onset of symptoms until about 10 days after onsetAmount of virus shed in stool [10-100 billion virion/gramof stool]infectionAmount of ingested virus required to cause infection asfew as 10 infective virions 4. ROTAVIRUS First recognized in1973, rotavirus belongsto viral familyReoviridae Rotavirus hascharacteristic wheellike appearance whenviewed under electronmicroscope Rotavirus is triplelayered capsulesurrounding RNA 5. The Rotavirus genome consist of 11 double strandedRNA segments each encoding one viral proteins Scientist have describe seven Rotavirus group [A toG] Only groups A, B AND C infect humans Group A which has multiple strains cause majority ofchildhood infections Vaccine candidates are designed to protect againstgroup A Rotaviruses The G type and P type define the serotype They are critical to a vaccine development becausethey are the vaccine for stimulating a protectiveimmune response 6. SEROTYPESSerotypes are described as variations within species ofbacteria or viruses or among immune cells of differentindividualsG1P[8] is the most common serotype worldwide andaccounts for over two thirds of rotavirus infectionsworldwideInfections with G1,G2,G3,G4 AND G9 togethercomprise almost 95% of rotavirus serotype observedBecause the two gene segments that encode theseprotein can segregate independently, A typing systemwhich 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 REPLICATION1. Receptor mediatedendocytosis leading toformation of endosome2. Viral RNA dependent RNApolymerase creates m RNAtranscript of double strandedviral genome3. Viral genome is in the core oftwo layered protein shell calledas double layered particle 8. VIRAL REPLICATION4. Third layer is disrupted5. By remaining in the core, the viral RNA evades innate host immuneresponses called RNA interference that are triggered by the presence ofdouble-stranded RNA6. Viroplasm is formed around the cell nucleus as early as two hoursafter virus infection, and consists of viral factories thought to be made by twoviral nonstructural proteins: NSP5 and NSP2 9. 7. In this viroplasm RNA is replicated and the DLPs are assembled8. The DLPs migrate to the endoplasmic reticulum where they obtain theirthird, outer layer9. Progeny viruses are released from the cell by lysis 10. WHY ROTAVIRUS INFECTION CAUSES DIARRHEAInfection of villus epithelial cells causes cell destruction, decreasedabsorption of salt and water and decreased dissachridase activity leadingto osmotic load in the gut lumen The osmotic load in the gut and increased fluid secretion leads todiarrhea and without fluid replacement it will ultimately lead todehydration and acidosis Rotavirus induced gastroenteritis in children with immunodeficiency maycause persistent infections lasting weeks or months 11. DIAGNOSIS OF ROTAVIRUS INFECTIONDiagnosis of infection with Rotavirus follows diagnosis of gastroenteritis ofsevere diarrheaMost children's are admitted to hospital with gastroenteritis are tested forRotavirus ASpecific diagnosis of infection with rotavirus A is made by finding the virus inchilds stool by enzyme immunoassayChildren with immunodeficiency disorders may be treated with specificrotavirus immunoglobulin preparation 12. DIAGNOSIS OF ROTAVIRUSLaboratory diagnosisElectron microscopy is used in the detection ofVirus in the stools which helps in early detectionOf diseaseOTHER DIAGNOSIS METHOD INCLUDE ELISARAPID ANTIGEN DETECTION BY ELISA OFROTAVIRUS IN STOOL SAMPLES GENOTYPING 13. TREATMENT FOR ROTAVIRUS DIARRHEATherapy for rotavirus induced diarrhea involves replacement of fluid andelectrolyte loss during infectionORAL REHYDRATION THERAPY is recommended in children with mildor moderate dehydrationFruit juices and soft drinks are not recommended due to there highglucose content low sodium content and high osmolarity Antibiotics, antisecretory drugs, antimotility drugs, absorbents andantiemeticsDo not clear acute infection but it prevents reinfection and reduce fluidlosses during rotavirus induced gastroenteritis and hence do not play rolein treatment 14. INFECTION CONTROLHome and daycare facilities1.HAND WASHING AREAS2.Food preparation areas3.Diaper changing surfaces4.Diaper disposable containers5.ToysHospital areas and clinics1.HAND WASHING AREAS2.Medication preparation areas3.Equipment4.Patient care areas 15. Rotavirus vaccine - Two oral,live,attenuated rotavirusvaccines 16. INDIA UNVEILS FIRST INDIGENOUS ROTAVIRUSVACCINERotavirus responsible for approximately 4,53,000 child deaths due todiarrhea globally each yearThe Phase-III clinical trial of low cost Indian-made rotavirus vaccineRotavac has demonstrated strong efficacy and excellent safetyprofile and if approved by the Drugs Controller General of India, itwould be available at Rs. 54 per dose.Clinical study has demonstrated for the first time that Rotavac isefficacious in preventing severe rotavirus diarrhea in low-resourcesettings in India, and developing countries in Asia and Africa. Straindiversity, too, has not apparently affected its efficacy. 17. Rotavirus is responsible for approximately 4,53,000 child deaths due todiarrhea globally each year. It is particularly threatening in India where according to a recent study around 1,00,000 children die each yearfrom severe diarrhea and dehydration caused by rotavirus.India accounts for 22 per cent of the estimated global deaths fromdiarrhea-causing rotavirus.Rotavac is an oral vaccine and is administered to infants in a three-dosecourse at the ages of 6, 10 and 14 weeks.It is given alongside routine immunizations' in the Universal ImmunizationProgramed (UIP) vaccines recommended at these ages. 18. The randomized, double-blind, placebo-controlled phase-III clinicaltrial enrolled 6,799 infants in India (aged six to seven weeks at the timeof enrolment) at three sites the Centre for Health Research andDevelopment, Society for Applied Sciences, in New Delhi; Shirdi SaiBaba Rural Hospital, KEM Hospital Research Centre in Vadu; andChristian Medical College in Vellore.Infants received Rotavac and the UIP vaccines, including the oral poliovaccine (OPV).Result showed that infants receiving OPV at the same time as Rotavacgenerated comparable immune responses to all three polio serotypesas the infants receiving OPV without Rotavac, supporting theconcurrent administration of OPV and Rotavac. 19. VACCINATING KIDS AGAINST ROTAVIRUS MAYREDUCE RISK OF SEIZURESThe researchers found that children who were fully vaccinatedagainst rotavirus had an approximately 20 percent reduced risk ofseizure-related hospitalizations and emergency department visitsduring the year following vaccination, compared to unvaccinatedchildrenLatest study estimated that rotavirus vaccination could potentiallysave more than $7 million in U.S. health care costs each year bypreventing approximately 1,000 hospitalizations and 5,000 emergencyroom visits for seizures among young children. "Caring for childrenwho have seizures can be expensive and emotionally taxing forfamilies," Dr. Payne said. "Seizures sometimes lead to painfulprocedures, medication regimens, trips to the emergency room, or 20. THANKYOU