Oct. 11, 2005 (Washington) -- A leading cause of gastrointestinal upset in children causes fear, stress, anxiety, and disruption in normal family life, Duke University researchers report.
Rotavirus results in sudden and severe bouts of diarrhea and vomiting. The CDC states that it is the leading cause of severe diarrhea in children, resulting in around 600,000 global deaths in children less than 5 years of age each year. In the U.S. it is the cause of 45% of diarrhea cases and is responsible for 500,000 doctor visits annually.
"Little has been known about the impact of the virus on people's every day lives," Carla DeMuro Mercon, MS, of the epidemiology department of Merck & Co. "Doctors need to know the emotional and economic stress this puts on a family."
In a study of 16 parents, researchers found that parents were alarmed at the severity of the diarrhea and the force of the vomiting. The researchers reported their findings at the American Academy of Pediatrics Conference and Exhibition in Washington.
The study involved parents of children, aged 2 months to 3 years, who visited two Duke University clinics or the emergency room with symptoms of rotavirus. Of 61 consenting parents, 44 parents provided stool samples from their children, of which 27 were confirmed with rotavirus. Researchers then did in-depth interviews with 17 parents of children diagnosed. Participants included 12 women and 5 men, average age was 32 years. Interviews were conducted between 2004 and 2005.
Parents reported that the virus placed an emotional and financial strain on the family, Mercon says.
Comments of Parents
Even though most of the parents were experienced, having gone through this with another child, they expressed fear and anxiety.
"The majority of parents were not first-timers; they have 'been there, done that' before," says Mercon. "Most reported alarm and panic over the severity of the diarrhea and the vomiting."
One mother described it as "hell," another commented, "we got home from church, I fed him lunch and he threw up in the den until Wednesday."
"The child was irritable, crying, clingy, and wouldn't eat," she says. "All parents talked about the inability to keep their child dry. They finally would just let them run around in their diaper because they couldn't keep clean clothes on them. Meanwhile parents talked about the constant cleaning and disinfecting the house."
The rotavirus affected the whole family, she notes.
The study found that parents on average took off work for two to three days, other children couldn't participate in activities, the diaper and disinfectant bill increased as well as doctor's visits, parents reported. "It has an emotional as well as an economic impact on the family," Mercon says.
Parents were scared that they weren't doing the right thing," she explains.
Despite advice from the medical profession that parents orally rehydrate children, 100% of the parents reported that it was impossible to get the child to drink enough liquids, she adds.
Some children ended up in the emergency room and received intravenous feedings, she says. Others, she commented, had unnecessary procedures - even spinal taps - performed on them in the emergency room.
The virus has a severe impact on the family members' lives. "Physicians need to understand this a little better. We need to change how we work with these parents," DeMuro says.
"This is not a benign disease," comments Donald Shifrin, MD, clinical professor of pediatrics, University of Washington School of Medicine. "It lasts for a significant length of time and is significant in terms of morbidity."
This study shows the stress and anxiety the rotavirus can place on family members of the patient, he explains.
Vaccine on the Horizon
Mercon says a vaccine would go a long way to preventing this.
In 1998, a vaccine was developed and approved for sale by the FDA, but it was withdrawn from the market in 1999 due to risk of serious side effects. Currently there are other vaccine candidates that await approval for sale in the U.S.