These are the signs to look out for as rotavirus infections continue in South Africa.
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Parents and caregivers are urged to watch closely for signs of dehydration in children as South Africa's rotavirus season continues, with health authorities reporting a drastic increase in cases in Pretoria and one death.
The National Institute for Communicable Diseases (NICD) said the 2026 rotavirus season is ongoing across South Africa and warned that the biggest danger for infants and young children is dehydration caused by vomiting and severe watery diarrhoea.
Rotavirus is a common childhood infection, with most children experiencing at least one infection by the age of two. The illness typically causes sudden vomiting followed by non-bloody, watery diarrhoea.
Symptoms to look out for include fever, loss of appetite, tiredness and mild abdominal discomfort.
However, even though it is a common infection and while many children recover, the rapid loss of fluids can become life-threatening if dehydration is not recognised and treated quickly.
According to the NICD, parents should watch for these warning signs of dehydration:
A child who cries with few or no tears may be losing too much fluid.
Dryness in the mouth, as well as sunken eyes or a sunken soft spot in babies, can be signs of dehydration.
Parents should pay attention to how often a child urinates. The NICD warned that having no wet nappy for six to eight hours is a sign that a child may be dehydrated.
A child who becomes unusually sleepy, listless, excessively tired or limp needs urgent attention, particularly if they are difficult to wake.
A child who refuses fluids or feeds, or cannot keep fluids down, is at greater risk of dehydration and should be assessed by a healthcare professional.
The NICD said severe dehydration is a medical emergency. Other serious signs can include dark urine, cold or discoloured skin, fast breathing or a rapid heartbeat, and skin that remains raised for longer than normal after being gently pinched.
Parents and caregivers should take a child showing signs of severe dehydration to the nearest clinic or healthcare facility immediately.
The NICD advises parents to continue breastfeeding infants and to increase fluid intake when a child has diarrhoea.
Oral rehydration solution can help replace fluids lost through vomiting and diarrhoea. The NICD said parents can administer oral rehydration solution to children with diarrhoeal symptoms and, where possible, continue giving it while travelling to a healthcare facility.
Parents are also encouraged to ensure that children receive their routine rotavirus vaccinations.
Rotavirus vaccination has been part of South Africa's Expanded Programme on Immunisation since 2009 and helps protect children against severe disease.
Parents should not ignore persistent vomiting or watery diarrhoea, particularly in babies and young children, as dehydration can develop quickly.
They should also not stop breastfeeding or feeding a child simply because they have diarrhoea, unless a healthcare professional advises otherwise.
Antibiotics should not be used to treat rotavirus unless prescribed for another confirmed condition, as rotavirus is caused by a virus rather than bacteria.
Most importantly, parents should not wait for severe symptoms before seeking help if they are concerned that their child is becoming dehydrated.
The NICD said recognising dehydration early and getting treatment quickly can help prevent serious complications, prolonged hospitalisation and death.
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