Abridged from in February 2009.
Clinical presentation and diagnosis of rotavirus infection
John J Treanor, MD
Section Editor
Martin S Hirsch, MD
Deputy Editor
Barbara H McGovern, MD
Last literature review version 16.3: October 2008  |  This topic last updated: May 30, 2008

  1. Bresee, JS, Hummelman, E, Nelson, EA, Glass, RI. Rotavirus in Asia: The Value of Surveillance for Informing Decisions about the Introduction of New Vaccines. J Infect Dis 2005; 192 Suppl 1:S1.
  2. Nakagomi, T, Nakagomi, O, Takahashi, Y, et al. Incidence and Burden of Rotavirus Gastroenteritis in Japan, as Estimated from a Prospective Sentinel Hospital Study. J Infect Dis 2005; 192 Suppl 1:S106.
  3. Moe, K, Hummelman, EG, Oo, WM, et al. Hospital-based surveillance for rotavirus diarrhea in children in yangon, myanmar. J Infect Dis 2005; 192 Suppl 1:S111.
  4. Man, NV, Luan le, T, Trach, DD, et al. Epidemiological profile and burden of rotavirus diarrhea in Vietnam: 5 years of sentinel hospital surveillance, 1998-2003. J Infect Dis 2005; 192 Suppl 1:S127.
  5. Bishop, RF, Davidson, GP, Holmes, IH, Ruck, BJ. Letter: Evidence for viral gastroenteritis. N Engl J Med 1973; 289:1096.
  6. Barnes, GL, Townley, RR. Duodenal mucosal damage in 31 infants with gastroenteritis. Arch Dis Child 1973; 48:343.
  7. Davidson, GP, Bishop, RF, Townlee, RRW, et al. Importance of a new virus in acute sporadic enteritis in children. Lancet 1975; 1:242.
  8. Konno, T, Suzuki, H, Imai, A, et al. A long term serosurvey of rotavirus infection in Japanese children with acute gastroenteritis. J Infect Dis 1978; 138:569.
  9. Konno, T, Suzuki, H, Imai, A, Ishida, N. Reovirus-like agent in acute epidemic gastroenteritis in Japanese infants: fecal shedding and serologic response. J Infect Dis 1977; 135:259.
  10. Pickering, LK, Bartlett, AV, Reves, RR et, al. Asymptomatic excretion of rotavirus before and after rotavirsu diarrhea in children in day care center. J Pediatr 1988; 112:361.
  11. Richardson, S, Grimwood, K, Gorrell, R, et al. Extended excretion of rotavirus after severe diarrhoea in young children. Lancet 1998; 351:1844.
  12. Barnes, GL, Callaghan, SL, Kirkwood, CD, et al. Excretion of serotype G1 rotavirus strains by asymptomatic staff: a possible source of nosocomial infection. J Pediatr 2003; 142:722.
  13. Fischer, TK, Ashley, D, Kerin, T, et al. Rotavirus antigenemia in patients with acute gastroenteritis. J Infect Dis 2005; 192:913.
  14. Ray, P, Fenaux, M, Sharma, S, et al. Quantitative evaluation of rotaviral antigenemia in children with acute rotaviral diarrhea. J Infect Dis 2006; 194:588.
  15. Bishop, RF, Davidson, GP, Holmes, IH, Ruck, BJ. Virus particles in epithelial cells of duodenal mucosa from children with acute gastroenteritis. Lancet 1973; 2:1281.
  16. Hyams, JS, Krause, PJ, Gleason, PA. Lactose malabsorption following rotavirus infection in young children. J Pediatr 1981; 99:916.
  17. Mavromichalis, J, Evans, N, McNeish, AS, et al. Intestinal damage in rotavirus and adenovirus gastroenteritis assessed by d-xylose malabsorption. Arch Dis Child 1977; 52:589.
  18. Sack, DA, Rhoads, M, Molla, A, et al. Carbohydrate malabsorption in infants with rotavirus diarrhea. Am J Clin Nutr 1982; 36:1112.
  19. Davidson, GP, Gall, DG, Petric, M. Human rotavirus enteritis induced in conventional piglets. J Clin Invest 1977; 60:1402.
  20. Graham, DY, Sackman, JW, Estes, MK. Pathogenesis of rotavirus induced diarrhea. Dig Dis Sci 1984; 29:1028.
  21. Ball, JM, Tian, P, Zieng, CQ-Y, et al. Age-dependent diarrhea induced by a rotaviral nonstructural glycoprotein. Science 1996; 272:101.
  22. Johansen, K, Hinkula, J, Espinoza, F, et al. Humoral and cell-mediated immune responses in humans to the NSP4 enterotoxin of rotavirus. J Med Virol 1999; 59:369.
  23. Ward, RL, Mason, BB, Bernstein,DI, et al. Attenuation of a human rotavirus vaccine candidate did not correlate with mutations in the NSP4 protein gene. J Virol 1997; 71:6267.
  24. Lee, CN, Wang, YL, Kao, CL, et al. NSP4 gene analysis of rotaviruses recovered from infected children with and without diarrhea. J Clin Microbiol 2000; 38:4471.
  25. Lundgren, O, Peregrin, AT, Persson, K, et al. Role of the enteric nervous system in the fluid and electolyte secretion of rotavirus diarrhea. Science 2000; 287:491.
  26. Salazar-Lindo, E, Santisteban-Ponce, J, Chea-Woo, E, Gutierrez M. Racecadotril in the treatment of acute watery diarrhea in children. N Engl J Med 2000; 343:463.
  27. Champsaur, H, Questiaux, E, Prevot, J, et al. Rotavirus carriage, asymptomatic infection, and disease in the first two years of life. I. Virus shedding. J Infect Dis 1984; 149:667.
  28. Champsaur, H, Henry-Amar, M, Goldszmidt, D, et al. Rotavirus carriage, asymptomatic infection, and disease in the first two years of life II serologic response. J Infect Dis 1984; 149:675.
  29. Carlson, JAK, Middleton, PJ, MT. Fatal rotavirus gastroenteritis. Am J Dis Child 1978; 132:477.
  30. Shukry, S, Zaki, AM, DuPont, HL, et al. Detection of enteropathogens in fatal and potentially fatal diarrhea in Cairo, Egypt. J Clin Microbiol 1986; 24:959.
  31. Rodriguez, WJ, Kim, HW, Brandt, CD, et al. Common exposure outbreak of gastroenteritis due to type 2 rotavirus with high secondary attack rates within families. J Infect Dis 1979; 140:353.
  32. Gurwith, M, Wenman, W, Hinde, D, et al. A prospective study of rotavirus infection in infants and young children. J Infect Dis 1981; 144:218.
  33. Bhan, MK, Bhandari, N, Wvensson, L, et al. Role of enteric adenoviruses and rotaviruses in mild and severe acute enteritis. Pediatr Infect Dis J 1988; 7:320.
  34. Rodriguez, WJ, Kim, HW, Arrobio, JO, et al. Clinical features of acute gastroenteritis associated with human reovirus-like agent in infants and young children. J Pediatr 1977; 91:188.
  35. Rodriguez, WJ, Kim, HW, Brandt, CD, et al. Longitudinal study of rotavirus infection and gastroenteritis in families served by a pediatric medical practice: clinical and epidemiologic observations. Pediatr Infect Dis J 1987; 6:170.
  36. Brandt, CD, Kim, HW, Rodriguez, WJ, et al. Simultaneous infections with different enteric and respiratory tract viruses. J Clin Microbiol 1986; 23:177.
  37. Kovacs, A, Chan, L, Hotrakitya, C, et al. Rotavirus gastroenteritis. clinical and laboratory features and use of the rotazyme test. Am J Dis Child 1987; 141:161.
  38. Tallett, S, MacKenzie, C, Middleton, P, et al. Clinical, laboratory, and epidemiologic features of a viral gastroenteritis in infants and children. Pediatrics 1977; 60:217.
  39. Foldenauer, A, Vossbeck, S, Pohlandt, F. Neonatal hypocalcaemia associated with rotavirus diarrhoea. Eur J Pediatr 1998; 157:838.
  40. Grimwood, K, Coakley, JC, Hudson, IL, et al. Serum aspartate aminotransferase levels after rotavirus gastroenteritis. J Pediatr 1988; 112:597.
  41. Pryor, WM, Bye, WA, Curran, DH, Grohmann, GS. Acute diarrhoea in adults: a prospective study. Med J Aust 1987; 147:490.
  42. Hieber, JP, Shelton, S, Nelson, JD. Comparison of human rotavirus disease in tropical and temperate settings. Am J Dis Child 1978; 132:853.
  43. Hrdy, DB. Epidemiology of rotaviral infection in adults. Rev Infect Dis 1987; 9:461.
  44. Wenman, WM, Hinde, D, Feltham, S, Gurwith, M. Rotavirus infection in adults. Results of a prospective family study. N Engl J Med 1979; 301:303.
  45. Vollet, JJ, Ericsson, CD, Gibson, G, et al. Human rotavirus in an adult population with travelers diarrhea and its relationship to the location of food consumption. J Med Virol 1979; 4:81.
  46. Echeverria, P, Ramirez, G, Blacklow, NR, et al. Traveler's diarrhea among US Army troops in South Korea. J Infect Dis 1979; 139:215.
  47. Keswick, GH, Blacklow, NR, Cukor, GC, et al. Norwalk virus and rotavirus in travelers'diarrhea in Mexico. Lancet 1982; 1:109.
  48. Foodborne outbreak of Group A rotavirus gastroenteritis among college students--District of Columbia, March-April 2000. MMWR Morb Mortal Wkly Rep 2000; 49:1131.
  49. Marrie, TJ, Lee, SH, Faulkner, RS, et al. Rotavirus infection in a geriatric population. Arch Intern Med 1982; 142:313.
  50. Echeverria, P, Blacklow, NR, Cukor, GG, et al. Rotavirus as a cause of severe gastroenteritis in adults. J Clin Microbiol 1983; 18:663.
  51. Saulsbury, FT, Winkelstein, JA, Yolken, RJ. Chronic rotavirus infection in immunodeficiency. J Pediatr 1980; 97:61.
  52. Yolken, RH, Bishop, CA, Townsend, TR, et al. Infectious gastroenteritis in bone-marrow-transplant recipients. N Engl J Med 1982; 306:1010.
  53. Willoughby, RE, Wee, SB, Yolken, RH. Non-group A rotavirus infection associated with severe gastroenteritis in a bone marrow transplant patient. Pediatr Infect Dis J 1988; 7:133.
  54. Wood, DJ, David, TJ, Chrystie, IL, Totterdell, B. Chronic enteric virus infection in two T-cell immunodeficient children. J Med Virol 1988; 24:435.
  55. Gilger, MA, Matson, DO, Conner, ME, et al. Extraintestinal rotavirus infections in children with immunodeficiency. J Pediatr 1992; 120:912.
  56. Fitts, SW, Green, M, Reyes, J, et al. Clinical features of nosocomial rotavirus infection in pediatric liver transplant recipients. Clin Transplant 1995; 9:201.
  57. Gonzalez, GG, Pujol, FH, Liprandi, F, et al. Prevalence of enteric viruses in human immunodeficiency virus seropositive patients in Venezuela. J Med Virol 1998; 55:288.
  58. Grohmann, GS, Glass, RI,Pereira, HG, et al. Enteric viruses and diarrhea in HIV-infected patients. Enteric Opportunistic Infections Working Group. N Engl J Med 1993; 329:14.
  59. Rotbart, HA, Nelson, WL, Glode, MP, et al. Neonatal rotavirus-associated necrotizing enterocolitis: Case control study and prospective surveillance during an outbreak. J Pediatr 1988; 112:87.
  60. Konno, T, Suzuki, H, Katsuzawa, T, et al. Human rotavirus and intussusception. N Engl J Med 1977; 297:945.
  61. Konno, T, Suzuki, H, Katsuzawa, T, et al. Human rotavirus infection in infants and young children with intussusception. J Med Virol 1978; 2:265.
  62. Mulcahy, DL, Kamath, KR, deSilva, LM, et al. A 2-part study of the aetiological role of rotavirus in intussusception. J Med Virol 1982; 9:51.
  63. Nicolas, JC, Ingrand, D, Fortier, B, Bricout, F. A one year virological survey of acute intussusception in childhood. J Med Virol 1982; 9:267.
  64. Nakagomi, T. Rotavirus infection and intussusception: a view from retrospect. Microbiol Immunol 2000; 44:619.
  65. Riepenhoff-Talty, M, Gouvea, V, Evans, MJ, et al. Detection of group C rotavirus in infants with extrahepatic biliary atresia. J Infect Dis 1996; 174:8.
  66. Bobo, L, Ojeh, C, Chiu, D, et al. Lack of evidence for rotavirus by polymerase chain reaction/enzyme immunoassay of hepatobiliary samples from children with biliary atresia. Pediatr Res 1997; 41:229.
  67. Takahashi, S, Oki, J, Miyamoto, A, et al. Encephalopathy associated with haemophagocytic lymphohistiocytosis following rotavirus infection. Eur J Pediatr 1999; 158:133.
  68. Riedel, F, Kroener, T, Stein, K, et al. Rotavirus infection and bradycardia-apnoea-episodes in the neonate. Eur J Pediatr 1996; 155:36.
  69. Komori, H, Wada, M, Eto, M, et al. Benign convulsions with mild gastroenteritis: a report of 10 recent cases detailing clinical varieties. Brain Dev 1995; 17:334.
  70. Iyadurai, S, Troester, M, Harmala, J, Bodensteiner, J. Benign afebrile seizures in acute gastroenteritis: is rotavirus the culprit?. J Child Neurol 2007; 22:887.
  71. Hongou, K, Konishi, T, Yagi, S, et al. Rotavirus encephalitis mimicking afebrile benign convulsions in infants. Pediatr Neurol 1998; 18:354.
  72. Makino, M, Tanabe, Y, Shinozaki, K, et al. Haemorrhagic shock and encephalopathy associated with rotavirus infection. Acta Paediatr 1996; 85:632.
  73. Lynch, M, Lee, B, Azimi, P, et al. Rotavirus and central nervous system symptoms: cause or contaminant? Case reports and review. Clin Infect Dis 2001; 33:932.
  74. Sigurdsson, L, Flores, A, Putnam, PE, et al. Postviral gastroparesis: presentation, treatment, and outcome. J Pediatr 1997; 131:751.
  75. Guarinom, A, Spagnuolom, MI, Russom, S, et al. Etiology and risk factors of severe and protracted diarrhea. J Pediatr Gastroenterol Nutrit 1995; 20:173.
  76. Szajewska, H, Kantecki, M, Albrecht, P, Antoniewicz, J. Carbohydrate intolerance after acute gastroenteritis--a disappearing problem in Polish children. Acta Paediatr 1997; 86:347.
  77. Bhardwaj, A, Aggarwal, V, Chakravarty, A, Mittal, SK. Does Rota virus infection cause persistent diarrhoea in childhood?. Trop Gastroenterol 1996; 17:18.
  78. Cromien, JL, Himmelreich, CA, Glass, RI, et al. Evaluation of a new commercial enzyme immunoassay for rotavirus detection. J Clin Microbiol 1987; 25:2359.
  79. Hornsleth, A, Jankowski, M. Sensitive enzyme immunoassay for the rapid diagnosis of influenza A virus infections in clinical specimens. Res Virol 1990; 141:373.
  80. Thomas, EE, Puterman, ML, Kawano, E et. al. Evaluation of seven immunoassays for detection of rotavirus in pediatric stool samples. J Clin Microbiol 1988; 26:1189.
  81. Brandt, CD, Arndt, CW, Evans, GL, et al. Evaluation of a latex test for rotavirus detection. J Clin Microbiol 1987; 25:1800.
  82. Sanekata, T, Okada, H. Human rotavirus detection by agglutination of antibody-coated erythrocytes. J Clin Microbiol 1983; 17:1141.
  83. Sanders, RC, Campbell, AD, Jenkins, MF. Routine detection of human rotavirus by latex agglutination: comparison with enzyme-linked immunosorbent assay, electron microscopy and polyacrylamide gel electrophoresis. J Virol Methods 1986; 13:285.
  84. Dennehy, PH, Gauntlett, DR, Tente, WE. Comparison of nine commercial immunoassays for the detection of rotavirus in fecal specimens. J Clin Microbiol 1988; 26:1630.
  85. Husain, M, Seth, P, Broor, S. Detection of group A rotavirus by reverse transcription and polymerase chain reaction in feces from children with acute gastroenteritis. Arch Virol 1995; 140:1225.
  86. Dimitrov, DH, Graham, DY, Estes, MK. Detection of rotaviruses by nucleic acid hybridization with cloned DNA of simian rotavirus SA11 genes. J Infect Dis 1985; 152:293.
  87. Flores, J, Purcell, RH, Perez, I, et al. A dot hybridization assay for detection of rotavirus. Lancet 1983; 1:222.
  88. Kasempimolporn, S, Lousririotchanul, S, Sinarachatanant, P, et al. Polyacrylamide gel electrophoresis and silver staining for detection of rotavirus in stools from diarrheic patients in Thailand. J Clin Microbiol 1988; 26:158.
  89. Pacini, DL, Brady, MT, Budde, CT, et al. Polyacrylamide gel electrophoresis of RNA compared with polyclonal- and monoclonal-antibody-based enzyme immunoassays for rotavirus. J Clin Microbiol 1988; 26:194.
  90. Sato, K, Inaba, Y, Shinozaki, T, et al. Isolation of human rotavirus in cell cultures. Arch Virol 1981; 69:155.
  91. Wyatt, RG, James, HDJ, Pittman, AL, et al. Direct isolation in cell culture of human rotaviruses and their characterization into four serotypes. J Clin Microbiol 1983; 18:310.
  92. Taniguchi, K, Urasawa, S, Urasawa, T. Electrophoretic analysis of RNA segments of human rotavirus cultivated in cell culture. J Gen Virol 1982; 60:171.
  93. Urasawa, T, Urasawa,S, Taniguchi, K. Sequential passages of human rotaviruses in MA-104 cells. Microbiol Immunol 1981; 25:1025.
  94. Urasawa, S, Urasawa, T, Taniguchi, K. Three human rotavirus serotypes demonstrated by plaque neutralization of isolated strains. Infect Immun 1982; 38:781.