Viral Diarrhea

Diarrhea is the second leading cause of death in children below 5 years of age worldwide. In developing countries, the mortality rate due to acute gastroenteritis is very high. In industrialized countries, the mortality rate is much lower but acute gastroenteritis still accounts for several hospitalizations in children below 5 years of age. Viruses are the most common etiologic agents, with Rotavirus and Norovirus being the most frequent pathogens. Rotaviruses have a predilection for young children, whereas Noroviruses affect people of all ages. Viral gastroenteritis is characterized by an abrupt appearance of vomiting and watery diarrhea, often accompanied by low-grade fever and abdominal pain, which is generally self-limited lasting no more than 5 days. Microbiological examination is not helpful in the majority of cases, and it is indicated only in specific circumstances such as immunocompromised patients for whom molecular biology has now become a rapid and sensitive method for diagnosis. The severity of acute gastroenteritis is reflected by the degree of dehydration, and treatment is focused on maintaining adequate hydration with oral rehydration solution. Feeding should be continued if possible. Intravenous rehydration is recommended in case of severe dehydration, failure of oral rehydration, and in the presence of complications. Active treatment of acute gastroenteritis with selected probiotics in adjunct to rehydration is effective in reducing the intensity and duration of symptoms. The incidence of viral diarrhea is consistently reduced by Rotavirus immunization.