Rotavirus season underway in South Africa as Pretoria cases surge

Parents are being urged to keep a close eye on young children as South Africa’s annual rotavirus season gets underway, with a sharp increase in cases reported in Pretoria and one death recorded.

The National Institute for Communicable Diseases (NICD) says surveillance shows that the 2026 season is ongoing across the country. For parents, the biggest concern is not simply diarrhoea itself, but how quickly a young child can become dangerously dehydrated.

Rotavirus is a highly common childhood infection. Most children will have been infected at least once by the age of two, and the virus spreads through the faecal-oral route.

What parents should look out for

Rotavirus often starts suddenly, with vomiting followed by watery diarrhoea. Fever can also occur, while children may lose their appetite, become tired or lethargic and experience mild abdominal discomfort. Prof Nicola Page, head of the NICD’s Centre for Enteric Diseases, warned that the illness can become serious when fluid loss leads to severe dehydration.

‘Clinical symptoms include the sudden onset of vomiting followed by non-bloody watery diarrhoea.’ – Professor Nicola Page, Head of the NCID’s Centre of Enteric Diseases

Parents should therefore pay particular attention to how much their child is drinking and whether they are producing wet nappies as usual. Early warning signs of dehydration include a dry mouth, no tears when crying, sunken eyes or soft spot, and fewer wet nappies.

A baby who has not had a wet nappy for six to eight hours should be closely monitored. Changes in behaviour can also be a warning sign, particularly unusual fussiness, listlessness, lethargy or refusing to eat or drink.

When dehydration becomes an emergency

More serious symptoms should not be ignored. A severely dehydrated child may become extremely sleepy or limp, have dark urine, cold or discoloured skin, rapid breathing or a fast heartbeat.

Another warning sign is skin that remains raised or ‘tented’ after being gently pinched rather than quickly returning to normal. These symptoms require urgent medical attention. ‘Severe dehydration is a medical emergency,’ the NICD warned, urging parents to get affected children to the nearest clinic or medical facility immediately.

Where possible, oral rehydration solution can be given while travelling to the facility.

Why rotavirus returns every winter

Rotavirus follows a seasonal pattern in South Africa, with infections generally increasing during the cooler, drier months. The country’s main season usually runs from July into August, although cases can continue into September.

The introduction of the rotavirus vaccine into South Africa’s Expanded Programme on Immunisation in August 2009 has formed an important part of the country’s response to the disease.

The current season is monitored through diarrhoeal disease surveillance at five sites around the country, including Red Cross Children’s Hospital in the Western Cape, as part of the GERMS-SA surveillance platform. This monitoring helps health authorities track trends in diarrhoeal illnesses and identify increases in rotavirus activity.

Vaccination remains a key protection

The NICD is encouraging parents to make sure their children are vaccinated against rotavirus. Parents are also encouraged to continue breastfeeding infants where applicable. For children experiencing diarrhoeal symptoms, oral rehydration solution can help replace lost fluids.

The recommended homemade solution given by the NICD consists of six teaspoons of sugar and half a teaspoon of salt mixed into one litre of clean water. The warning comes at a particularly important time for parents of babies and young children, as rotavirus can move quickly from vomiting and diarrhoea to significant fluid loss.

Recognising the early signs of dehydration, and acting before symptoms become severe, can make a crucial difference.

For further information, parents can consult the NICD’s rotavirus information page, here.

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Source: nicd.ac.za

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