rotavirusinfektion (LH Indholdsside)

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    <Content>
      <HtmlField Name="PageContent"><![CDATA[<h2>Diagnose</h2>
<h3>Diagnostiske kriterier</h3>
<ul>
    <li>Mist&aelig;nkes hos sp&aelig;db&oslash;rn i alderen 6 mdr.-2 &aring;r med akut sv&aelig;r gastroenteritis, specielt i rotaviruss&aelig;sonen fra februar til maj</li>
    <li>P&aring;visning af rotavirus i f&aelig;ces ved antigen-test eller PCR-test</li>
</ul>
<ul>
    <li><img alt="Rotavirus" src="D4BE9E4F346B41068A6EF3EE386116B9-200-157" text="Rotavirus" style="width: 200px; height: 157px;" height="157" width="200"></li>
</ul>
<h3>Sygehistorie</h3>
<ul>
    <li>Inkubationstiden er 1&ndash;2 dage</li>
    <li>Symptomer inkluderer diarr&eacute;, opkastninger, mavesmerter og feber. Sv&aelig;r gastroenteritis ses is&aelig;r ved f&oslash;rste rotavirusinfektion hos b&oslash;rn i alderen 6 mdr.-2 &aring;r
    <ul>
        <li>Opkastning stopper som regel efter 1-2 d&oslash;gn</li>
        <li>Diarr&eacute;&nbsp;kan vare 4-6 dage</li>
    </ul>
    </li>
</ul>
<h3>Kliniske fund</h3>
<ul>
    <li>Almindeligvis ingen eller let feber</li>
    <li>Objektivt kan der ses tegn p&aring; dehydrering
    <ul>
        <li>Tr&aelig;thed, t&oslash;rst, oliguri, akut v&aelig;gttab, t&oslash;rre slimhinder, nedsat hudturgor, takykardi og lavt blodtryk
        <ul>
            <li>Let dehydrering - akut tab af 5 % af kropsv&aelig;gten</li>
            <li>Moderat dehydrering - tab af 5-10 % af kropsv&aelig;gten</li>
            <li>Alvorlig dehydrering - tab af over 10-15 % af kropsv&aelig;gten</li>
        </ul>
        </li>
    </ul>
    </li>
</ul>
<h3>Supplerende unders&oslash;gelser i almen praksis</h3>
<ul>
    <li>I de fleste tilf&aelig;lde er det ikke n&oslash;dvendigt at stille en eksakt &aelig;tiologisk diagnose</li>
    <li>F&aelig;cespr&oslash;ve til p&aring;visning af rotavirus ved PCR
    <ul>
        <li>B&oslash;r tages indenfor 48-72 timer efter sygdomsdebut, s&aring;fremt man &oslash;nsker at diagnosticere tilstanden laboratoriem&aelig;ssigt</li>
        <li>Men det er muligt at p&aring;vise virus ved PCR op til 5 dage efter sygdomsdebut</li>
    </ul>
    </li>
    <li>Blodpr&oslash;ve med henblik p&aring; elektrolytforstyrrelser og nyrep&aring;virkning&nbsp;</li>
</ul>
<h3>Differentialdiagnoser</h3>
<ul>
    <li>Andre &aring;rsager til viral gastroenteritis - norovirus, sapovirus, adenovirus og astrovirus</li>
    <li>Bakteriel gastroenteritis</li>
    <li>Cryptosporidosis</li>
</ul>
<h2>Behandling</h2>
<h3>Behandlingsm&aring;l</h3>
<ul>
    <li>Erstatte v&aelig;ske- og elektrolyttab</li>
    <li>Forebygge smittespredning af rotavirus</li>
</ul>
<h3>Generelt om behandlingen</h3>
<ul>
    <li>Der findes ingen specifik antiviral behandling</li>
    <li>De fleste patienter har ikke brug for nogen egentlig behandling</li>
    <li>I nogle tilf&aelig;lde er der indikation for at behandle dehydreringen ved tegn p&aring; elektrolytforstyrrelser</li>
    <li>Peroral rehydrering er at foretr&aelig;kke, men hos medtagede patienter kan intraven&oslash;s rehydrering v&aelig;re n&oslash;dvendig. Ved moderat dehydrering er peroral rehydrering som regel nok<a href="%20" title="Atherly-John YC, Cunningham SJ, Crain EF, A randomized trial of oral vs intravenous rehydration in a pediatric emergency department. Arch Pediatr Adolesc Med 2002;156: 1240-3" data-url="reference-link" data-value-piped="Atherly-John YC, Cunningham SJ, Crain EF|A randomized trial of oral vs intravenous rehydration in a pediatric emergency department|Arch Pediatr Adolesc Med|2002|156|1240-3" data-value="Atherly-John YC, Cunningham SJ, Crain EF, A randomized trial of oral vs intravenous rehydration in a pediatric emergency department. Arch Pediatr Adolesc Med 2002;156: 1240-3" data-type="journal-reference"><sup>1</sup></a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Spandorfer PR, Alessandrini EA, Joffe MD, Localio R, Shaw KN, Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial. Pediatrics 2005;115: 295-301" data-value-piped="Spandorfer PR, Alessandrini EA, Joffe MD, Localio R, Shaw KN|Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial.|Pediatrics|2005|115|295-301|15687435" data-url="reference-link" data-pubmedid="15687435" title="Spandorfer PR, Alessandrini EA, Joffe MD, Localio R, Shaw KN, Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial. Pediatrics 2005;115: 295-301"><sup>2</sup></a></li>
</ul>
<h3>H&aring;ndtering i almen praksis</h3>
<ul>
    <li>Informere patienten om forl&oslash;b og indtagelse af v&aelig;ske</li>
    <li>Hygiejniske foranstaltninger for at forhindre smittespredning</li>
</ul>
<h3>R&aring;d til patienten</h3>
<ul>
    <li>I starten af diarr&eacute;-episode og ved vedvarende moderate sygdomsbilleder anbefales rigelig drikke</li>
    <li>For b&oslash;rn 2-10 &aring;r
    <ul>
        <li>100-200 ml saft efter hver l&oslash;s aff&oslash;ring</li>
        <li>Mulig blanding: 1 liter vand, &frac12; teske salt og 6-8 teskeer glukose; alternativt tynd solb&aelig;rsaft med &frac12; teske salt pr. liter v&aelig;ske</li>
    </ul>
    </li>
    <li>For voksne drikke mere end normalt
    <ul>
        <li>Undg&aring; hypertone sodavand</li>
    </ul>
    </li>
    <li>Ved&nbsp;diarr&eacute; og tegn p&aring; dehydrering anbefales balanceret sukker-saltl&oslash;sning
    <ul>
        <li>Hjemmelavet: &frac12; teske bordsalt og 3 spiseskeer sukker i en liter vand</li>
    </ul>
    </li>
</ul>
<h3>Medicinsk behandling</h3>
<ul>
    <li>Kvalmestillende
    <ul>
        <li>Hos b&oslash;rn med gastroenteritis og dehydrering, har et enkelt studie vist, at peroral&nbsp;[DliActiveSubstance;5872;ondansetron]&nbsp;reducerede kvalme og opkastninger og gjorde det lettere at gennemf&oslash;re peroral rehydrering<a href="%20" title="Zaman D, Anh DD, Victor JC, et al, Efficacy of a pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in Asia: a randomised, double blind, placebo-controlled trial. Lancet 2010;376: 615-23" data-url="reference-link" data-value-piped="Zaman D, Anh DD, Victor JC, et al|Efficacy of a pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in Asia: a randomised, double blind, placebo-controlled trial|Lancet|2010|376|615-23" data-value="Zaman D, Anh DD, Victor JC, et al, Efficacy of a pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in Asia: a randomised, double blind, placebo-controlled trial. Lancet 2010;376: 615-23" data-type="journal-reference"><sup>3</sup></a></li>
    </ul>
    </li>
</ul>
<h3>Andre medicinske behandlinger</h3>
<ul>
    <li>Ingen</li>
</ul>
<h3>Anden behandling</h3>
<ul>
    <li>Underst&oslash;ttende</li>
</ul>
<h3>Forebyggende behandling</h3>
<ul>
    <li>God h&aring;ndhygiejne er vigtig
    <ul>
        <li>Hos b&oslash;rn i b&oslash;rnehaver kan et program for h&aring;ndvask f&oslash;r madlavning og efter toiletbes&oslash;g reducere antallet af diarr&eacute;-tilf&aelig;lde med op mod 30 %<a href="%20" title="RI Ejemot, JE Ehiri, MM Meremikwu, JA Critchley. Hand washing for preventing diarrhoea. Cochrane Database of Systematic Reviews, Issue 1, 2008" data-url="http://www.ncbi.nlm.nih.gov/pubmed/18254044" data-value="RI Ejemot, JE Ehiri, MM Meremikwu, JA Critchley. Hand washing for preventing diarrhoea. Cochrane Database of Systematic Reviews, Issue 1, 2008" data-type="other-reference"><sup>4</sup></a></li>
    </ul>
    </li>
    <li>B&oslash;rnehave
    <ul>
        <li>B&oslash;rn med akutte diarr&eacute;-tilstande kan vende tilbage til b&oslash;rnehaven 2 d&oslash;gn efter, at de er blevet symptomfrie; dette g&aelig;lder ogs&aring; bleb&oslash;rn</li>
        <li>Ved diarr&eacute;-tilstande, hvor man mist&aelig;nker f&oslash;devarer som &aring;rsag (f.eks. efter udlandsrejse), b&oslash;r barnet unders&oslash;ges af l&aelig;ge</li>
    </ul>
    </li>
    <li>[DliActiveSubstance;6338;Vaccination mod rotavirus],&nbsp;som WHO anbefaler&nbsp;indf&oslash;rt i alle b&oslash;rnevaccinationsprogrammer, reducerer sygdomsbyrden globalt</li>
</ul>
<h4>[DliActiveSubstance;6338;Vaccine mod rotavirus]</h4>
<ul>
    <li>Flere kliniske unders&oslash;gelser har vist, at&nbsp;[DliActiveSubstance;6338;rotavirus vaccine] giver god beskyttelse mod rotavirusinfektion hos sp&aelig;db&oslash;rn, med opf&oslash;lgning indtil 2-&aring;rsalder</li>
    <li>Der er findes to forskellig orale levende sv&aelig;kkede vacciner mod rotavirus, Rotarix og Rotateq
    <ul></ul>
        </li>
        <li>Aktuelt er [DliActiveSubstance;6338;Rotarix]&nbsp;markedsf&oslash;rt I Danmark. Vaccinen giver 85 % beskyttelse mod sv&aelig;r gastroenteritis og indl&aelig;ggelse. Der gives to doser med mindst to ugers interval. F&oslash;rste dosis kan gives fra 6 ugers alderen, og sidste dosis skal gives senest i 24 ugers alderen</li>
        <li>Vaccination mod rotavirus er ikke indf&oslash;rt i b&oslash;rnevaccinationsprogrammet i Danmark, da der stort set ikke er nogen b&oslash;rn, der d&oslash;r af rotavirus her</li>
        <li>Et Cochrane review har, i overensstemmelse med resultaterne fra de kliniske studier, fundet at rotavirusvaccine reducerer forekomst af rotavirus-induceret diarre, uden &oslash;get risiko for alvorlige bivirkninger<a href="%20" title="Soares-Weiser K, Bergman H, Henschke N, Pitan F, Cunliffe N, Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database Syst Rev 2019;3: CD008521" data-url="reference-link" data-value-piped="Soares-Weiser K, Bergman H, Henschke N, Pitan F, Cunliffe N|Vaccines for preventing rotavirus diarrhoea: vaccines in use.|Cochrane Database Syst Rev|2019|3|CD008521|30912133" data-value="Soares-Weiser K, Bergman H, Henschke N, Pitan F, Cunliffe N, Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database Syst Rev 2019;3: CD008521" data-type="journal-reference" data-pubmedid="30912133"><sup>5</sup></a></li>
    </ul>
    <h2>Henvisning</h2>
    <ul>
        <li>Indl&aelig;ggelse ved tegn til dehydrering hos b&oslash;rn</li>
        <li>Ved alvorligere dehydrering hos voksne</li>
    </ul>
    <h2>Opf&oslash;lgning</h2>
    <ul>
        <li>Sygemelding fra arbejde ved ans&aelig;ttelse i:
        <ul>
            <li>F&oslash;devareindustrien eller restaurationsbranchen</li>
            <li>Sundhedsv&aelig;senet</li>
        </ul>
        </li>
        <li>Der b&oslash;r g&aring; mindst 48 timer efter symptomfrihed, f&oslash;r man genoptager sit arbejde</li>
    </ul>
    <h3>Udbrud</h3>
    <h4>Udbrud i b&oslash;rnehave</h4>
    <ul>
        <li>B&oslash;rn b&oslash;r holdes hjemme ved symptomer og 48 timer efter symptomfrihed</li>
        <li>Kontrolpr&oslash;ve er ikke n&oslash;dvendig</li>
    </ul>
    <h4>Udbrud p&aring; sygehus eller plejehjem</h4>
    <ul>
        <li>Patienter med akut gastroenteritis b&oslash;r isoleres i eget rum eller egen afdeling; rummet b&oslash;r have eget bad/toilet</li>
        <li>Personale med symptomer sendes hjem og returnerer f&oslash;rst efter 48 timers symptomfrihed</li>
        <li>H&aring;ndvask indsk&aelig;rpes efter kontakt med patienter eller ber&oslash;ring af mulig kontaminerede genstande</li>
        <li>Mundbind benyttes sammen med handsker og overtr&aelig;kskittel pga. smitterisiko ved opkastninger</li>
        <li>Isolationsrummet reng&oslash;res dagligt p&aring; almindelig m&aring;de</li>
        <li>Ved oph&oslash;r af isoleringen reng&oslash;res rummet i henhold til retningslinjer for kontaktsmitteisolering</li>
    </ul>
    <h3>Anmeldelse</h3>
    <ul>
        <li>Mistanke om vand- eller levnedsmiddelb&aring;ren infektion skal indberettes elektronisk til Statens Serum Institut via Sundhedsdatastyrelsens Elektroniske Indberetningssystem (SEI2)</li>
    </ul>
    <h2>Sygdomsforl&oslash;b, komplikationer og prognose</h2>
    <h3>Sygdomsforl&oslash;b</h3>
    <ul>
        <li>Normalt g&aring;r tilstanden over i l&oslash;bet af 4-6 dage</li>
    </ul>
    <h3>Komplikationer</h3>
    <ul>
        <li>Dehydrering</li>
        <li>Forstyrrelser i elektrolytbalancen</li>
        <li>Alvorlig komplikation/d&oslash;dsfald er meget sj&aelig;lden i Danmark, men ikke us&aelig;dvanlig i lande med d&aring;rligere sociale forhold</li>
        <li>Der er hos b&oslash;rn set aspirationspneumoni i forbindelse opkastninger</li>
        <li>Der er beskrevet krampeanfald, men sammenh&aelig;ngen med rotavirus er usikker</li>
    </ul>
    <h3>Prognose</h3>
    <ul>
        <li>Generelt god, og d&oslash;dsfald hos sp&aelig;db&oslash;rn ses sj&aelig;ldent i Danmark</li>
    </ul>
    <h2>Baggrundsoplysninger</h2>
    <h3>Definition</h3>
    <ul>
        <li>Akut viral gastroenteritis&nbsp;for&aring;rsaget af infektion med rotavirus</li>
        <li>Rotavirus er den hyppigste &aring;rsag til alvorlig&nbsp;diarr&eacute; hos b&oslash;rn under 5 &aring;r i alle dele af verden</li>
    </ul>
    <h3>Forekomst</h3>
    <h4>Internationalt</h4>
    <ul>
        <li>Rotavirus er globalt den mest almindelige &aring;rsag til sv&aelig;r diarresygdom hos b&oslash;rn under 5 &aring;r</li>
        <li>Det estimeres, at der er omkring 139 millioner tilf&aelig;lde &aring;rligt med 611.000 d&oslash;dfald</li>
        <li>Rotavirus er &aring;rsag til omkring 6 % af d&oslash;dsfald hos b&oslash;rn under 5 &aring;r. Langt de fleste d&oslash;dsfald er hos b&oslash;rn under 5 &aring;r, der bor i udviklingslande</li>
        <li>I de lande, der har indf&oslash;rt vaccination mod rotavirusvaccine i b&oslash;rnevaccinationsprogrammer, har man set en markant reduceret hospitalisering p&aring; grund af rotavirusinfektion</li>
    </ul>
    <h4>I Danmark</h4>
    <ul>
        <li>Rotavirus rammer n&aelig;sten alle b&oslash;rn inden de fylder to &aring;r</li>
        <li>Der er i Danmark hos b&oslash;rn &aring;rligt omkring 45.000 tilf&aelig;lde af rotavirus infektion, 10.000 kontakter til l&aelig;ge, 1.000 indl&aelig;ggelser og 0-1 d&oslash;dsfald</li>
        <li>Man regner med, at ca. 40 % af alle tilf&aelig;lde af akut, alvorlig diarre i Danmark skyldes&nbsp;rotavirusinfektion</li>
        <li>Et dansk studie p&aring;viste rotavirus hos 9 % af voksne indlagt med akut gastroenteritis</li>
    </ul>
    <h3>&AElig;tiologi og patogenese</h3>
    <ul>
        <li>Rotavirus er et dobbelstrenget RNA-virus tilh&oslash;rende familien <em>Reoviridae</em></li>
        <li>Rotavirus kan opdeles i serotyper p&aring; baggrund to overflade proteinger: G-protein (VP7) og P-protein (VP4). Fem G-P kombinationer udg&oslash;r 90 % af cirkulerende rotavirus globalt</li>
        <li>Rotavirus producerer et protein NSP4, som har en toksisk effekt p&aring; tarmepitelet medf&oslash;rende diarr&eacute;</li>
        <li>Det betyder, at man kan blive smittet med rotavirus mere end en gang, sv&aelig;reste kliniske forl&oslash;b er altid ved f&oslash;rste infektion</li>
        <li>Sygdommen er som regel mildere hos st&oslash;rre b&oslash;rn og voksne, der tidligere har haft rotavirus gastroenteritis</li>
        <li>Reservoir for virusset er antagelig kun mennesker, og virus smitter hovedsageligt f&aelig;ko-oralt fra person til person</li>
    </ul>
    <h4>Smitteforhold</h4>
    <ul>
        <li>Smitte sker hovedsageligt fra person til person f&aelig;ko-oralt enten direkte eller indirekte</li>
        <li>Rotavirus forekommer i store m&aelig;ngder i f&aelig;ces 10<sup>10</sup>-10<sup>12</sup>&nbsp;viruspartikler/ml f&aelig;ces, og der skal ikke mere end 100 viruspartikler til for at smitte&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;
        <ul>
            <li>Smitterisikoen er st&oslash;rst de f&oslash;rste 4 dage af sygdommen</li>
        </ul>
        </li>
        <li>Virus kan forblive smitsomt i et stykke tid p&aring; overflader, fx leget&oslash;j</li>
        <li>Luftb&aring;ren smitte er ogs&aring; beskrevet (aerosol fra opkast)</li>
    </ul>
    <h3>Disponerende faktorer</h3>
    <ul>
        <li>D&aring;rlig h&aring;ndhygiejne s&aelig;rligt i kombination med eksposition</li>
    </ul>
    <h3>ICPC-2</h3>
    <div>[ICPC]</div>
    <ul>    </ul>
        <h3>ICD-10/SKS-koder</h3>
        <div>[ICD10]</div>
        <ul>
        </ul>
        <h2>Patientinformation</h2>
        <h3>Link til patientinformation</h3>
        <ul>
            <li><a href="~/link.aspx?_id=81AABDE728314941BB0B7E0CB32AA2A9&amp;_z=z">Information om tarminfektion for&aring;rsaget af virus</a></li>
            <li><a href="~/link.aspx?_id=21958CE59A1843939E44F5A3504E71DA&amp;_z=z">Rotavirusinfektion</a></li>
        </ul>
        <h2>Link til vejledninger</h2>
        <ul>
            <li>Forl&oslash;bsbeskrivelser og regionale pakkeforl&oslash;b [ICPC]</li>
        </ul>]]></HtmlField>
      <HtmlField Name="Resume"><![CDATA[<h2>Resum&eacute;</h2>
<h4>
Diagnose
</h4>
<ul>
    <li>Mist&aelig;nkes hos sp&aelig;db&oslash;rn i alderen 6-24 mdr. med sv&aelig;r akut gastroenteritis, specielt i rotavirus s&aelig;sonen fra februar til maj</li>
    <li>P&aring;visning af rotavirus i f&aelig;ces ved antigen-test eller PCR-test</li>
</ul>
<h4>
Behandling
</h4>
<ul>
    <li>Erstatte v&aelig;ske- og elektrolyttab</li>
    <li>Hygiejniske foranstaltninger for at forhindre smittespredning</li>
</ul>
<h4>
Henvisning
</h4>
<ul>
    <li>Sp&aelig;db&oslash;rn med sv&aelig;r gastroenteritis og tegn p&aring; dehydring indl&aelig;gges til observation og v&aelig;sketerapi</li>
</ul>
<h4>Seneste v&aelig;sentlige &aelig;ndringer</h4>
<ul>
    <li>Ingen</li>
</ul>]]></HtmlField>
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]]></Media>
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