With the start of the 2026 rotavirus season in South Africa, parents have received an urgent recommendation to closely monitor their children's condition. Dr. Angelique Kotze warned that infants and young children can suffer from dangerous dehydration within 24–48 hours.
The National Institute for Communicable Diseases (NICD) reported a sharp increase in cases in Pretoria. Despite the alarming nature of the warning, health experts emphasize that panic is unnecessary. Parents and caregivers are advised to ensure their children are vaccinated, continue breastfeeding infants, and act promptly if diarrhea or vomiting occurs.
Parents Are Advised to Remain Calm
Discussing this topic with the publication IOL, South African general practitioner Dr. Angelique Kotze advised parents to be aware of the risks while remaining calm. She noted that rotavirus is very common among young children and spreads easily, especially through contaminated surfaces, objects, and hands.
How to Monitor a Child's Condition
One of the simplest ways to observe a sick child is by monitoring the frequency of urination. Kotze listed signs of dehydration as dry mouth, lack of tears when crying, reduced number of wet diapers, or very little urine. Other symptoms include sunken eyes, unusual drowsiness or lethargy, and refusal to drink.
Immediate medical attention is necessary for a child who becomes very sleepy or lethargic, has cold or mottled skin, rapid breathing, or a fast pulse, or cannot drink. Professor Nicola Page, head of the Gastrointestinal Diseases Centre at NICD, described the symptoms parents should watch out for.
According to Page, clinical signs include the sudden onset of vomiting followed by watery, non-bloody diarrhea, which can lead to severe, life-threatening dehydration. Fever may rise in approximately 30–50% of patients. Accompanying symptoms include loss of appetite (anorexia), lethargy, and mild abdominal discomfort.
It Can Happen Alarmingly Fast
Parents might mistakenly believe they have enough time to monitor a child with diarrhea and vomiting, but Kotze cautioned that dehydration can develop rapidly. She stressed that rotavirus is capable of turning a previously healthy infant into a state of significant dehydration requiring hospitalization within just 24–48 hours, starting from diarrhea and vomiting.
Therefore, parents are recommended to give children with diarrheal symptoms oral rehydration solution to help replenish lost fluids and prevent dehydration.
Vaccination Can Protect Infants
The NICD urged parents and caregivers to ensure that children are vaccinated against rotavirus. Kotze explained that the vaccine is not intended to prevent every episode of diarrhea. Its most important advantage is reducing the likelihood of a young child developing severe rotavirus gastroenteritis, dangerous dehydration, and the need for hospitalization.
The World Health Organization (WHO) recommends rotavirus vaccination as part of childhood immunization programs, and this vaccine is also included in the South African immunization program.
What About Vaccine Concerns?
For parents who are hesitant about vaccination, Kotze advised them to seek information from healthcare professionals rather than from social media. She acknowledged that vaccines, like medicines, can have side effects, including a small risk of intussusception—a rare condition where one part of the intestine slides into another. However, she stated that the benefits of vaccination significantly outweigh this risk.
In conclusion, Kotze emphasized that decisions regarding childhood vaccination should be based on reliable scientific data, not on fear or misinformation.
Monitor the Child, Not Just the Diapers
When caring for a sick child, parents can easily focus solely on the number of diarrhea episodes. Kotze insisted that the child's overall condition is more important. A child who continues to drink, urinate, and interact normally is vastly different from one who becomes drowsy, dehydrated, and stops urinating. The simple message for parents: remain vigilant, maintain fluid intake, know the signs of dangerous dehydration, and seek emergency medical care promptly if the child shows signs of severe dehydration.