Friederike Ostermeyer

February 8, 2025, 3:59 pm | Read time: 4 minutes

Watery diarrhea, vomiting, fever, abdominal pain–hardly any child escapes the rotavirus. Most recover without lasting effects. However, for infants and toddlers under two years old, the high fluid loss can be dangerous. Fortunately, this is preventable.

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What is the rotavirus?

Rotaviruses are highly contagious and the most common cause of diarrheal diseases in children worldwide–especially in February and March, cases increase.¹ Rotaviruses infect the gastrointestinal tract, multiply there, and cause gastroenteritis, an inflammation of the stomach and small intestine lining.² The younger the child, the more severe the course typically is. In developing countries, rotaviruses are the leading cause of death in children and are estimated to be responsible for 453,000 deaths per year worldwide in children under 5.³ Even in Western industrialized nations, according to the Robert Koch Institute (RKI), infants and children aged 6 months to 2 years are most frequently affected, as the child’s immune system takes several years to develop protection against the infection. Infection with rotaviruses can occur multiple times in life and often goes unnoticed or is mild in adulthood.⁴

Has my child contracted the rotavirus? These are the symptoms

The symptoms of a rotavirus infection in children usually start suddenly and can quickly worsen. They include:

• Watery, severe diarrhea, up to ten times a day
• Vomiting, sometimes forceful
• Persistent abdominal pain
• Fever, usually only slightly or moderately elevated
• Loss of appetite and general fatigue
• Cough and runny nose may occur but are not required

After two to six days, the symptoms usually subside on their own⁵.

How to treat your child at home correctly

The most important thing: Drink, drink, drink! To compensate for fluid and mineral loss, give your child one to two teaspoons of electrolyte solution from the pharmacy every few minutes. This way, they consume about a cup of fluid per hour. Slow drinking also helps reduce nausea. Additionally, provide still mineral water that contains a lot of sodium, magnesium, potassium, and calcium, but little sulfate.

According to “Kinder- und Jugendärzte im Netz,” the “Fanconi solution” is also ideal: dissolve 3 tablespoons of (grape) sugar and ½ teaspoon of salt in 300 milliliters of orange juice. Offer small portions of this regularly as well.

Also: Do not force your child to eat; their appetite will return naturally. Until then, offer small amounts of white bread, pasta, zwieback, potatoes, or bananas and avoid dairy products entirely. Regular abdominal massages can also help relieve pain.

Also interesting: Hip cold in children–symptoms, course, and treatment

With these symptoms, you should go to the pediatrician or emergency room immediately

For infants and very young children, extreme vigilance is required due to the risk of dehydration from the rotavirus. Seek medical attention immediately if …

• … diarrhea lasts longer than six hours in infants and longer than two days in children.
• … the fontanelle in infants is sunken.
• … the mouth appears dry and chapped.
• the child seems apathetic and very sleepy.
• … the eyes are sunken, and the skin feels cool and inelastic.
• … the urine is noticeably scant and dark.

More on the topic

Gastrointestinal Infection Symptoms and Treatment of Norovirus in Children

One Virus Strain, Many Illnesses Adenovirus Infection in Children – Symptoms, Progression, and Prevention

Transmission and incubation period

Rotaviruses are so contagious that just ten virus particles are enough to infect a child. Transmission occurs orally-fecally, but also through contaminated food or water. The incubation period, the time between transmission and infection, is about one to three days. As long as the virus is excreted in the stool (about 8 days), the infected child can infect others.⁶

Prevention and vaccination

While hygiene is crucial for protecting against infections, unfortunately, handwashing and similar measures are not effective against rotaviruses. Since 2013, the STIKO has recommended an oral vaccination for newborns with a live vaccine. Depending on the vaccine, two (Rotarix®) or three doses (RotaTeq®) are administered starting at the 6th week of life, at intervals of at least four weeks. The vaccine’s effectiveness is considered very high and protects over 90 percent against hospitalizations. Vaccinated children may still contract the virus, but usually without life-threatening complications.⁷

The vaccine is considered very well tolerated, especially when administered early. The only exception: children with a tendency for an intussusception (a section of the intestine folds into another) should not receive the vaccine. According to current knowledge, these occur extremely rarely. ⁸