The Dreaded “Stomach Bug”

What causes the "stomach bug"?

Acute Gastroenteritis (AGE) in U.S. children, commonly referred to as the "the stomach bug" by frustrated parents everywhere, is most often caused by a short list of viruses.  The usual suspects each have their own peak incidence during the year but can also be found in random outbreaks.

 

Until recently, the most common stomach virus was Rotovirus, which peaks in the fall and winter months, and can cause severe diarrhea, especially in young infants and children. Fortunately, a Rotovirus vaccine was introduced in 2006, resulting in a 90% decrease in cases every year. Other common bugs include Norovirus, Adenovirus, Sapovirus and Astrovirus – each with distinct symptoms and peak seasons, and all of which no fun!

 

What are the most common symptoms of the "stomach bug"?

• Diarrhea
  • -generally frequent and watery or loose
  • -can contain mucous or blood (but usually not)
  • –causes fluid and electrolyte losses
  • -may last a week or more
• Vomiting
  • –affects more than half of sufferers.
  • –causes fluid and electrolyte losses
  • -usually lasts 1-2 days

Symptoms vary by age, from person to person and from day to day.  Other symptoms can include fever, crampy abdominal pain, muscle aches, fatigue, loss of appetite and runny nose or sore throat.

The first infection with one of the common viruses suspects generally results in the most severe or prolonged illness.  This explains why young infants and children tend to have the worst cases.

 

 

What should I be worried about?

• The severity of the illness is reflected by the degree of dehydration
• Mild Dehydration: slightly dry or sticky mouth, mild dizziness, urinating less

Most common

Give fluids at home

• Worsening dehydration: dry mouth, decreased urination, increased heart rate, faster and deeper breathing, sunken soft spot, sunken eyes, no tears with crying, listlessness or irritability. 

Infants and young children more susceptible

Call your pediatrician

• Replacing loss of water and electrolytes is #1 priority.
• Pedialyte is preferred for young infants and children.
• Water
• Sports drinks are ok for older children
• Breastfeeding and full strength formula feeding should not be stopped unless infant cannot hold it down
• Start small and go slow if there is vomiting. Popsicles are great for this.
• Resume child's usual diet as soon as child is rehydrated and not vomiting
• Avoid high fat and high sugar foods. Don't give pizza as soon as your child is hungry again!

 

Do any medications or supplements help?

• Your pediatrician may prescribe Zofran (ondansetron) dissolvable tablet, if needed
• aids in oral rehydration by stopping vomiting
• can be used with children over 6 months with viral AGE and persistent vomiting
• slow and steady fluids until child can drink freely without vomiting
• Probiotics
• reduce both the frequency and duration or diarrhea in viral AGE
• no significant side effects
• available and safe for infants and children
• Available at most drug stores
• give probiotics at the start of the illness and then daily for 5-7 days

 

Diarrhea versus the skin?

Diarrhea wreaks havoc on the tender skin of the diaper area in infants and young children.  Irritant diaper dermatitis caused by frequent stool contact with the skin is extremely common in AGE and can be a headache to manage.

A Air time.  Go diaper free and get air to the skin

B Barrier.  Use a zinc oxide based ointment or paste like Desitin with every diaper change.  Do not attempt to remove all the ointment when you change the diaper.  Just clean off what is soiled and easily removed then add more.

C  Clean.  Keep skin clean and dry.  You can rinse out wipes or use soft washcloth with warm water to clean away stool and urine.  Older infants can soak in a 10 minute baking soda bath once a day to aid in healing the skin.

D  Diaper changes.  Change diapers frequently.

 

 

How can I keep my kids from getting "the stomach bug"?

• Vaccination: Rotavirus vaccine is recommended for all infants at 2, 4 and 6 months of age.  Rotavirus vaccine provides protection in the first 1-2 years of life.
• Handwashing: Wash your hands with soap and water after diaper changes or any contact with stool or vomit.  Common alcohol based hand sanitizers are not recommended in place of washing with soap.
• Prevent spread to others: Individuals can spread the virus in stool for several days after all symptoms have stopped and may also be contagious before symptoms have begun.

Recommendations on returning to daycare or school vary, but erring on the side of caution will help reduce the spread of infection to other children.
At a minimum, children should be kept home if

• They've had 2 or more incidents of diarrhea in one day, or any stools are not contained in the diaper.
• Any stool accidents in a toilet trained child
• any vomiting within last 24 hours

 

With any luck, you can keep the bug at bay this season. But if you're not that lucky, hopefully these tips can help provide some comfort to your little ones – and a speedy recovery!

 

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