Rotavirus infections: guidelines for treatment and prevention

The classification of rotaviruses as well as the pathogenesis and the diagnosis of rotavirus infections are briefly reviewed. Treatment of rotavirus disease consists mainly of oral or intravenous rehydration, using World Health Organization-recommended oral rehydration solutions or lactated Ringer's solutions, respectively. Specific antivirals have been tried in animal models but are not used for human treatment at present. The epidemiology of rotaviruses is complex as at any one time and in any geographical area different types co-circulate. The development of rotavirus candidate vaccines is reviewed, one of which, the tetravalent, rhesus rotavirus-based human reassortant vaccine, was licensed for universal use in the US in 1998. Its implementation requires careful surveillance of co-circulating rotavirus types (molecular epidemiology) as well as of any potential adverse effects not previously detected.