Rotavirus Infection as a Contributor to Early-Onset Type 1 Diabetes: Review and Recommendations

Rotavirus infection is a major cause of acute gastroenteritis in children, which is characterized by fever, emesis, and diarrhea. In some children, rotaviral infection can spread beyond the gastrointestinal tract and affect the nervous system, kidneys, liver, or pancreas. There are relatively few longitudinal studies of such long-term sequalae. One area of interest has been damage to pancreatic beta islet cells, the lack of which causes type 1 diabetes mellitus. This chronic disease can be life threatening, especially in young children, and is associated with lifelong elevated risks of cardiovascular disease, neuropathy, nephropathy, and retinopathy. This narrative review summarizes the scientific evidence relevant to rotavirus infection and early-onset type 1 diabetes. The results of epidemiologic, animal, and laboratory research indicate that rotavirus infection increases the risk of type 1 diabetes in young children (<5 years of age). Rotavirus vaccination is associated with lower incidence rates; the data suggest a somewhat stronger effect with the pentavalent vaccine than the monovalent vaccine. Continued surveillance of both rotavirus infection and type 1 diabetes are necessary, considering the increases in vaccine hesitancy. The benefits of rotavirus vaccination should be discussed with parents and individuals planning to have children.