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This review summarizes current knowledge on RV infections, with a particular focus on viral structure, pathophysiological mechanisms, and age-dependent clinical presentation. Special attention is given to systemic manifestations, including central nervous system involvement, autoimmune responses such as type 1 diabetes and celiac disease, and rare associations with biliary atresia. The mechanisms of RV-induced diarrhea and vomiting are discussed in detail. Clinical severity scoring systems\u2014such as the Vesikari and Clark scales\u2014and dehydration assessment tools\u2014the Clinical Dehydration Scale (CDS) and the Dehydration: Assessing Kids Accurately (DHAKA) score\u2014are compared. The review highlights differences in disease course between children under and over five years, emphasizing that RV is not limited to early childhood. A major section addresses the global effectiveness of vaccination programs, their role in reducing disease burden, coverage challenges, and decreased efficacy in low-income countries. Particular focus is placed on high-risk groups, including preterm and immunocompromised infants.<\/jats:p>","DOI":"10.3390\/pathogens14050480","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T10:27:41Z","timestamp":1747218461000},"page":"480","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Rotavirus Infections: Pathophysiology, Symptoms, and Vaccination"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1297-5958","authenticated-orcid":false,"given":"Karolina","family":"Paw\u0142uszkiewicz","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Wroclaw Medical University, Wybrze\u017ce L. Pasteura 1, 50-367 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5544-5543","authenticated-orcid":false,"given":"Piotr J\u00f3zef","family":"Ryglowski","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Wroclaw Medical University, Wybrze\u017ce L. Pasteura 1, 50-367 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Idzik","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Wroclaw Medical University, Wybrze\u017ce L. Pasteura 1, 50-367 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6529-8040","authenticated-orcid":false,"given":"Katarzyna","family":"B\u0142aszczyszyn","sequence":"additional","affiliation":[{"name":"Jan Mikulicz-Radecki University Hospital in Wroclaw, Borowska 213, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9100-9321","authenticated-orcid":false,"given":"Emilia","family":"Kucharczyk","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Wroclaw Medical University, Wybrze\u017ce L. Pasteura 1, 50-367 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9076-4247","authenticated-orcid":false,"given":"Dagmara","family":"Gawe\u0142-D\u0105browska","sequence":"additional","affiliation":[{"name":"Division of Public Health, Faculty of Health Sciences, Wroclaw Medical University, Bujwida 44, 50-345 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Siczek","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine, Wroclaw Medical University, J. Mikulicza-Radeckiego 4, 50-345 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3154-9138","authenticated-orcid":false,"given":"Jaros\u0142aw","family":"Widelski","sequence":"additional","affiliation":[{"name":"Department of Pharmacognosy with Medicinal Plant Unit, Medical University of Lublin, Chod\u017aki 1, 20-093 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3549-6136","authenticated-orcid":false,"given":"Emil","family":"Paluch","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, Wroclaw Medical University, St. T. Cha\u0142ubi\u0144skiego 4, 50-376 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2389606","DOI":"10.1080\/21645515.2024.2389606","article-title":"Systematic literature review and meta-analysis on the prevalence of rotavirus genotypes in Europe and the Middle East in the post-licensure period","volume":"20","author":"Jesudason","year":"2024","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_2","unstructured":"Cortese, M.M., and Haber, P. (2021). RV. Epidemiology and Prevention of Vaccine-Preventable Diseases, Public Health Foundation. 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