Rotavirus: symptoms, how long it lasts and the baby vaccine

Rotavirus causes diarrhoea and vomiting. NHS inform lists the main symptoms of gastroenteritis, which in young children is mostly caused by rotavirus, as sudden, watery diarrhoea, feeling sick, vomiting (which can be projectile) and a mild fever. Some children also have a loss of appetite, an upset stomach, aching limbs or headaches.

NHS inform says symptoms usually appear up to a day after becoming infected and typically last less than a week, but can sometimes last longer. Because the symptoms look like other tummy bugs, rotavirus cannot be told apart from norovirus or other infections by looking at a child; a stool sample is only sent if the GP wants to confirm the cause.

• Sudden, watery diarrhoea

• Feeling sick and vomiting, which can be projectile

• A mild fever

• Loss of appetite, an upset stomach, aching limbs or headaches in some children

• Fewer wet nappies, which the NHS lists as a sign of dehydration in under-5s

Rotavirus is a virus that infects the gut. The NHS describes it as very common in babies and young children, and says it spreads very easily, which is why vaccination is recommended for babies. NHS inform says most cases of gastroenteritis in children are caused by rotavirus.

NHS inform explains that the bugs that cause gastroenteritis pass from person to person when small particles of vomit or poo get into the mouth, through close contact, touching contaminated surfaces or objects, or eating contaminated food.

The NHS says that in adults and children, diarrhoea usually stops within 5 to 7 days and vomiting usually stops in 1 or 2 days. NHS inform says most children start feeling better in a few days and that the illness usually clears up within a week.

Ask for advice if it goes on longer. The NHS says to call 111 for diarrhoea lasting more than 7 days or vomiting lasting more than 2 days.

The aim in the first days is to keep up fluids rather than to stop the diarrhoea. The NHS says to carry on breast or bottle feeding, to give small feeds more often if the baby is being sick, and to give babies on formula or solid foods small sips of water between feeds. NHS inform adds that special rehydration drinks from a pharmacy can be used if a child is dehydrated, and the pharmacist can advise how much to give.

The NHS says not to make baby formula weaker, not to give fruit juice or fizzy drinks, not to give children under 12 medicine to stop diarrhoea, and not to give aspirin to children under 16. Paracetamol can be used for discomfort; check the leaflet before giving it to a child.

• Offer small, frequent sips and feeds rather than large amounts at once.

• Keep formula at its usual strength.

• Let a child eat if they feel hungry; NHS inform suggests small amounts of plain foods such as soup, rice, pasta and bread.

• Wash hands with soap and water after nappy changes and before preparing food.

Dehydration is the main danger from rotavirus. The NHS asks people to call 111 now if they are worried about a baby under 12 months, if a child stops breast or bottle feeding while ill, if a child under 5 has signs of dehydration such as fewer wet nappies, if a child cannot keep fluids down or keeps being sick, if there is bloody diarrhoea or bleeding from the bottom, or if diarrhoea lasts more than 7 days or vomiting more than 2 days. NHS inform also lists passing less urine than normal, being unusually irritable or unresponsive, pale or mottled skin, and cold hands and feet.

Some symptoms need 999 or A&E. The NHS lists vomiting blood or vomit like ground coffee, yellow-green or green vomit in children, a stiff neck with pain on looking at bright lights, a sudden severe headache or tummy ache, blue, grey, pale or blotchy skin, lips or tongue, severe difficulty breathing, and confusion or not responding as usual. NHS inform also lists a child under 3 months with a temperature of 38C or above (or 36C or less) who has not had a vaccination in the past 2 days. Do not drive to A&E.

Yes. The NHS says rotavirus spreads very easily. NHS inform says a person with gastroenteritis is most infectious from when their symptoms start until 48 hours after all symptoms have passed, although they may also be infectious for a short time before and after this.

The NHS says to stay off school or work until you have not been sick or had diarrhoea for at least 2 days, to wash hands with soap and water frequently (NHS inform says not to rely on alcohol gels), to wash soiled clothing and bedding separately on a hot wash, to clean toilet seats, flush handles, taps, surfaces and door handles every day, and not to share towels, flannels, cutlery or utensils. For swimming, the NHS says to wait until at least 48 hours after symptoms stop, while NHS inform advises at least 2 weeks for a child, so follow the guidance given locally.

Babies are given 2 doses as part of the NHS vaccination schedule, at 8 weeks and 12 weeks old. The vaccine is a liquid squirted into the mouth, and if the baby spits it out or brings it up straight away a further dose is given. Babies can feed and carry on normal activities, including swimming, afterwards, and it can be given at the same time as other vaccines. If a baby has a high temperature, diarrhoea or vomiting at the time of the appointment, the NHS says to wait until they feel better.

Some babies cannot have it. The NHS lists a serious allergic reaction to a previous dose or ingredient, severe combined immunodeficiency, a past bowel blockage (intussusception) or a bowel problem that raises the risk of one, rare sugar-intolerance conditions, and a mother taking biological medicines during pregnancy or breastfeeding. The GP surgery can advise if you are unsure.

Common side effects are diarrhoea and irritability, and some babies are sick or have a rash, a high temperature or lose their appetite. Very rarely there is a risk of a bowel blockage in the week after vaccination, so the NHS asks parents to seek an urgent GP appointment or call 111 if a baby keeps being sick, has blood in the poo or poo like redcurrant jelly, has a swollen or painful tummy or stops feeding. For a few weeks after the vaccine a baby's poo may contain a weakened version of rotavirus, so wash hands after nappy changes.

According to the NHS, the vaccine works very well at stopping babies getting infected by rotavirus and prevents rotavirus infection in about 8 out of every 10 babies who have it. It does not protect against diarrhoea and vomiting caused by other illnesses such as norovirus, so a vaccinated baby can still have a tummy bug.

The NHS says a baby can have a missed first dose up to 15 weeks old and a missed second dose up to 24 weeks old, so contact the GP surgery promptly if an appointment is missed. NHS inform confirms the same schedule for Scotland: all babies are offered 2 doses, given at 8 weeks and 12 weeks.

Most cases are managed at home with fluids, after phoning the GP surgery or 111 for advice if there is doubt. A pharmacist can suggest rehydration powder. The NHS says to call 111 if a child cannot keep fluids down, and to use 999 or A&E for the emergency signs listed above.

Private paediatric clinics can offer assessment for children with prolonged diarrhoea, but acute dehydration is an emergency pathway rather than a planned one. The routine vaccine is provided through GP surgeries on the NHS, and parents who have missed the window should check with their surgery rather than waiting.