On March 22, World Water Day, we most often think about natural resources, climate, and access to safe drinking water. In medicine, however, water has another very important dimension—it is the basis of our life. This is particularly evident in rotavirus infections, one of the most common causes of acute diarrhea in young children.
A review prepared by students of Wroclaw Medical University under the supervision of Prof. Emil Paluch from the Department of Microbiology shows that in rotavirus infections, it is not the virus itself that is the most dangerous, but the rapid loss of water and electrolytes from the body.
As Karolina Pawłuszkiewicz, a fifth-year medical student at WUM and co-author of the paper, explains , –In our review, we analyzed the current literature and applicable recommendations for the treatment of acute gastroenteritis in children, including the recommendations of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN).
Why dehydration is so dangerous
Rotavirus remains one of the main causes of acute gastroenteritis in children under 5 years of age. Symptoms such as diarrhea, vomiting, fever, and weakness can quickly lead to dehydration.
This process progresses particularly quickly in the youngest patients.
–A child’s body contains proportionally more water than an adult’s body. Even a relatively small loss of fluids due to diarrhea and vomiting can therefore quickly lead to water and electrolyte imbalances and clinically significant dehydration,- explains the author.
An additional problem is that young children are unable to ensure adequate hydration on their own or clearly communicate their deteriorating well-being.
Hydration as basic therapy
In the case of rotaviruses, treatment is primarily symptomatic.
–We do not have a drug that acts directly on rotavirus, so it is crucial to ensure adequate hydration and replenish the electrolytes lost during diarrhea and vomiting, – emphasizes the student.
In mild to moderate dehydration, oral rehydration solutions are used. These are specially prepared solutions containing water, glucose, and electrolytes that help restore the body’s balance. In more severe cases, enteral or intravenous hydration may be necessary.
Not all “water” works the same
During diarrhea, a child loses not only water but also important electrolytes.
–That is why giving water alone is not always enough. In the treatment of acute diarrhea, hypoosmolar oral glucose-electrolyte fluids are recommended, which allow both water and lost mineral salts to be replenished, – explains Karolina Pawłuszkiewicz.
The author of the review also points out common mistakes in home treatment.
–Parents often reach for juices or sweetened drinks. However, the sugars they contain can exacerbate diarrhea and increase fluid loss.
Water in pediatrics
Vaccinations also play an important role in reducing severe rotavirus infections.
–In Poland, rotavirus vaccinations have been mandatory since 2021. Studies show that their introduction has significantly reduced the number of hospitalizations and severe cases of the disease in children, – notes the author.
World Water Day is usually associated with environmental protection. However, the example of rotavirus infections reminds us that water is also one of the most basic “tools” of modern medicine.
In the case of rotaviruses, it is not only the comfort of the sick child that is at stake, but also their safety. Adequate hydration is crucial for the functioning of the circulatory system, cells, and electrolyte balance, and for the possibility of a quick recovery.
That is why, on March 22, it is worth considering water not only as an environmental resource but also as a substance without which many acute conditions in children cannot be effectively treated. Sometimes, when administered in the right form and at the right time, it proves to be the most important therapy.
The material is based on the article:
DOI: 10.3390/ijms26189175
Authors: Karolina Pawłuszkiewicz, Emilia Kucharczyk, Matylda Korgiel, Tomasz Busłowicz, Anita Faltus, Natalia Kucharczyk, Emil Paluch
International Journal of Molecular Sciences 2025
Advances in the Diagnosis and Treatment of Rotavirus Infections: Narrative Review