Parents and guardians are strongly advised to closely monitor signs of dehydration in children as the season for rotavirus infections continues in South Africa. Health authorities have reported a sharp increase in cases in Pretoria and one death.
The National Institute for Communicable Diseases (NICD) stated that the 2026 rotavirus season is ongoing across South Africa and warned that the greatest danger for infants and young children is dehydration caused by severe watery diarrhea and vomiting.
Rotavirus is a common childhood infection; most children contract it at least once before the age of two. The illness usually presents with sudden vomiting followed by necrotizing, watery diarrhea. Symptoms to watch for include fever, loss of appetite, fatigue, and mild abdominal discomfort.
Although this is a frequent infection and many children recover, rapid fluid loss can become life-threatening if dehydration is not recognized and treated promptly.
Five Signs Indicating the Need for Medical Attention
According to NICD data, parents should look out for the following signs of dehydration:
- No tears when crying
- Dry mouth or sunken eyes
- Decreased number of wet diapers
- Unusual drowsiness or lethargy
- Refusal to drink or eat
NICD warned that the absence of a wet diaper for six to eight hours is a sign of possible dehydration. Also, dry mouth, sunken eyes, or a sunken soft spot in infants can indicate dehydration.
Children who become unusually sleepy, lethargic, excessively tired, or weak require urgent intervention, especially if they are difficult to wake up. Furthermore, a child refusing fluids or food, or unable to retain fluids, is at increased risk of dehydration and requires specialist assessment.
NICD emphasized that severe dehydration is a medical emergency. Other serious signs include dark urine, cold or discolored skin, rapid breathing or fast pulse, and skin that remains tented for a long time after a light pinch.
Parents and guardians must immediately take a child showing signs of severe dehydration to the nearest clinic or medical facility.
Recommendations for Parents
NICD advises parents to continue breastfeeding infants and increase fluid intake when a child has diarrhea. Oral rehydration solution can help replenish fluids lost through vomiting and diarrhea. Parents can give this solution to children with diarrheal symptoms and, if possible, continue giving it during a trip to a medical facility.
Parents are also encouraged to ensure timely vaccination of children against rotavirus. Rotavirus vaccination has been part of South Africa's expanded immunization program since 2009 and helps protect children from severe illnesses.
What Parents Should Avoid
Parents should not ignore persistent vomiting or watery diarrhea, especially in infants and young children, as dehydration can develop very quickly. Nor should they stop breastfeeding or feeding the child just because they have diarrhea, unless advised by a doctor.
Antibiotics should not be used to treat rotavirus unless prescribed for another confirmed condition, as rotavirus is caused by a virus, not bacteria. Most importantly, parents should not wait for severe symptoms to appear before seeking help if they are concerned about their child's dehydration.
NICD noted that early recognition of dehydration and prompt treatment can prevent serious complications, prolonged hospitalization, and death.