Rotavirus

Nationwide Children’s Hospital

Rotavirus (row-tuh-vai-ruhs) is a contagious illness that causes diarrhea. The virus spreads easily from person to person. When someone touches an infected person’s poop (stool), and does not wash their hands well, they can leave the virus on anything they touch. The virus enters the body when a person’s fingers touch something contaminated with the virus, and then put their fingers in their mouth.

• Rotavirus often occurs in the winter and spring. It’s more common in infants and children up to about 2 years of age, but older children and adults can get it too.
• Most infants have been immunized (vaccinated) against rotavirus and are likely to have only mild symptoms. A person can get a mild case again if re-exposed.
• Rotavirus usually does not cause serious illness. The greatest risk is for infants. Severe vomiting and diarrhea can lead to losing too much body fluid (dehydration). Some infants may need to be hospitalized to replace the lost body fluids.

Diagnosis and Symptoms

The diagnosis of rotavirus is usually made based on symptoms. Stool specimen tests are rarely done. Symptoms start 1 to 2 days after a child is infected and can last for 3 to 8 days. They include:

• Fever
• Nausea, vomiting, and loss of appetite
• Watery stools or diarrhea
• Mild stomach pain or cramping

Signs of Dehydration

Dehydration is the most serious risk to children and can be dangerous. Call your child’s doctor or health care provider if you see any of these signs (Picture 1):

• Newborns (0 to 4 months of age) – less than 6 wet diapers in one day
• Children (4 months or older) – less than 3 wet diapers in one day or pees (urinates) less than 3 times in one day
• Very dark urine
• A dry, sticky  mouth. Sometimes, lips may be dry or cracked on the outside, especially in the winter.
• Fewer or no tears when crying
• Hard or fast. breathing
• No energy (lethargic) or hard to wake up, acts confused
• Bellyache (abdominal pain) that will not go away

Treatment

Rotavirus symptoms usually go away without treatment. Since it is caused by a virus, antibiotics will not help and may cause more diarrhea.

• Make sure your child gets plenty of rest.
• Give regular foods. If your child is vomiting, wait a few hours and try again.
• Avoid any red-colored food or drinks that might look like blood in diarrhea or vomit.
• Do not give over-the-counter medicines to stop the diarrhea or vomiting.
• Check your child’s temperature using a digital thermometer. Wash the thermometer thoroughly after each use.
  • Use only a rectal thermometer in infants under 3 months of age.
  • For infants 4 months of age or older, take rectal, oral, ear, or armpit (axillary) temperatures.
  • When your child reaches 4 years of age, mouth (oral) temperatures are okay.

For Dehydration:

• Continue giving breast milk or formula to infants, and milk to toddlers and older children. Do not only give them water.
• Give extra fluids in little sips throughout the day. Do not give fruit juice or liquids that are high in sugar, such as Hi-C®, Hawaiian Punch®, Kool-Aid®, or syrups. Too much juice can cause diarrhea.
• Your child may need to drink an oral rehydration solution (ORS) like Pedialyte®, Naturalyte®, Infalyte®, or K-Electrolyte®. An ORS helps replace the electrolytes (salts) and fluids that your child needs.
  • You can buy ORS in liquid or powder form or as popsicles at most pharmacies without a prescription. ORS store brands are just as good as a brand name.
  • The amount depends on your child’s weight. Ask the doctor or health care provider how much to give. Do not water down (dilute) or mix an ORS with formula.
  • Offer your child other things to drink. An ORS should not be given as the only fluid for more than 6 hours.
• Do not use sports drinks.  and home remedies instead of an ORS. They do not have the right mix of electrolytes.

Prevention

These are the best ways to prevent rotavirus from spreading to others are:

• Make sure your child gets the rotavirus vaccines on time. The first one starting at 2 months of age. All doses should be given by 8 months of age.
• Wash your hands before and after every diaper change, after helping your child in the bathroom, before touching food and before eating (Picture 2).
• If your child is old enough to crawl or walk, wash their hands often.
• Teach older children to avoid touching their mouths.
• Wipe down any toys that your child usually puts in their mouth and hard surfaces that your child touches with disinfectant, bleach solution, or soap and water.
• Wash soiled clothes right away, in hot soapy water.
• Do not send your child to school or childcare until the diarrhea has stopped.

When to Call the Doctor

Call your child’s doctor or health care provider if they:

• Will not eat or drink liquids and look dehydrated.
• Have blood in their diarrhea
• Have severe stomach pain
• Have a high fever. Use a digital thermometer and wash it thoroughly after each use.

Rotavirus (PDF), Somali (PDF), Spanish (PDF)

HH-I-206 | ©1999, revised 9/2022 | Nationwide Children’s Hospital

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Gastroenteritis (Stomach Flu): Symptoms, Causes, Treatments

Written by Mary Jo DiLonardo

Medically Reviewed by Neha Pathak, MD on September 17, 2021

• Symptoms of Gastroenteritis
• Stomach Flu and Children
• What Causes Gastroenteritis?
• Gastroenteritis Treatment

When you have diarrhea and vomiting, you may say you have the “stomach flu. ” These symptoms often are due to a condition called gastroenteritis.

With gastroenteritis, your stomach and intestines are irritated and inflamed. The cause is typically a viral or bacterial infection.

With gastroenteritis, the main symptoms you probably have are watery diarrhea and vomiting. You might also have stomach pain, cramping, fever, nausea, and a headache.

Because of diarrhea and vomiting, you also can become dehydrated. Watch for signs of dehydration, such as dry skin and a dry mouth, feeling lightheaded, and being really thirsty. Call your doctor if you have any of these symptoms.

Children can get dehydrated quickly, so if your child has the stomach flu, it’s important that you look for signs that they are very thirsty or has dry skin or a dry mouth. If you have a baby, look for fewer, drier diapers.

Keep children with gastroenteritis out of day care or school until all symptoms are gone. Check with your doctor before giving your child any medicine. Drugs used to control diarrhea and vomiting aren’t usually given to children younger than 5.

To help prevent rotavirus — the most common cause of stomach flu for children — there are two vaccines that can be given to infants. Talk to your doctor about the vaccines.

There are many ways gastroenteritis can be spread:

• Contact with someone who has the virus
• Contaminated food or water
• Unwashed hands after going to the bathroom or changing a diaper

The most common cause of gastroenteritis is a virus. The main types are rotavirus and norovirus.

Rotavirus is the world’s most common cause of diarrhea in infants and young children. Norovirus is the most common cause of serious gastroenteritis and also foodborne disease outbreaks in the U.S.

Although not as common, bacteria such as E. coli and salmonella can also trigger the stomach flu. Salmonella and campylobacter bacteria are the most common bacterial causes of gastroenteritis in the U. S. and are usually spread by undercooked poultry, eggs, or poultry juices. Salmonella can also be spread through pet reptiles or live poultry.

Another bacteria, shigella, is often passed around in day care centers. It typically is spread from person to person, and common sources of infection are contaminated food and drinking water.

Parasites can also cause gastroenteritis, but it’s not common. You can pick up organisms such as giardia and cryptosporidium in contaminated swimming pools or by drinking contaminated water.

There are also other unusual ways to get gastroenteritis:

• Heavy metals (arsenic, cadmium, lead, or mercury) in drinking water
• Eating a lot of acidic foods, like citrus fruit and tomatoes
• Toxins that might be found in certain seafood
• Medications such as antibiotics, antacids, laxatives, and chemotherapy drugs

Prevent dehydration:

• Give a child an oral rehydration solution. Call your doctor for age-appropriate dosing specifics.
• Give an adult as much clear fluid as possible.
• The person should drink fluids slowly in frequent, small amounts. Drinking too much too fast can make nausea worse.

As symptoms start to ease:

• Gradually ease food back into the person’s diet.
• Start with bland, easy-to-digest food such as crackers, bananas, toast, rice, and chicken.
• Avoid dairy, caffeine, and alcohol until recovery is complete.

When to call a doctor

Call 911 if the person is in shock from severe dehydration (faints, can’t walk, is confused, or is having trouble breathing)

Seek medical help if:

• Vomiting in an adult or a child age 2 or older lasts more than 1 day or a fever or severe diarrhea (large amounts of loose stool every 1 to 2 hours) lasts more than 2 days.
• A child under age 2 has vomiting or diarrhea for more than 12 hours or has a fever with vomiting and diarrhea.
• Vomit or diarrhea turns bloody or tarry.
• The person has kidney, liver, or heart disease and must restrict fluid intake.
• The person develops sudden, severe abdominal pain.
• There are symptoms of dehydration.
• Symptoms don’t go away after a week.

Dehydration with these symptoms should be treated in an emergency room:

• Little to no urination
• Extreme thirst
• Lack of tears
• Dry mouth
• Sunken eyes
• Dizziness or lightheadedness
• Rapid breathing and heartbeat
• Lack of alertness
• Blurred or double vision
• Trouble swallowing or breathing
• Muscle weakness

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It became known what disease causes convulsions and diarrhea – Gazeta.

Ru

It became known what disease causes convulsions and diarrhea – Gazeta.Ru | News

May 25, 2023, 12:37

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There are several symptoms that indicate infection with rotavirus. This was reported to Gazeta.Ru by Professor, Doctor of Medical Sciences, Head of the Department for the Prevention of Infectious Diseases of the Children’s Scientific and Clinical Center for Infectious Diseases of the FMBA Susanna Kharit.

According to the doctor, after an incubation period of one to 3 days, fever and vomiting followed by watery diarrhoea. Symptoms last from 3 to 7 days, but in some cases the illness can last up to 3 weeks.

Harit warned that diarrhea and vomiting cause dehydration and electrolyte disturbances, which can lead to death if the patient does not see a doctor in time.

“In young children, rotavirus infection can lead to convulsions, damage to the heart, liver, brain tissue and its membranes. As a result of a complicated course, deaths are possible, ”the doctor noted.

The professor added that after a rotavirus infection, lingering or chronic intestinal lesions can occur.

“Infection is a trigger for type 1 diabetes in children. In healthy adults, rotavirus infection may cause only mild signs and symptoms or no symptoms at all, but they will also be contagious to others, ”the doctor warned.

As the professor concluded, recurrence occurs throughout life, but after 2-3 infections in childhood or vaccination, most episodes are mild.

Previously reported that pain radiating to the left shoulder blade may be a symptom of a stomach ulcer.

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Intestinal infection: signs, symptoms and treatment

Contents:

• Classification
• Particular supporting clinical symptoms
• Diagnosis and treatment of intestinal infections
• Prevention of intestinal infection
• Treatment

Acute intestinal infections (AII) is a polyetiological group of infectious diseases accompanied by intoxication, impaired motility of the gastrointestinal tract with the development of diarrhea, and in some cases vomiting and dehydration, and the possible development of an inflammatory reaction.

Ways of transmission:

• household contact;
• food;
• water.

Transmission mechanism:

• fecal-oral

Symptoms of intestinal infection:

• vomiting;
• diarrhea;
• temperature;
• pain along the gastrointestinal tract;
• weakness;
• signs of dehydration.

Classification

According to the localization of the lesion of the gastrointestinal tract with diarrhea of ​​infectious genesis, the following syndromes are distinguished:

• acute enteritis;
• acute colitis;
• acute gastroenteritis;
• acute enterocolitis;
• acute gastroenterocolitis.

According to the severity of the course of the disease, there are:

• mild course;
• moderate;
• severe course.

According to the degree of dehydration (dehydration):

• I degree dehydration – loss of body weight does not exceed 3%;
• II degree dehydration – loss of body weight 4-6%;
• III degree dehydration – loss of body weight 7-9%;
• IV degree dehydration – weight loss of 10% or more.

The severity of the intestinal infection is assessed by the severity of the intoxication syndrome and the degree of dehydration.

Partial supporting clinical symptoms

With dysentery:

1. Acute onset of the disease with hyperthermia and headache.
2. The presence of cramping pains in the abdomen with their subsequent localization in the area of ​​the sigma.
3. On palpation of the abdomen, there is pain in the left iliac region with spasm and induration of the sigmoid colon.
4. The presence of tenesmus up to the prolapse of the rectum, in young children, as the equivalent of tenesmus, reddening of the face.
5. Stools are not abundant with an admixture of mucus, streaks of blood, pus, odorless, like “rectal spitting”.

In case of salmonellosis occurring as gastroenteritis:

1. Acute onset of the disease with high fever, vomiting, pain in the abdomen.
2. On palpation of the abdomen, there is pain in the epigastrium and around the umbilicus.
3. Stools are plentiful, watery, fetid with an admixture of greenery, like “swamp mud”.

Cholera:

1. The onset of the disease with the appearance of loose stools against the background of normal (or subfebrile) body temperature and the presence of rumbling in the abdomen.
2. Rapidly develops dehydration with the addition in severe cases of vomiting, tonic-clonic convulsions, cyanosis, thirst, a sharp decrease in skin turgor; laboratory data indicate hemoconcentration.
3. Stools are copious, watery, odorless, outwardly “rice water” (light liquid with flakes).

Escherichiosis:

This is a group of diarrhea caused by five serogroups of Escherichia coli:

• enterotoxigenic;
• enteroinvasive;
• enteropathogenic;
• enterohemorrhagic;
• enteroadhesive.

Enteroinvasive and enterotoxigenic Escherichia also cause disease in adults, while other pathogens cause disease only in children of the first and second year of life.

In diseases caused by enterotoxigenic Escherichia coli, profuse watery, colorless stools with flakes are observed. The onset of the disease can be acute with the onset of vomiting and the development of exsicosis against a background of normal or subfebrile temperature. Dehydration sets in fairly quickly.

In case of escherichiosis caused by enteroinvasive intestinal bacteria, there is a high temperature with scanty stools mixed with mucus, pus, blood, abdominal pain, headache. The disease occurs not only in children, but also in adults and clinically resembles dysentery.

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Staphylococcal enterocolitis:

1. The disease occurs mainly in children under one year of age with a characteristic epidemiological history (presence of purulent foci in a child, mastitis in a mother, consumption of infected food, prolonged antibiotic treatment, etc. ).
2. Gradual development of intestinal dysfunction against the background of subfebrile temperature and moderate intoxication.
3. Dysfunction is observed for a long time while maintaining the source of infection.
4. Stools are liquid with an admixture of mucus, sometimes streaked with blood.

Staphylococcal food poisoning:

1. Indication of eating food in which staphylococcus multiplies well (cakes, creams, pastries, salads with mayonnaise). Most often, the disease is of a group nature.
2. Rapid development of the disease with persistent, debilitating vomiting against the background of high temperature with the addition of secretory diarrhea.
3. Quite often there are cramps in the calf muscles.
4. Liquid, watery stool without pathological impurities.

Campylobacteriosis:

1. Acute onset with fever, abdominal pain, mainly around the umbilicus, preceded by bowel dysfunction and intoxication.
2. Enlargement of the liver and involvement of the pancreas.
3. Pain in the abdomen is localized around the navel and in the right iliac region, they are persistent, sometimes so intense that they require the exclusion of surgical pathology.
4. Stools are plentiful, “foamy”, fetid with an admixture of mucus and greenery, and from the 2-3rd day and blood, but without signs of distal colitis (no tenesmus, spasm of the sigmoid colon).

Intestinal yersiniosis:

1. Acute onset of the disease with the development of a variety of symptoms (skin rash, pain in the joints, enlarged liver and spleen) or only in the form of diarrheal syndrome.
2. Pain in the abdomen is localized around the navel and along the mesenteric lymph nodes, mainly in the right iliac region, which requires differential diagnosis with acute appendicitis.
3. Stool 3-6 times a day, liquid, fecal, fetid without pathological impurities in the first days of the disease, later it may be enterocolitic in nature.

Pseudomembranous colitis:

1. The disease is caused by Clostridium difficile in adults and children older than 2 years due to irrational antibiotic therapy (clindamycin, ampicillin, cephalosporins, etc.) and cytostatics due to inhibition of normal intestinal microflora.
2. Antibiotic treatment causes fever, pain in the abdomen, frequent stools.
3. On palpation of the abdomen, there is tenderness around the navel and along the large intestine. The chair is liquid, plentiful with the release of films, which consist of a clot of fibrin and mucus. Continued antibiotic treatment worsens the condition of patients, intestinal dysfunction increases.
4. The disease has a wide range of clinical manifestations, from mild to severe with complications such as intestinal perforation, megacolon and peritonitis.

Viral diarrhea

In rotavirus gastroenteritis, an acute onset of the disease is observed: fever, vomiting as the initial symptom of the disease and copious watery stools with rumbling along the small intestine against the background of scant respiratory symptoms (moderate hyperemia and granularity of the soft palate and arches, congestion nose) or without respiratory syndrome.

In adenoviral and enterovirus infections, there are a number of characteristic symptoms that are not associated with intestinal manifestations. Dehydration rarely develops.

Amoebiasis

The onset of the disease is gradual with the appearance of pain in the abdomen and an increase in the frequency of bowel movements against the background of normal or subfebrile temperature.

1. On palpation of the abdomen, there is pain along the large intestine with induration of the caecum and sigmoid colon.
2. Fluid stools mixed with sticky glassy mucus, pink colored (“raspberry jelly”) or bloody.

Cryptosporidiosis:

1. Clinical and laboratory data confirm the presence of an immunodeficiency in the patient (HIV infection, congenital T-cell immunodeficiency).
2. Prolonged diarrhea (2 months or more), not amenable to treatment with antibacterial drugs and leading to exhaustion of patients.
3. Abundant, watery stool without pathological impurities, 5-10 times a day.
4. In people with a normal immune system, cryptosporidiosis begins acutely and proceeds as gastroenteritis or enteritis with a stool frequency of no more than 10 times and spontaneous recovery within 2 weeks.

Giardiasis:

1. Presence of nausea, discomfort in the epigastrium, loss of appetite against the background of normal temperature.
2. On palpation of the abdomen, rumbling, pain in the epigastrium and around the navel.
3. Stools are liquid, watery, without pathological impurities 2-6 times a day without a tendency to normalize against the background of antibacterial treatment.

Diagnosis and treatment of intestinal infections

Standard for examination of patients with AII:

• Complete blood count (normocytosis or leukocytosis with a stab shift, sometimes up to 40-50% in dysentery and an increase in red blood cells and hemoglobin in severe dehydration) with the determination of hematocrit.
• Complete urinalysis (may have toxic changes and high specific gravity with dehydration).
• Sowing feces for dysentery, salmonellosis, escherichiosis, pathogenic staphylococcus aureus, yersiniosis, opportunistic flora, as well as epidemic and clinical indications for cholera and examination of feces for rotavirus antigens (ELISA) and enteroviruses.
• Coprological examination of feces allows you to clarify the predominant part of the intestine affected by the lesion.
• Serological blood test in the dynamics of the disease (RNHA in case of suspected dysentery, salmonellosis, campylobacteriosis, yersiniosis, etc.).
• Sowing of vomit and washings for pathogenic microflora.
• Biochemical blood test with determination of K, Na, Ca, Cl, total protein, urea, creatinine, CBS.
• Examination of feces for cryptosporidiosis, amebiasis (vegetative forms of amoebae in warm feces), balantidiasis, giardiasis, helminthic infestations according to indications.
• Blood culture for sterility and blood culture with persistent fever and suspicion of typhoid fever, salmonellosis, staphylococcal sepsis.
• Duodenal sounding for suspected giardiasis.
• Sigmoidoscopy or colonoscopy for diarrhea over two weeks with blood in the stool.
• Fibrogastroscopy.
• Ultrasound of the abdominal organs.

Prevention of intestinal infection

1. Use only pre-washed chicken eggs for cooking.
2. Meat of all kinds must be cooked before eating.
3. Heat treatment (boiling) of dairy products purchased from individuals.
4. Store food in separate containers in the refrigerator.
5. Avoid prolonged storage of finished products.
6. Use separate kitchen utensils for cooked and raw foods.
7. Wash fruits and vegetables before eating.
8. Observe the rules of personal hygiene.
9. Pay attention to expiration dates, release dates of products purchased in stores.
10. Avoid buying products from private markets.
11. When swimming in ponds and pools, keep water out of the mouth.