Diagnosis of Human Illness: Specific diagnosis of the disease is made by identification of the virus in the patient's stool. Enzyme immunoassay (EIA) is the test most widely used to screen clinical specimens, and several commercial kits are available for group A rotavirus. Electron microscopy (EM) and polyacrylamide gel electrophoresis (PAGE) are used in some laboratories in addition or as an alternative to EIA. A reverse transcription-polymerase chain reaction (RT-PCR) has been developed to detect and identify all three groups of human rotaviruses. (Source: FDA Bad Bug Book)
Food Analysis: The virus has not been isolated from any food associated with an outbreak, and no satisfactory method is available for routine analysis of food. However, it should be possible to apply procedures that have been used to detect the virus in water and in clinical specimens, such as enzyme immunoassays, gene probing, and PCR amplification to food analysis. (Source: FDA Bad Bug Book)
Diagnosis may be made by rapid antigen detection of rotavirus in stool specimens. Strains may be further characterized by enzyme immunoassay or reverse transcriptase polymerase chain reaction, but such testing is not commonly done. (Source: excerpt from Rotavirus: DVRD)
The following medical news items are relevant to diagnosis of Rotavirus:
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Accurate assessment helps identify infectious diseases and prevents avoidable complications. Complete assessment consists of patient history, physical examination, and laboratory data. The history should include the patient's sex, age, address, occupation, and place of work; known exposure to illness and recent medications, including antibiotics; and date of disease onset. Signs and symptoms, including their duration and whether they occurred suddenly or gradually, should be included in the history as well as precipitating factors, relief measures, and weight loss or gain. Detail information about recent hospitalization; blood transfusions; blood donation denial by the Red Cross or other agencies; recent travel or camping trips; exposure to animals; and vaccinations. (See Immunization schedule.) If applicable, ask about possible exposure to sexually transmitted diseases or about drug abuse. Also, try to determine the patient's resistance to infectious disease. Ask about usual dietary patterns, unusual fatigue, and any conditions, such as neoplastic disease or alcoholism, that may predispose him to infection. Notice if the patient is listless or uneasy, lacks concentration, or has any obvious abnormality of mood or affect.
In suspected infection, a physical examination must assess the skin, mucous membranes, liver, spleen, and lymph nodes. Check for and make note of the location and type of drainage from any skin lesions. Record skin color, temperature, and turgor; ask if the patient has pruritus. Take his temperature, using the same route consistently, and watch for a fever, which is the best indicator of many infections. (Keep in mind that some patients, such as those who are immunocompromised, are unable to spike a fever.) Note and record the pattern of temperature change and the effect of antipyretics. Be aware that certain analgesics may contain antipyretics. With a high fever, especially in children, watch for seizures.
Check the pulse rate. Infection commonly increases the pulse rate, but some infections, notably typhoid fever and psittacosis, may decrease it. Also observe for increased respiratory rate or a change in mental status. In severe infection or when complications are possible, watch for hypotension, hematuria, oliguria, hepatomegaly, jaundice, bleeding from gums or into joints, and an altered level of consciousness. Obtain laboratory studies and appropriate cultures as ordered.
Source: Professional Guide to Diseases (Eighth Edition), 2005
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