Rota virus Antigen

Bacterial/ Viral

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No Fasting Required

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Stool antigen detection.

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Rotavirus Antigen Test - Comprehensive Medical Guide

Why is it done?
- Detects rotavirus antigen in stool samples to identify acute rotaviral gastroenteritis infection in symptomatic patients
- Primary indication: Diagnosis of viral gastroenteritis presenting with acute diarrhea, vomiting, and abdominal discomfort
- Typically performed in infants and young children (6 months to 5 years) presenting with acute watery diarrhea
- Useful in outbreak investigations and epidemiological surveillance of rotaviral infections
- Helps differentiate viral gastroenteritis from bacterial or parasitic causes of diarrhea
- Best performed within the first 3-5 days of symptom onset for optimal sensitivity
Normal Range
- Normal/Negative Result: No rotavirus antigen detected (reported as 'Negative' or 'Not Detected')
- Abnormal/Positive Result: Rotavirus antigen detected (reported as 'Positive' or with antigen concentration values in ng/mL or similar units)
- Units of Measurement: Qualitative (Positive/Negative) or semi-quantitative (Weak, Moderate, Strong positive)
- Reference Standard: Absence of rotavirus antigen in stool is normal; presence indicates acute infection
- Test Sensitivity: 90-98% depending on assay method (ELISA, immunochromatography, or RT-PCR)
- Test Specificity: 95-99% depending on assay method
Interpretation
- Positive Result Interpretation: Confirms acute rotaviral gastroenteritis; indicates active viral shedding in stool; patient is contagious and capable of transmitting the virus to others; infection is self-limiting in most cases
- Negative Result Interpretation: Rotavirus not detected; may indicate non-rotaviral gastroenteritis (bacterial, parasitic, or other viral etiologies); early infection (test performed before significant antigen shedding); or recovered from infection
- Semi-quantitative Results: Weak positive: Low antigen concentration, typically early or late infection phase; Moderate positive: Moderate antigen levels, compatible with acute infection; Strong positive: High antigen concentration, peak phase of viral shedding
- Factors Affecting Results: Timing of specimen collection (best within 3-5 days of symptom onset); improper sample collection or handling; contaminated or inadequate stool sample; rotavirus strain variation; concurrent use of antimotility agents may affect viral shedding
- Clinical Significance: Positive result guides symptomatic management and infection control measures; helps determine need for hospitalization in severe cases; informs public health surveillance; negative result in symptomatic patient warrants testing for other causes
- False Negatives: Can occur if specimen is collected too early or too late in infection course; poor sample quality; or low viral burden
- False Positives: Rare but can occur due to cross-contamination or laboratory error; vaccination may produce minor viral shedding in immunocompromised individuals
Associated Organs
- Primary Organ System: Gastrointestinal tract, particularly the small intestine (duodenum, jejunum, ileum) where rotavirus causes mucosal inflammation and epithelial damage
- Associated Conditions: Acute viral gastroenteritis; watery diarrhea; vomiting; dehydration; electrolyte imbalances; failure to thrive in infants; fever and malaise
- Diagnosed Diseases: Rotaviral gastroenteritis; infectious diarrhea syndrome; seasonal viral diarrhea; winter vomiting disease (colloquial term)
- Potential Complications: Severe dehydration (requiring IV fluid replacement); electrolyte disturbances (hypokalemia, hyponatremia); acute kidney injury from severe dehydration; failure to thrive in malnourished or immunocompromised children; rarely, malabsorption or secondary lactose intolerance
- High-Risk Populations: Infants and young children (<5 years); premature infants; immunocompromised patients; hospitalized individuals; children in daycare or institutional settings
- Epidemiological Significance: Leading cause of severe gastroenteritis in infants and young children worldwide; significant burden of disease in developing countries; seasonal peaks in winter months in temperate regions; major public health concern prior to rotavirus vaccination programs
Follow-up Tests
- If Positive Result: Serum electrolytes (sodium, potassium, chloride, bicarbonate) to assess for electrolyte abnormalities and acid-base status; blood urea nitrogen and creatinine to evaluate renal function and hydration status; blood glucose to monitor for hypoglycemia in severe cases; complete blood count to rule out secondary bacterial infection
- If Negative Result with Persistent Symptoms: Stool culture to test for bacterial pathogens (Salmonella, Shigella, Campylobacter); stool ova and parasites examination; Clostridioides difficile toxin testing (if antibiotic-associated diarrhea suspected); adenovirus antigen testing; norovirus and sapovirus testing; enteric panel (multiplex PCR for multiple viral/bacterial/parasitic pathogens)
- Complementary Diagnostic Tests: Rotavirus RT-PCR for confirmation or typing in outbreak investigations; abdominal ultrasound or CT if intussusception suspected; stool pH testing if lactose intolerance suspected
- Monitoring Frequency: Outpatient cases: reassessment if no improvement within 48-72 hours or if dehydration worsens; hospitalized cases: continuous monitoring of fluid balance and vital signs; repeat electrolytes if severe dehydration or ongoing fluid losses; stool testing not recommended for routine follow-up as viral shedding persists after clinical recovery
- Testing in Special Populations: Immunocompromised patients: prolonged viral shedding may warrant repeat testing; immunosuppressed post-transplant patients may require molecular testing for viral quantification
- Outbreak Investigation Tests: Rotavirus strain typing (G and P genotypes) using RT-PCR or sequencing; epidemiological data collection; environmental sampling if healthcare-associated outbreak suspected
Fasting Required?
- Fasting Requirement: No - fasting is NOT required for rotavirus antigen testing
- Sample Collection Instructions: Collect fresh stool sample directly into sterile container without touching interior surfaces; minimum 5-10 grams or 5-10 mL of stool required; specimen should be collected during acute diarrheal phase for optimal sensitivity; avoid contamination with urine or other body fluids
- Specimen Handling: Keep specimen at room temperature if delivered to laboratory within 2 hours; refrigerate (2-8°C) if delay anticipated; do NOT freeze specimen unless specifically instructed; use preservative vials if provided by laboratory; transport specimen in biohazard container with appropriate labeling
- Medication Restrictions: No medications need to be avoided; antimotility agents (loperamide, diphenoxylate) should NOT be used as they may worsen infection and reduce viral shedding in stool, potentially causing false-negative results; antibiotics do not need to be discontinued
- Patient Preparation: No special preparation required; patient can eat and drink normally; continue hydration efforts for symptomatic relief and to prevent dehydration; collect specimen during active diarrheal phase (ideally within first 3-5 days of symptom onset); allow natural bowel movement - do not induce with laxatives
- Special Considerations: Use collection kits provided by laboratory if available; ensure proper labeling with patient identifiers, date, and time of collection; inform patient about contagiousness and hygiene measures (handwashing with soap and water is most effective against rotavirus); specimens should not contain stool softeners, barium, or bismuth within one week prior to collection

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