Rotavirus cases on the rise

Rotavirus is spread by hands touching an infected surface and then touching the mouth. Early symptoms include a fever of around 101 degrees Fahrenheit along with vomiting.

"Both of those go away pretty quickly, within a day to a day and a half," said Stephanie Deleon, associate CMO and a pediatric hospitalist at Oklahoma Children's OU Health. "But then the diarrhea will start after, often upwards of 20-plus episodes per day."

There's no treatment for the infection other than supportive care such as fluids, so children have to wait for the virus to run its course. Symptoms can last between three and eight days.

Hand-washing and cleaning surfaces can help stop the spread of the virus, but it's tough to kill. "The virus lives on surfaces for a long time," said Yvonne Maldonado, Taube Endowed Professor of Global Health and Infectious Diseases at Stanford University. "Even with washing your hands, it's easy for the virus to remain."

It's possible for rotavirus to infect anyone, but it's especially fast-moving and severe in babies and young children, often leading to hospitalization.

"The problem with rotavirus is it's a vomiting illness," said Paul Offit, director of the Vaccine Education Center and professor of pediatrics at Children's Hospital of Philadelphia. "You vomit and vomit and vomit. It's very hard to rehydrate someone by mouth who's vomiting, and that's why they end up coming into the hospital for intravenous fluids."

Deleon said she's seen a steady influx of children admitted for rotavirus over the past two months at her hospital, and there's no sign of it slowing.

Declining vaccination rates

According to the National Foundation for Infectious Diseases, rotavirus was responsible for more than 200,000 ED visits, up to 70,000 hospitalizations, and dozens of deaths every year until the first oral vaccine was approved 20 years ago.

"Children who are not vaccinated are absolutely at higher risk of severe disease and the need for hospitalization," she said.

However, HHS Secretary Robert F. Kennedy Jr. earlier this year announced changes to the childhood immunization schedule, including removing the rotavirus vaccine from the schedule and instead advising that parents talk to their doctor before deciding to vaccinate.

"The virus is still circulating," Offit said. "So a choice not to get a vaccine is a very real choice to experience that infection."

The changes to the childhood vaccine schedule were put on hold by a federal judge last month, but doctors worry that even attempts to change the guidelines likely planted seeds of doubt among some new parents who might now hesitate to vaccinate their children for rotavirus.

"These are young people and they are getting confusing messaging," Maldonado said. "They don't know where to turn."

According to Monica Gandhi, an infectious disease specialist at the University of California, San Francisco, while deaths from rotavirus will likely never be common in the United States because of access to healthcare, the rate of severe complications could increase significantly because of resistance to vaccination.