Rotavirus is primarily transmitted via the fecal-oral route, as the virus is shed in large quantities in the stool of infected individuals. Contaminated hands, surfaces, water, and food facilitate its spread, especially in settings with poor hygiene. This mode of transmission explains the high incidence of rotavirus in young children and in areas with inadequate sanitation. Respiratory droplets, vectors, and sexual contact are not significant routes for rotavirus infection. Understanding this is crucial for implementing effective infection control measures and preventing outbreaks.

Reference: Nelson Textbook of Pediatrics, Kliegman RM, 21st Edition.