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Viral gastroenteritis (stomach flu) – Diagnosis and treatment


Your doctor will likely diagnose gastroenteritis based on symptoms, a physical exam and sometimes on the presence of similar cases in your community. A rapid stool test can detect rotavirus or norovirus, but there are no quick tests for other viruses that cause gastroenteritis. In some cases, your doctor may have you submit a stool sample to rule out a possible bacterial or parasitic infection.


There’s often no specific medical treatment for viral gastroenteritis. Antibiotics aren’t effective against viruses, and overusing them can contribute to the development of antibiotic-resistant strains of bacteria. Treatment initially consists of self-care measures.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

To help keep yourself more comfortable and prevent dehydration while you recover, try the following:

  • Let your stomach settle. Stop eating solid foods for a few hours.
  • Try sucking on ice chips or taking small sips of water. You might also try drinking clear soda, clear broths or noncaffeinated sports drinks. Drink plenty of liquid every day, taking small, frequent sips.
  • Ease back into eating. Gradually begin to eat bland, easy-to-digest foods, such as soda crackers, toast, gelatin, bananas, rice and chicken. Stop eating if your nausea returns.
  • Avoid certain foods and substances until you feel better. These include dairy products, caffeine, alcohol, nicotine, and fatty or highly seasoned foods.
  • Get plenty of rest. The illness and dehydration may have made you weak and tired.
  • Be cautious with medications. Use many medications, such as ibuprofen (Advil, Motrin IB, others), sparingly if at all. They can make your stomach more upset. Use acetaminophen (Tylenol, others) cautiously; it sometimes can cause liver toxicity, especially in children. Don’t give aspirin to children or teens because of the risk of Reye’s syndrome, a rare, but potentially fatal disease. Before choosing a pain reliever or fever reducer, discuss with your child’s pediatrician.

For infants and children

When your child has an intestinal infection, the most important goal is to replace lost fluids and salts. These suggestions may help:

  • Help your child rehydrate. Give your child an oral rehydration solution, available at pharmacies without a prescription. Talk to your doctor if you have questions about how to use it. Don’t give your child plain water — in children with gastroenteritis, water isn’t absorbed well and won’t adequately replace lost electrolytes. Avoid giving your child apple juice for rehydration — it can make diarrhea worse.
  • Get your child back to a normal diet slowly. Gradually introduce bland, easy-to-digest foods, such as toast, rice, bananas and potatoes.
  • Avoid certain foods. Don’t give your child dairy products or sugary foods, such as ice cream, sodas and candy. These can make diarrhea worse.
  • Make sure your child gets plenty of rest. The illness and dehydration may have made your child weak and tired.
  • Avoid giving your child over-the-counter anti-diarrheal medications, unless advised by your doctor. They can make it harder for your child’s body to eliminate the virus.

If you have a sick infant, let your baby’s stomach rest for 15 to 20 minutes after vomiting or a bout of diarrhea, then offer small amounts of liquid. If you’re breast-feeding, let your baby nurse. If your baby is bottle-fed, offer a small amount of an oral rehydration solution or regular formula. Don’t dilute your baby’s already-prepared formula.

Preparing for your appointment

If you or your child needs to see a doctor, you’ll likely see your health care provider first. If there are questions about the diagnosis, your doctor may refer you to an infectious disease specialist.

What you can do

Preparing a list of questions will help you make the most of your time with your doctor. Some questions you might want to ask your or your child’s doctor include:

  • What’s the likely cause of the symptoms? Are there other possible causes?
  • Is there a need for tests?
  • What’s the best treatment approach? Are there any alternatives?
  • Is there a need to take medicine?
  • What can I do at home to ease the symptoms?

What to expect from your doctor

Some questions the doctor may ask include:

  • When did symptoms begin?
  • Have the symptoms been continuous, or do they come and go?
  • How severe are the symptoms?
  • What, if anything, seems to improve symptoms?
  • What, if anything, appears to worsen symptoms?
  • Have you been in contact with anyone with similar symptoms?

What you can do in the meantime

Drink plenty of fluids. Stick with bland foods to reduce stress on your digestive system. If your child is sick, follow the same approach — offer plenty of fluids and bland food. If you’re breast-feeding or using formula, continue to feed your child as usual. Ask your child’s doctor if giving your child an oral rehydration solution, available without a prescription at pharmacies, would help.

Oct. 16, 2018

Stomach flu: How long am I contagious?

How long am I contagious if I have the stomach flu?

You can be contagious from a few days up to two weeks or more, depending on which virus is causing your stomach flu (gastroenteritis).

A number of viruses can cause gastroenteritis, including noroviruses and rotaviruses. The contagious period — the time during which a sick person can give the illness to others — differs slightly for each virus.

  • Norovirus. With norovirus — the most common cause of viral gastroenteritis in adults — you’re contagious when you begin to feel ill. Symptoms usually appear within one to two days of exposure.

    Although you typically feel better after a day or two, you’re contagious for a few days after you recover. The virus can remain in your stool for up to two weeks or more after recovery.

    Children should stay home from school or child care for at least 48 hours after the last time they vomit or have diarrhea.

  • Rotavirus. Symptoms of rotavirus — the leading cause of viral gastroenteritis in infants and young children — usually appear one to three days after exposure. But you’re contagious even before you develop symptoms, and up to two weeks after you’ve recovered.

The viruses that cause gastroenteritis are spread through close contact with infected people, such as by sharing food or eating utensils, and by touching contaminated surfaces and objects. Eating contaminated food also can cause norovirus.

Washing your hands often with soap and water is the most effective way to stop the spread of these viruses to others. If you can’t wash your hands, use an alcohol-based hand sanitizer, which can reduce germs.

To help keep others from getting sick, disinfect contaminated surfaces immediately after someone vomits or has diarrhea. Wear disposable gloves, and use a bleach-based household cleanser or 2 cups (0.5 liters) of bleach in a gallon (3.8 liters) of water. Norovirus can survive for months on surfaces not adequately disinfected with bleach solution.

Also wear disposable gloves to immediately wash clothes or linens that might be contaminated.

Two oral rotavirus vaccines are available for young infants — RotaTeq and Rotarix. Vaccines for norovirus are in clinical trials.


Pritish K. Tosh, M.D.

  • Flu shot: Will it prevent the stomach flu?

March 04, 2020

Show references

  1. Norovirus. Centers for Disease Control and Prevention. http://www.cdc.gov/norovirus/about/index.html. Accessed Feb. 4, 2018.
  2. Matson DO. Acute viral gastroenteritis in children in resource-rich countries: Management and prevention. https://uptodate.com/contents/search. Accessed Feb. 4, 2018.
  3. Prevent the spread of norovirus. Centers for Disease Control and Prevention. https://www.cdc.gov/features/norovirus/index.html. Accessed Feb. 4, 2018.
  4. Viral gastroenteritis. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/viral-gastroenteritis. Accessed Feb. 4, 2018.

See more Expert Answers


Headache and Nausea: Causes and Treatment


National Headache Foundation: “American Migraine Study II: A Ten Year Report Card on the State of Migraine,” “Migraine,” “Menstrual Migraine,” “Glaucoma.”

American Academy of Family Physicians, familydoctor.org: “Headaches,” “Management of Cluster Headache,” “Food Poisoning.”

U.S. Department of Health and Human Services, womenshealth.gov: “Migraine.”

Vestibular Disorders Association: “Vestibular migraine.”

American Hearing Research Foundation: “Migraine Associated Vertigo.”

American Headache Society: “Migraine Variants in Children.”

National Digestive Diseases Information Clearinghouse: “Cyclic vomiting syndrome.”

WebMD Medical Reference: “Nausea medications for migraines and headaches.”

News release, FDA.

Mayo Clinic: “Cluster headache,” “Hangovers,” “Anxiety disorders,” “Chronic kidney disease,” “Depression (major depressive disorder),” “Nicotine (Inhalation Route),” “Strep throat,” “Stress management,” “Tonsillitis,” “Hyperglycemia in diabetes,” “Hypertensive crisis: What are the symptoms?” “Preeclampsia,” “Hyponatremia.

Alcohol Health & Research World: “Treatment of Alcohol Withdrawal.”

Brain Aneurysm Foundation: “Warning Signs/Symptoms.”

University of Arkansas for Medical Sciences: “TRIUMPH Traumatic Brain Injury Guidelines.”

Cancer.net: “Brain Tumor: Symptoms and Signs.”

News Release, Johns Hopkins Medicine.

American College of Allergy, Asthma & Immunology: “Allergy Headaches.”

National Health Service: “Hepatitis A.”

National Kidney Foundation: “3 Early Warning Signs of Kidney Disease.”

The Migraine Trust: “Hypoglycaemia.”

CDC: “Malaria,” “Yellow Fever,” “Middle East Respiratory Syndrome (MERS), “Scarlet Fever: All You Need to Know,” “Anthrax,” “Ebola (Ebola Virus Disease),” “Carbon Monoxide Poisoning,” “West Nile Virus.”

American Migraine Foundation: “Menstrual Migraine,” “Pregnancy Often Leads to Changes in Migraines.”

University of Rochester Medical Center: “Headaches in Early Pregnancy.”

Anxiety and Depression Association of America: “Headaches.”

Primary Care Companion: Journal of Clinical Psychiatry: “The Link Between Depression and Physical Symptoms.”

Johns Hopkins Medicine: “Conditions We Treat: Benign Paroxysmal Positional Vertigo (BPPV),” “Shigella Infections.”

Northwell Health: “Severe acute respiratory syndrome (SARS).”

National Capital Poison Control Center: “Food Poisoning.”

StatPearls: “Malignant Hypertension.”

NHS inform: “Labyrinthitis.”

Nemours/KidsHealth: “Encephalitis.”

National Organization for Rare Disorders: “Colorado Tick Fever,” “Toxic Shock Syndrome,” “Dengue Fever.”

Medline Plus: “Polio and Post-Polio Syndrome.”

Fairview Health Services: “Black Widow Spider Bite.”

European Society of Human Reproduction and Embryology: “ESHRE Guideline for the Diagnosis and Treatment of Endometriosis.”

Cleveland Clinic: “Altitude Sickness,” “Acoustic Neuroma.”

Medscape: “Leptospirosis.

Children’s Hospital of Philadelphia: “Fifth Disease.”

National Health Service (U.K.): “Addison’s disease.”

Cedars-Sinai: “HELLP Syndrome.”

Victoria State Government Better Health Channel: “Kidneys – medullary cystic kidney disease.”

UpToDate: “Coronavirus disease 2019 (COVID-19): Clinical features.”

Viral Gastroenteritis | Cedars-Sinai

Not what you’re looking for?

What is viral gastroenteritis?

Viral gastroenteritis is an inflammation, swelling, and irritation of the inside lining of your gastrointestinal tract. A virus causes this illness. It can infect your stomach, small intestine, and large intestine.

Viral gastroenteritis is very common. In most cases, it lasts only a few days and doesn’t require treatment. The biggest danger is dehydration from loss of fluid due to diarrhea and vomiting.

What causes viral gastroenteritis?

Several viruses can cause gastroenteritis. Viruses can be found in the vomit and the diarrhea of infected people. It can live for a long time outside the body. People who are infected can spread the virus to objects they touch, especially if they don’t wash their hands after using the bathroom. Food workers with the infection can spread it to others through food and beverages. Sewage that gets into the water supply can also spread the illness. Although viral gastroenteritis is sometimes called “stomach flu,” the seasonal influenza (flu) virus does not cause it.

Some of the common viruses that cause gastroenteritis include:

  • Rotavirus. This virus most commonly infects infants age 3 to 15 months. The illness lasts for 3 to 7 days and is most common in fall and winter.
  • Norovirus. This is the most common cause of adult infections and the virus that’s usually responsible for outbreaks on cruise ships. Symptoms last from 1 to 3 days and can occur any time of the year.
  • Adenovirus. This virus occurs year-round and affects children under age 2. Symptoms last from 5 to 12 days.

Many other viruses can also cause viral gastroenteritis.

What are the symptoms of viral gastroenteritis?

Symptoms of viral gastroenteritis usually begin about 1 to 2 days after the virus gets into the body.

Common symptoms include:

  • Nausea
  • Vomiting
  • Watery diarrhea

 Other possible symptoms are:

  • Headache
  • Fever
  • Chills
  • Stomachache

Signs of dehydration:

  • Decreased urine output
  • Dark-colored urine
  • Dry skin
  • Thirst
  • Dizziness

Signs of dehydration in young children:

  • Dry diapers (from a lack of urination)
  • Lack of tears
  • Dry mouth
  • Drowsiness
  • Sunken fontanel (the soft spot on the top of an infant’s head)

How is viral gastroenteritis diagnosed?

Your healthcare provider will most likely diagnose your condition based on your history and symptoms. You will rarely need testing. If your symptoms persist, your healthcare provider may ask for a stool sample to look for viruses, bacteria, and parasites.

Can viral gastroenteritis be prevented?

Vaccines are available to protect children from rotavirus. Healthcare providers give shots to babies before age 6 months. You and your children can help prevent viral gastroenteritis by taking these steps:

  • Wash hands for 20 seconds with soap and water after going to the bathroom, after changing a diaper, and before touching any food.
  • Use alcohol-based sanitizers.
  • If someone in the house has gastroenteritis, wash all surfaces that might be contaminated with a bleach-based cleaner.
  • Don’t
    eat or drink any food or water with warnings of contamination.

How is viral gastroenteritis treated?

Specific treatment is usually not needed. In most cases, you simply need to drink plenty of fluids and rest at home until the virus leaves your system. In rare cases, you may need treatment for severe dehydration, with IV (intravenous) fluids.

Helpful home care tips include:

  • Drink plenty of light fluids like water, ice chips, fruit juice, and broth. Keep in mind that sports drinks are high in sugar and are not appropriate if you are extremely dehydrated. In this case, you will need an oral rehydration solution.
  • Don’t
    have drinks that contain milk, caffeine, or alcohol.
  • Once you feel hungry again, start with mild, easy to digest foods.
  • Rehydrate children with oral rehydration solutions.
  • You may
    take antidiarrheal medicines for a couple days. But don’t take these if you have a
    fever or bloody stool. Don’t take them if you are an elderly adult.. Don’t give these
    to a child.

When should I call my healthcare provider?

Viral gastroenteritis is common in children and adults. In most cases, the disease is not serious and will run its course in a few days. Call your healthcare provider if you or a family member has vomiting or diarrhea that’s not getting better, if you see blood or tar-like stool, or if you have any signs of dehydration.

Key points about viral

  • Viral gastroenteritis is an inflammation of the inside lining of your gastrointestinal tract.
  • It can
    be caused by rotavirus, norovirus, adenovirus, and other viruses.
  • Babies can be vaccinated against rotavirus.
  • Symptoms of viral gastroenteritis are nausea, vomiting, and watery diarrhea.
  • Dehydration is the most serious complication of this illness.
  • This illness should run its course in a few days but may need medical attention of diarrhea or vomiting persists or if there are signs of dehydration.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider
    tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines,
    treatments, or tests. Also write down any new instructions your provider gives
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also
    know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or
  • If you have a follow-up appointment, write down the date, time, and purpose for that
  • Know how you can contact your provider if you have questions.

Not what you’re looking for?

Simple Ways to Determine if You Have a Stomach Bug or Food Poisoning

We all have those days when our tummy’s don’t agree with us. But how do you know if you’ve just got the bug du jour or if you ate some bad seafood?

Better yet— how do you know when it’s time to guzzle some Pepto or hop in the car and see a doctor?

Let’s look at the differences, symptoms and ways to keep our bellies happy.

What is food poisoning?

Food poisoning is an illness that can cause nausea, vomiting or diarrhea.  It is caused by eating food that contains germs, such as bacteria, viruses or parasites.

Two examples of bacteria that are common causes of food poisoning are Salmonella and E. coli.

What is viral gastroenteritis?

Viral gastroenteritis is an infection that can cause diarrhea and vomiting.  It happens when a person’s stomach and intestines get infected with a virus.

How can germs get into food? 

Germs can get in food in different ways:

  • People who are sick can spread their germs to the food they cook.
  • Germs can live in or on food.
  • Germs from one food can get on another when the same cutting board or knife are used.

How do I get gastroenteritis?

People can get the infection if they:

  • Touch an infected person or surface with the virus on it, and then don’t wash their hands.
  • Eat foods or drink liquids with the virus in them.

What are the symptoms of each?

  • Nausea or vomiting
  • Belly pain (can be either but more common with food poisoning)
  • Diarrhea that can be watery or bloody
  • Loss of appetite
  • Fever (can be either but more common with viral gastroenteritis)
  • Headache or muscle aches (more common with gastroenteritis)

Is there anything I can do on my own to feel better?

Yes.   You can:

  • Drink plenty of fluids so you don’t get dehydrated
  • Avoid drinking juice or soda as this can make diarrhea worse
  • Eat small meals and avoid eating foods with a lot of fat or sugar
  • Do NOT take anti-diarrhea medicines as these can make the infection last longer

When should I call a doctor/nurse or seek medical care?

  • If you have severe belly pain
  • Cannot eat or drink and have symptoms of dehydration (tired, dizzy, confused)
  • Vomiting blood or have blood in your bowel movements

Do I need to have tests?

No.  Not usually but your doctor may want to check for dehydration or determine which bacteria or virus is causing your infection.  This may include:

  • Blood tests
  • Urine tests
  • Tests on a sample of your bowel movement

How is food poisoning treated?

Many people do not need any treatment because their symptoms will get better on their own.  Some individuals may need specific antibiotics or IV fluids depending on their medical history, risk factors, symptoms and clinical signs.

How is viral gastroenteritis treated?

Again, many people do not need any treatment because their symptoms will get better on their own.  Antibiotics are NOT indicated in viral diseases.  Some individuals may benefit from IV fluids.

How can these conditions be prevented?

Pay attention to food safety

Wash your hands after you change a diaper, go to the bathroom, blow your nose, touch animals/pets, take out the trash and always before you eat.

With a little care and good sense, many common germs can be avoided and both stomach bugs and food poisoning will leave you and your loved ones alone!

Kids and the Stomach Flu

Gastroenteritis, also known as the stomach flu, is inflammation in the digestive tract, including the stomach and the small and large intestines. It is very common, especially in children. Although gastroenteritis is sometimes called “stomach flu,” the seasonal influenza (flu) virus does not cause it. It is most commonly caused by a virus, such as the rotavirus, but may also be caused by bacteria or parasites. Vaccines are available to protect children from rotavirus. Your pediatrician can explain your options for vaccinating your baby.

Viruses that cause the stomach flu can be found in the vomit and diarrhea of infected people. They can live for a long time outside the body. People who are infected with the virus can spread it to objects they touch, especially if they do not wash their hands after using the bathroom or changing a diaper.

Symptoms of the stomach flu usually begin about one to two days after the virus gets into the body. Common symptoms include nausea, vomiting and watery diarrhea. Other possible symptoms are headache, fever, chills and stomachache.

“The most dangerous consequence of the stomach flu is dehydration,” says Dr. Jeffrey Ho, CHOC pediatric gastroenterologist. “Infants and young children in particular can become dehydrated very easily. Call your child’s doctor right away if you notice any signs of dehydration.”

Parents should watch carefully for signs of dehydration which include decreased urine output, dark-colored urine, dry skin, thirst and dizziness. In younger children, signs of dehydration are dry diapers (from a lack of urination), lack of tears, dry mouth, drowsiness and sunken fontanel (the soft spot on the top of an infant’s head).

In most cases, your child should drink plenty of fluids and rest at home until the virus leaves their system. Helpful home care tips include:

  • Have your child drink plenty of light fluids like ice chips, water, diluted fruit juice and broth. Start with small, frequent volumes and increase slowly as tolerated. For older children, keep in mind that sports drinks are high in sugar and may not be appropriate if they are extremely dehydrated.
  • For infants and younger children, ask your child’s doctor if you should rehydrate your child with an oral rehydration solution such as Pedialyte or Enfalyte. These fluids have the right balance of water, sugar and salts. Some are available as popsicles.
  • It can be dangerous to give plain water to a baby and too much plain water to kids of any age.
  • Avoid drinks that contain milk and caffeine.
  • Keep breastfeeding or feeding your baby formula, but only if they are able to keep it down.
  • Once your child feels hungry again, start with mild, easy to digest foods.

In rare cases, children may need treatment for severe dehydration with IV (intravenous) fluids.

Diarrhoea and vomiting – NHS

Diarrhoea and vomiting are common in adults, children and babies. They’re often caused by a stomach bug and should stop in a few days.

The advice is the same if you have diarrhoea and vomiting together or separately.

How to treat diarrhoea and vomiting yourself

You can usually treat yourself or your child at home. The most important thing is to have lots of fluids to avoid dehydration.


  • stay at home and get plenty of rest

  • drink lots of fluids, such as water or squash – take small sips if you feel sick

  • carry on breast or bottle feeding your baby – if they’re being sick, try giving small feeds more often than usual

  • give babies on formula or solid foods small sips of water between feeds

  • eat when you feel able to – you do not need to eat or avoid any specific foods

  • take paracetamol if you’re in discomfort – check the leaflet before giving it to your child


  • do not have fruit juice or fizzy drinks – they can make diarrhoea worse

  • do not make baby formula weaker – use it at its usual strength

  • do not give children under 12 medicine to stop diarrhoea

  • do not give aspirin to children under 16

How long diarrhoea and vomiting last

In adults and children:

  • diarrhoea usually stops within 5 to 7 days
  • vomiting usually stops in 1 or 2 days

Diarrhoea and vomiting can spread easily


Stay off school or work until you’ve not been sick or had diarrhoea for at least 2 days.

To help avoid spreading an infection:


  • wash your hands with soap and water frequently

  • wash any clothing or bedding that has poo or vomit on it separately on a hot wash

  • clean toilet seats, flush handles, taps, surfaces and door handles every day


  • do not prepare food for other people, if possible

  • do not share towels, flannels, cutlery or utensils

  • do not use a swimming pool until 2 weeks after the symptoms stop

A pharmacist can help with diarrhoea and vomiting

Speak to a pharmacist if:

  • you or your child (over 5 years) have signs of dehydration – such as dark, smelly pee or peeing less than usual
  • you need to stop diarrhoea for a few hours

They may recommend:

  • oral rehydration sachets you mix with water to make a drink
  • medicine to stop diarrhoea for a few hours (like loperamide) – not suitable for children under 12


Call a pharmacy or contact them online before going in person. You can get medicines delivered or ask someone to collect them.

Urgent advice: Get advice from 111 now if:

  • you’re worried about a baby under 12 months
  • your child stops breast or bottle feeding while they’re ill
  • a child under 5 years has signs of dehydration – such as fewer wet nappies
  • you or your child (over 5 years) still have signs of dehydration after using oral rehydration sachets
  • you or your child keep being sick and cannot keep fluid down
  • you or your child have bloody diarrhoea or bleeding from the bottom
  • you or your child have diarrhoea for more than 7 days or vomiting for more than 2 days

111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need one.

Go to 111.nhs.uk or call 111.

Other ways to get help

Get an urgent GP appointment

A GP may be able to help you.

Ask your GP practice for an urgent appointment.

Check with the GP surgery before going in. A GP may speak to you on the phone.

Immediate action required: Call 999 or go to A&E if you or your child:

  • vomit blood or have vomit that looks like ground coffee
  • have bright green or yellow vomit
  • might have swallowed something poisonous
  • have a stiff neck and pain when looking at bright lights
  • have a sudden, severe headache or stomach ache

What we mean by severe pain

Severe pain:
  • always there and so bad it’s hard to think or talk
  • you cannot sleep
  • it’s very hard to move, get out of bed, go to the bathroom, wash or dress
Moderate pain:
  • always there
  • makes it hard to concentrate or sleep
  • you can manage to get up, wash or dress
Mild pain:
  • comes and goes
  • is annoying but does not stop you doing things like going to work

Causes of diarrhoea and vomiting

You probably will not know exactly what the cause is, but the main causes of diarrhoea and vomiting are treated in the same way.

The most common causes are:

Other causes of diarrhoea or vomiting

Diarrhoea can also be caused by:

Vomiting can also be caused by:

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Page last reviewed: 07 December 2020
Next review due: 07 December 2023

90,000 Can COVID-19 be recognized by the first symptoms?

With the approach of autumn and winter, and with them cold weather and the period of colds and flu, and at a time when the coronavirus pandemic reappears in many countries of the world, the question becomes more and more urgent: “How to distinguish the symptoms of these viral respiratory diseases?” . .. The answer to this question was sought by researchers in the United States, who showed: although the symptoms of these diseases overlap, the decisive factor in the definition is likely to be the sequence in which these symptoms occur, writes Radio Svoboda.

As this study shows, in particular, the flu most often starts with a cough, while the first symptom of COVID-19 is fever. But both researchers and other doctors note that this is the most likely move – but not the only possible one, there are other cases.

The study, published back in mid-August using data available at the time, concludes that, from a statistical point of view, the most typical sequence of onset of symptoms, which are easiest to recognize, with the coronavirus disease COVID-19 is different than with other significant viral respiratory diseases – in particular, with flu or with ARVI.

After all, the symptoms of COVID-19, such as a fever or cough, are very similar to the symptoms of a number of other common diseases, such as the seasonal flu or the common cold.

Now a study at the University of Southern California in the United States has determined that symptoms of these diseases most often occur in a certain sequence – in each differently, according to the online publication Healthline .

This can help people with COVID-19 to quickly go into self-isolation and receive the necessary treatment, which is important for the patients themselves and for their environment.

COVID-19 and influenza

Researchers studied data from about 57 thousand cases of this coronavirus disease from China, as well as data from almost 2500 cases of influenza from different parts of the world.

And, according to the study, the most likely sequence of onset of syndromes in COVID-19 is as follows:

  • high temperature,
  • cough and muscle pain,
  • nausea or vomiting,
  • diarrhea (severe indigestion).

And in the case of seasonal flu, the cough usually occurs before the fever.

In more detail, the researchers present the sequence of symptoms in coronavirus disease as follows:

  • fever,
  • fever and cough;
  • fever, cough, sore throat, headache, muscle pain;
  • fever, cough, sore throat, headache, muscle pain, nausea and vomiting;
  • fever, cough, sore throat, headache, muscle pain, nausea and vomiting, diarrhea.

Moreover, according to the researchers, such a course is most likely, regardless of the severity of the disease.

In the case of seasonal flu, the most common sequence is:

  • cough and muscle pain;
  • cough, muscle pain and headache;
  • cough, muscle pain, headache and sore throat;
  • cough, muscle pain, headache, sore throat and fever;
  • cough, muscle pain, headache, sore throat, fever, diarrhea, nausea and vomiting.

At the same time, doctors pay attention that with COVID-19, the cough is often dry.

Other variants are possible

New York City Emergency Physician Robert Glatter commented on this study for Healthline, the results may be useful in evaluating large numbers of patients admitted to the hospital.

But, he notes, the flu often begins abruptly with three symptoms at once – such as back pain, a feeling of frost and a dry cough. Likewise, he warned, a new coronavirus disease could start with other symptoms.

According to the doctor, fever is really usually called the most common first symptom of COVID-19 – but, in the experience of his hospital, the reality is much more varied: people who have been diagnosed with this disease have been admitted, and generally without fever, cough or other symptoms respiratory diseases.

According to the specialist, among the important clinical signs by which COVID-19 can be distinguished from seasonal flu is an unexpected loss of smell and taste, as well as skin reactions such as itching or swelling and redness of the toes.

Other researchers also compare the symptoms of COVID-19 and flu to those of common colds, that is, acute respiratory viral infections, as well as allergy symptoms, which may also be similar. But, experts note, they are still somewhat different.

In particular, the most important difference between COVID-19 and influenza is that influenza usually does not have such a strong feeling of shortness of breath as with coronavirus infection, writes Healthline.

And a runny nose or eye irritation are common symptoms of allergies or the common cold, but they are atypical for COVID-19 – there it is primarily a fever, general fatigue and a dry cough.

Also with allergies, symptoms such as sneezing or coughing are more chronic.

Someone has symptoms, some don’t

The American Centers for Disease Control and Prevention lists 11 main signs of coronavirus infection:

  • fever or cold sensation,
  • cough,
  • feeling short of breath or shortness of breath,
  • fatigue,
  • muscle or body pain,
  • headache,
  • sore throat,
  • loss of sense of smell and taste,
  • stuffy nose or runny nose,
  • nausea or vomiting,
  • diarrhea.

But, pay attention to the World Health Organization, some are infected with the new coronavirus without any symptoms at all and do not feel bad at the same time. But such people can still transmit the virus to everyone around them, although they themselves do not feel sick.

Symptoms of coronavirus disease do not appear immediately after infection: in different cases, they become noticeable 2-14 days after the virus enters the body.

Be careful!

At the same time, according to doctors, some signs of COVID-19 mean that you need to seek help immediately.In particular, this is (but the list is not exhaustive):

  • difficulty breathing,
  • Continuous chest pain or pressure,
  • loss of mental orientation,
  • inability to wake up and get out of bed or stay blindfolded,
  • blue lips or face.

And it is also very important to realize, experts say, that the appearance of any symptoms of coronavirus disease means that a person with these symptoms must take all measures to prevent the spread of the disease.This is, first of all, self-isolation, or at least maintaining sufficient physical distance, wearing a mask and enhanced hygiene measures, frequent and thorough hand washing.

As noted by physician Robert Glatter, it is important to remember that the new coronavirus is twice or three times more infectious than the flu virus.

Coronavirus infection COVID-19

Coronavirus SARS-CoV-2 , formerly known as 2019-nCoV , was discovered in China at the end of 2019.

It causes diseases COVID-19 .In some cases, the course of the disease is mild, in others – with symptoms of colds and flu, including fever and cough. This can develop into pneumonia, which can be fatal. Most patients recover; predominantly people with weakened immune systems, in particular the elderly, die.

On March 11, 2020, the World Health Organization recognized the outbreak of the disease caused by the new coronavirus as a pandemic.

Temperature, vomiting, abdominal pain …

Date of publication: .Category: News.

Summer is the time of vacations and vacations. Understandably, the desire of parents to pamper their children with fresh vegetables, fruits and berries from the garden, take them to swim in the nearest body of water. But the joy of communicating with nature can be overshadowed by an enterovirus infection.

The beginning of the epidemic rise of this disease, as a rule, falls on June, and the peak – in August-September. Last year, 14 cases of enterovirus infection were registered in the district (4 cases – gastroenteritis.10 – herpangins). In the region, 481 such cases were registered, of which 459 were in children.

– A common symptom for all types of this infection is fever and a sharp rise in temperature, which usually lasts for 3-5 days, – says the infectious disease doctor of the district hospital E. V. Vasilieva. – If the infection is intestinal, the child will have abdominal pain, diarrhea and vomiting. If the mucous membranes are attacked, signs of a respiratory disease will appear – a runny nose, cough, sore throat.

Well, if at a high temperature the child has a headache, vomiting does not stop, there is photophobia, the doctor already has reason to suspect serous-viral meningitis.

– Enterovirus infection is a “disease of dirty hands,” continues Elena Viktorovna. – The name is one, but there are a great many diseases that can be attributed to this type. It affects not only the gastrointestinal tract. It can affect the mouth and eyes. Becoming the cause of herpetic sore throat or conjunctivitis can cause fever with or without a rash, and can also cause very serious diseases such as serous viral meningitis or encephalitis.

The exact same answer to the question of whether the child has an enterovirus infection, and what kind of virus infected him, will only help laboratory tests.

Enterovirus most often affects children under the age of 10. The most likely way of infection is waterborne. The virus can enter the body when children splash in bodies of water and swallow water. Or if they drink unboiled water.

Airborne droplets and contact-household are also options for a wide spread of infection, primarily among organized preschool children and primary schoolchildren.Food products, in particular fresh vegetables, fruits, berries, can also be a source of infection.

How to protect yourself from infection? First of all, follow the rules of personal hygiene. Use boiled or bottled water for drinking. Be sure to wash your hands with soap and water before eating and after each visit to the toilet. Ventilate the rooms more often and carry out wet cleaning in the apartment.

Before use, vegetables and fruits (including bananas, watermelons, kiwi) should be thoroughly washed with a brush and soap and rinsed with boiling water.The same goes for eggs. You should not purchase food products from individuals, in places not designated for trade.

Swim – only in officially approved places, when bathing, try to prevent water from getting into your mouth.

If you still did not manage to protect yourself from the disease, and you have clinical manifestations of an infectious disease, do not self-medicate, but seek qualified medical help!

90,000 Intestinal infections – Easier to prevent than cure


When in the summer your eyes simply run up from the abundance of vegetables and fruits, you want to try everything you see.And then for some reason I remember that there is nowhere to wash my hands before sending that strawberry … or that peach into my mouth … And they shamelessly lie and seduce with their ruddy sides, promising an unearthly taste with their whole appearance.

What are intestinal infections?

There are quite a few causative agents of intestinal infections – it can be both bacteria and different types of viruses that enter the body along with poor-quality or unsanitary food, with unwashed vegetables and fruits, through contact of food and dishes with dirty hands, etc.e. As you can see – mainly through the mouth. And, once in the body, these uninvited guests develop vigorous activity there, as a result of which a person feels bad.

Common signs of acute intestinal infections are a feeling of weakness, headache, and fever. These signs are the more pronounced, the more the organism is poisoned. And each gastrointestinal disease has its own special symptomatology.

If the stomach is damaged, then we are talking about gastritis.The most common signs are that the upper abdomen begins to hurt, vomiting and nausea are also present.

If the small intestine is affected, the diagnosis of enteritis is made. The doctor can determine this if there are complaints of abdominal pain, bloating, liquid watery diarrhea (possibly even with mucus or greens) – this indicates a malfunction in the process of digestion and absorption of food.

Pathologies in the work of the large intestine are called colitis. If there are greens, mucus or streaks of blood in the stool, the desire to visit the toilet is accompanied by severe pain and cramping pains periodically appear in the abdomen – this is it.

But in real life, it rarely happens that only one part of the gastrointestinal tract is affected. Basically, several sections come under attack – if the large and small intestines, then the diagnosis will sound like “enterocolitis”, if the stomach and small intestines – then it will already be gastroenteritis, if the entire digestive tract is affected – this is called gastroenterocolitis.

Just do not delude yourself that with a cold snap, intestinal infections will also “hibernate”.The autumn-summer bacterial infections in winter and spring are replaced by their viral relatives. So the principle “forewarned is forearmed” will never be superfluous.

Types of intestinal infections

Dysentery, it is also shigellosis (the second name is due to the fact that it is caused by bacteria of the genus Shigella) can be picked up from a carrier or a sick person. Shigella bacteria are quite tenacious – they are cold-resistant, can live for quite a long time in food (especially dairy products) and water.The incubation period for dysentery is 2-3 days. It is determined with symptoms such as fever, lack of appetite, lethargy, frequent but scanty stools streaked with blood or mucus, and abdominal pain. Vomiting can be only on the first day, no more than a couple of times.

Salmonellosis caused by bacteria of the genus Salmonella is transmitted not only from a sick person, but also from domestic animals (chickens, cows, etc.). These bacteria can live for a long time in water and food (meat, eggs, dairy products) and are resistant to low temperatures.Once in a warm environment, bacteria begin to multiply diligently, resulting in the formation of toxic substances. The incubation period is from four hours to two days, the symptoms are fever, abdominal pain, lack of appetite, weakness (doesn’t it look like dysentery?). To differentiate from dysentery, look for frequent loose stools and profuse vomiting.

Rotavirus infection got its name due to the fact that outwardly its pathogen resembles a wheel in shape (in Latin – rota).You can get it only from a sick person (he is considered contagious 7-10 days from the onset of the disease). Since this virus easily tolerates cold weather, the peak of the incidence of rotavirus infection occurs just in the cold season (late autumn-winter-early spring). Symptoms of the disease are fever up to 38 ° C (maybe higher), lack of appetite, pain in the upper abdomen, frequent vomiting, very frequent bowel movements, loose stools. The incubation period for this disease is 1-2 days, but with the transferred rotavirus, a person is provided with immunity for life.

Norovirus infection comes from the enterovirus family. The most unpleasant thing about this sore is the incredible vitality of its pathogen: norovirus, which is called “does not burn in fire and does not drown in water.” It will not only easily survive being in water, heating up to 60 ° C, but also freezing and drying. And when it enters the human body, after a few hours, it manages to do a lot of trouble. With this infection, the rise in temperature is minimal, but with nausea, abdominal pain, and diarrhea.After a couple of days, the condition may stabilize, but the person will be contagious for several more weeks. So wind it up.

Foodborne infection (as doctors call poisoning in a tricky way) is also considered an intestinal infection, it is provoked by such bacteria as Klebsiella, Staphylococcus aureus, Escherichia coli or Proteus. The most frequent places of “residence” of this muck are cream cakes and pastries, milk and dairy products, cottage cheese, sausages, which are stored incorrectly (for example, in the heat).

Sometimes it also happens that there are no pronounced symptoms in a person, but pathogenic bacteria (the same Escherichia coli, etc.) are found in the analyzes. This is called “bacterial carrier” and carries a latent threat – the spread of infection, without even knowing about its presence. In this case, treatment is required until the host is fully recovered.

How to avoid intestinal infection?

It is easier to prevent a nuisance than to get rid of its consequences later.The most important thing is hygiene. The slogan “Wash your hands before eating” hung in Soviet canteens does not lose its relevance today. And to be more specific – not only before eating, but also after using the toilet, after returning from the street. If you want to have a snack in the city and there is no way to wash your hands, carry at least wet wipes or a bottle of antibacterial gel with you.

If you intend to cook or eat raw vegetables and fruits, they must be thoroughly washed under running water.Would you like to treat a child with a berry? Remember – it is especially necessary to wash strawberries very carefully, as they are in contact with the ground. Dairy products, meat, sausages, ready-made salads are the safest to buy in retail outlets equipped with refrigerators. Store them at home only in appropriate conditions, do not leave them on the table for a long time, especially in the heat, and if the expiration date has expired, throw them away. Greed can be thrown up for the money thrown away, but treating an intestinal infection can be more expensive. Will it be more convincing?

If you are going to cook food for the whole family, just in case, keep in mind that it is best to store the prepared dishes even in the refrigerator for no more than two days.And try to drink only bottled or boiled water. Without a refrigerator, such water can withstand from six to eight hours, then the effect of boiling is reduced to almost zero and you have to boil it again.

So take precautions and let infections pass you by!

Foodborne Disease Listed Pathogens

Click on a pathogen name for information on:

  • Food is commonly associated with each pathogen.
  • Symptoms of the victim’s illness.
  • controls or steps a food establishment can take to limit or prevent the spread of a pathogen.
  • Onset , that is, from the moment the victim is exposed to the pathogen until symptoms begin to appear.
  • Duration The amount of time that symptoms persist.

Visit List of Foodborne Illnesses for Cooking Temperature, Pathogens and Control for Specific Foods.

    1. Pathogen: Anisakis Simplex
      • Type: Parasite
      • Onset: One hour to two weeks
      • Duration: 928
      • 4 Up to three weeks3

        74 Up to three weeks

        • raw or undercooked seafood, including
          • cod
          • haddock
          • fluke
          • Pacific salmon
          • herring
          • flounder
          • Monkfish
      • Most common symptoms: Anis Diagnosed when the affected person feels a tingling or tickling sensation in the throat and coughs or manually pulls out the nematode.
      • In more severe cases, there is acute abdominal pain, very similar to acute appendicitis, accompanied by nausea.
    2. Control:
      • Cook fish to the minimum prescribed core temperature.
      • Use fish from certified suppliers.
      • If the supplier has not treated the fish for parasites, freeze fish to -35 ° C (-31 ° F) or below for 15 hours, or to -20 ° C (-4 ° F) or below for seven days.

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    1. Causative agent: Bacillus cereus
      • Type: Bacteria
      • Onset: One to hours
      • 24 hours

      • Food:
        • dairy products
        • vegetables
        • fish
        • rice
        • potatoes
        • pasta
      • Symptoms:
        • watery diarrhea
        • abdominal cramps
        • pain
        • vomiting occurs mainly with the vomiting type of syndrome
      • Management:
        • Ensure good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.
        • Hold, refrigerate, and reheat food properly.

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    1. Causative agent: Campylobacter
      • Type: Bacteria
      • Onset: Two to five days
      • -XNUMX days

      • Food:
        • raw and undercooked chicken
        • raw and improperly pasteurized milk
        • raw shellfish
        • unchlorinated water
      • Symptoms:
        • diarrhea that can be watery or watery contain blood
        • fever
        • abdominal pain
        • nausea
        • Headache
        • muscle pain
      • Administration:
        • Ensure good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.
        • Provide adequate water treatment.

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    1. Causative agent: Cigarette poisoning
      • Type: Natural toxin
      • Onset: Six hours
      • seven days

      • Food:
        • Marine fish most frequently involved in ciguatera poisoning include
          • perches
          • barracuda
          • perches
          • Nests
          • mackerel
          • triggerfish
      • 26 Symptoms: 26 Symptoms: 26 and tingling in the mouth, which can spread to the extremities
      • nausea
      • vomiting
      • diarrhea
      • headache
      • temperature
      • sensory treatment
      • acute sensitivity to extreme temperatures
      • dizziness
      • muscle weak awn to prostration point
      • arrhythmia
      • bradycardia or tachycardia
      • blood pressure lowering
    2. Management:
      • Obtain fish from approved suppliers.

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    1. Causative agent: Clostridium botulinum
      • Type: Bacteria
      • Onset: 1827 – 36 hours

        0 death without antitoxin

      • Food:
        • Improperly canned food.
        • Reduced Oxygenated Food (ROP).
        • Temperature overused vegetables such as baked potatoes.
        • Unrefined garlic-oil mixtures.
      • Symptoms:
        • Weakness and dizziness, accompanied by double vision and progressive difficulty speaking, breathing and swallowing.
        • There may also be bloating and constipation.
        • The toxin eventually causes paralysis, which suppresses breathing and leads to death by asphyxiation.
      • Management:
        • Ensure good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.
        • Hold, refrigerate, and reheat food properly.
        • Inspect the cans for damage.

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    1. Causative agent: Clostridium Perfringens
      • Type: Bacteria
      • Onset: 24
      • Duration: hours
      • Food:
        • beef
        • pork
        • lamb
        • chicken
        • turkey
        • produces
      • Symptoms:
        • intense abdominal cramps
        • vomiting
        • 9003

        • diarrhea
        • Office:

          • Ensure good personal hygiene and hand washing.
          • Cook food to the minimum prescribed core temperature.
          • Use correct food handling to prevent contamination.
          • Keep food at the correct temperature.
          • Hold, refrigerate, and reheat food properly.

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    1. Causative agent: Cryptosporidium parvum
      • Type: Parasite
      • Onset: 100004
      • Usually two to four days, but can last up to two weeks.
      • Food:
        • Cryptosporidium parvumis is commonly associated with contaminated water, but because it is spread through the faecal-oral route, it can be transmitted through any contaminated food.
      • Symptoms:
        • frequent watery diarrhea
        • nausea
        • vomiting
        • abdominal cramps
        • low fever
      • Management:
        • Ensure good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.
        • Avoid untreated water.

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    1. Causative agent: Cyclospora cayetanensis
      • Type: Parasite
      • Onset eight days:
      • a few weeks to a month
      • Food:
        • Cyclospora cayetanensis is commonly associated with raspberries, but because they are spread by the faecal-oral route, they can be taken from any food contaminated by an infected person.
      • Symptoms:
        • watery diarrhea
        • loss of appetite
        • weight loss
        • bloating and cramps
        • increased flatulence
        • nausea
        • fatigue
        • low fever
        • 9003


        • Provide good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.
        • Wash food thoroughly.

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    1. Causative agent: E. coli 0157: H7
      • Type: Bacteria
      • Onset:
      • Duration: Eight days
      • Food:
        • beef
        • contaminated vegetables
      • Symptoms:
        • abdominal pain
        • diarrhea, which may be bloody
        • vomiting
        • fever
        • Office:

          • Ensure good personal hygiene and hand washing.
          • Cook food to the minimum prescribed core temperature.
          • Use correct food handling to prevent contamination.
          • Keep food at the correct temperature.
          • Obtain products from approved suppliers.
          • Keep staff who have diarrhea or have been diagnosed with hemorrhagic colitis outside of surgery.

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    1. Exciter: Giardia duodenalis
      • Type: Parasite
      • Onset: 9003 9003 9000 Two to six weeks
      • Food:
        • Giardia duodenalis is commonly associated with untreated water from lakes and streams, but because it is spread through the faecal-oral route, it can be transmitted through any contaminated food.
      • Symptoms:
        • diarrhea
        • gas or flatulence
        • fatty stools that float
        • stomach or abdominal cramps
        • indigestion or nausea
        • dehydration
      • Control:
        • personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.
        • Avoid untreated water.

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    1. Causative agent: Hepatitis A
      • Type: virus
      • Onset: 15 in 50 days
      • From one to two weeks
      • Food:
        • Hepatitis A virus has been found in human feces and is associated with ready-to-eat foods and shellfish from contaminated water.
        • A person with hepatitis A is contagious before symptoms appear.
      • Symptoms:
        • fever
        • anorexia
        • nausea
        • lethargy
        • dark urine
        • jaundice
        • enlarged and painful liver
      • Control:

        • or diagnosed with hepatitis A.
        • Hand Wash – It is very important to wash your hands.
        • Avoid bare hand contact with ready-to-eat foods.
        • Obtain shellfish from approved suppliers.

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    1. Causative agent: Listeria
      • Type: Bacteria
      • Onset: Three days to three weeks 3
      • : 9000 -XNUMX days

      • Food:
        • raw or inadequately pasteurized milk
        • cheeses
        • ice cream
        • raw vegetables
        • raw and cooked poultry, meat and pork
        • raw and smoked fish
      • Symptoms:
        • Mild flu symptoms in healthy people.
        • Symptoms that may also occur include
          • fever
          • muscle pain
          • nausea
          • diarrhea
          • headaches
          • neck pain
          • confusion
          • loss of balance
        • May cause miscarriage in pregnant women …
      • Management:
        • Ensure good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.
        • Discard any product that has expired or expired.
        • Avoid using unpasteurized dairy products.

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    1. Causative agent: Fungal toxins
      • Type: Natural toxin
      • Onset: 15 minutes to 15 days From
      • 9000 two hours to several months
      • Food:
        • Mushroom poisoning is caused by eating raw or boiled fruit bodies (mushrooms, mushroom mushrooms) of a number of higher mushroom species.
      • Symptoms:
        • Symptoms range from mild indigestion to diarrhea and vomiting to seizures, coma and death.
      • Management:
        • Obtain mushrooms from approved suppliers.

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    1. Causative agent: Norovirus
      • Type: virus
      • Onset: 16 to 72 hours
      • 60 hours
      • 60 hours Food:
        • Noroviruses are found in human feces and are associated with ready-to-eat foods and shellfish from contaminated water.
      • Symptoms:
        • Diarrhea
        • Nausea
        • Vomiting
        • Abdominal Cramps
        • Headache
        • Body Pain
        • Chills
        • Malaise
        • Anorexia
        • Low Fever
        • 0

          • Avoid employees with diarrhea and vomiting or diagnosed with norovirus.
          • Hand Wash – It is very important to wash your hands.
          • Avoid bare hand contact with ready-to-eat foods.
          • Obtain shellfish from approved suppliers.

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    1. Causative agent: Salmonella
      • Type: Bacteria
      • Onset: 12 to 723 hours From one
      • 9000 9000 up to seven days

      • Food:
      • Symptoms:
        • Salmonella gastroenteritis (caused by any type of Salmonella except salmonella typhi):
          • Mild, prolonged diarrhea.
        • Typhoid fever (caused by salmonella typhi ):
          • nausea
          • vomiting
          • abdominal cramps
          • diarrhea
          • fever
          • chills
          • low fever
          • muscle pain
          • Headache
        • Management:
          • Ensure good personal hygiene and hand washing.
          • Cook food to the minimum prescribed core temperature.
          • Use correct food handling to prevent contamination.
          • Keep food at the correct temperature.

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    1. Causative agent: Scromboid poisoning
      • Type: Natural toxin
      • Onset: Three at once to
      • hours to several days

      • Food:
        • Fish products implicated in the poisoning by fraudsters include
          • tuna (e.g. skipjack and yellowfinch)
          • Mahi Mahi
          • blue fish
          • sardines
          • mackerel
          • Amberjack
          • abalone
      • Symptoms:
        • Initial symptoms may include
          • tingling or burning sensation in the mouth,
          • rash on the upper body and
          • a drop in blood pressure.
          • Headaches and itching of the skin are common.
        • Symptoms may progress to nausea, vomiting and diarrhea and may require hospitalization, especially in elderly or debilitated patients.
      • Management:
        • Obtain fish from trusted suppliers.

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    1. Causative agent: Shellfish toxins
      • Type: Natural toxin
      • Onset: 3027 to hours
      • Three to five days

      • Food:
        • Shellfish poisoning is caused by a group of toxins created by the planktonic algae that shellfish feed on.
        • All molluscs (filter-fed molluscs) are potentially toxic.
          • PSP is commonly associated with mussels, clams, barnacles and scallops.
          • NSP is associated with shellfish harvested along the Florida coast and the Gulf of Mexico.
          • DSP is associated with mussels, oysters and scallops.
          • ASP is associated with mussels.
      • Symptoms:
        • In the case of PSP, the effects are predominantly neurological and include tingling, burning, numbness, drowsiness, incoherent speech and respiratory paralysis.
        • DSP is mainly seen as a mild gastrointestinal disorder.
        • Symptoms of NSP are tingling and numbness of the lips, tongue and throat, muscle pain, dizziness, changes in hot and cold sensations, diarrhea and vomiting.
        • ASP is characterized by gastrointestinal disorders (vomiting, diarrhea, abdominal pain) and neurological problems (confusion, memory loss, disorientation, convulsions, coma).
      • Management:
        • Obtain shellfish from approved suppliers.

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    1. Exciter: Shigella spp.
      • Type: Bacteria
      • Offensive: 12 to 96 hours
      • Duration: 14-XNUMX days
      • Food:
        • Salads (potatoes, tuna, shrimp, pasta, chicken)
        • raw vegetables
        • milk and dairy products
        • fruits
        • baked goods
        • ready meals
      • Symptoms:
        • diarrhea, which can be watery or bloody
        • fever
        • nausea
      • 04


        • Provide good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.

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    1. Causative agent: Staphylococcus aureus
      • Type: Duration of bacteria
      • Onset: hours
      • Food:
        • Staph is common in the nasal passages, throat, hair and skin.
        • Food agents are the main source of contamination.
      • Symptoms:
        • nausea
        • vomiting
        • urge to vomit
        • abdominal cramps
        • diarrhea
        • prostration (complete physical or mental exhaustion)
        • Management:
          • hygiene and hand washing.
          • Cook food to the minimum prescribed core temperature.
          • Use correct food handling to prevent contamination.
          • Keep food at the correct temperature.
          • Reheat food correctly.

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    1. Pathogen: Taenia saginata and Taenia Solium
      • Type: Parasite
      • Typically
      • food: or pork.
    2. Symptoms:
      • Tapeworms are usually asymptomatic.However, severe infection often results in
        • weight loss
        • dizziness
        • abdominal pain
        • diarrhea
        • headaches
        • nausea
        • constipation
        • chronic stomach upset
        • loss of appetite
      • obstruction, and this can be corrected with surgery.
      • Tapeworm can also expel antigens that can cause an allergic reaction in humans.
    3. Management:
      • Ensure good personal hygiene and hand washing.
      • Cook food to the minimum prescribed core temperature.
      • Use correct food handling to prevent contamination.
      • Keep food at the correct temperature.
      • Obtain beef and pork from certified suppliers.

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    1. Causative agent: Toxoplasma gondii
      • Type: Parasite
      • Feeding:
        • It is spread by the faecal-oral route and can be transmitted through any contaminated food.
        • This is due to undercooked, contaminated meat (especially pork, lamb and venison).
      • Symptoms:
        • Healthy people infected with Toxoplasma gondii usually show no symptoms or have mild “flu-like” symptoms.
        • In newly infected pregnant women, this can cause miscarriage, stillbirth, or in a baby, vision loss, mental disability and seizures.
      • Management:
        • Ensure good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.

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    1. Causative agent: Trichinella spiral
      • Type: Parasite
      • Onset:
      • hours to two From a few weeks to a month
      • Food:
        • Usually associated with pork.
      • Symptoms:
        • nausea
        • vomiting
        • sweating
        • diarrhea
        • Facial edema and fever may occur five to seven days after the onset of symptoms.
        • After 10 days, severe muscle pain, difficulty breathing, weakening of pulse and blood pressure, heart damage and various nervous disorders may occur, eventually leading to death due to heart failure, respiratory complications or kidney failure.
      • Control:
        • Cook food to the minimum prescribed core temperature.
        • Obtain pork from a certified supplier.

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    1. Exciter: Vibrio spp.
      • Type: Bacteria
      • Offensive: four hours to five days
      • Duration: Three to seven days Vibro vulnificus can be fatal within three days.
      • Food:
        • raw and undercooked fish
        • Clams / oysters
      • Symptoms:
        • nausea
        • vomiting
        • abdominal pain
        • diarrhea
        • fever
        • Headache
        • Shock
        • Sepsis
      • Management:
        • Obtain seafood from an approved source.
        • Provide good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.

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    1. Exciter: Yersinia spp.
      • Type: Bacteria
      • Offensive: 11 days
      • Duration: One to three days
      • Food:
        • meat
        • oysters
        • fish
        • raw milk
      • Symptoms:
        • Diarrhea and / or vomiting, but fever and abdominal pain are the hallmarks.
        • Yersinia infections mimic appendicitis, resulting in unnecessary surgery.
        • Yersiniosis is known to cause death in rare cases.
      • Management:
        • Ensure good personal hygiene and hand washing.
        • Cook food to the minimum prescribed core temperature.
        • Use correct food handling to prevent contamination.
        • Keep food at the correct temperature.

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Adverse events in people taking macrolide antibiotics

Review question

We wanted to find out if people taking macrolide antibiotics experience more adverse events than those taking placebo.


Macrolide antibiotics are a group of antibiotics commonly used to treat acute and chronic infections.The four most commonly used macrolides are azithromycin, clarithromycin, erythromycin, and roxithromycin. People taking macrolide antibiotics are at risk of adverse events such as nausea, diarrhea, and rash.

Search Date

We searched the literature up to May 2018.

Research characteristics

We included 183 studies with 252,886 participants. Most of the studies were conducted in a hospital setting.Azithromycin and erythromycin have been studied to a greater extent than clarithromycin and roxithromycin. Most of the studies (89%) reported some adverse event, or at least stated that there were no adverse events.

Sources of research funding

Pharmaceutical companies supplied investigational drugs or funded research, or both, in 91 studies. Funding sources were unclear in 59 studies.

Key findings

People treated with macrolide antibiotics experienced gastrointestinal adverse events such as nausea, vomiting, abdominal pain, and diarrhea more often than those treated with placebo.

Taste disturbance was reported more often by people taking macrolides than people taking placebo. However, since few studies have reported these adverse events, these results should be interpreted with caution.

Hearing loss was reported more frequently by people taking macrolide antibiotics, but only four studies reported this outcome.

Macrolides caused less cough and fewer respiratory tract infections than placebo.

We found no evidence that macrolides cause more heart problems, liver problems, blood infections, skin and soft tissue infections, liver enzyme changes, loss of appetite, dizziness, headache, respiratory symptoms, itching, or rash than placebo.

We did not find more deaths in people treated with macrolides than those treated with placebo.

There was very limited information on whether people treated with macrolides have a greater risk of developing resistant bacteria than those treated with placebo. However, bacteria resistant to macrolide antibiotics were more likely to be detected immediately after initiation of treatment in people taking macrolides than in those taking placebo, but the difference in resistance after treatment was controversial.

Quality of evidence

The quality of the evidence ranged from very low (heart disorder, liver enzyme changes, liver problems) to low (abdominal pain, death, diarrhea, dizziness, hearing loss, skin and soft tissue infections, taste disturbances, wheezing) to moderate (loss of appetite, blood infections, cough, fever, headache, itching, nausea, rash, respiratory symptoms, respiratory infections, vomiting).

Search for a disease by symptoms -healthgate4all.gr

Anemia (pallor)

White spots on the tongue or mouth

Pale or blotchy skin and blue lips

Pale skin with spots

Lighter cough (attacks become less frequent and finally go away completely)

Soreness and inflammation of the joints

Soreness and enlargement of the lymph nodes (usually the occipital)

Joint pain

Sore throat

Chest pain

Muscle pain

Muscle and joint pain

Pain in muscles, joints, and limbs (arms or legs)

Pain in the lower abdomen

Abdominal pain

Joint pain (rare)

Body pain

Testicular pain in men

Pain and burning sensation when urinating

Stomach pain and cramps

Pain and tenderness in the lower abdomen (less common)

Pain or tenderness in the testicles or prostate (less common)

Pain when urinating

Pain, discomfort, or discharge from the anus

Pain, swelling, irritation, and discharge from the eyes

Pain, discomfort, discharge, or bleeding from the anus

The person cannot bend the neck (muscle stiffness)

Watery stool (like a decoction)

Inflammation (swelling) of the foreskin (the skin that covers the head of the penis)

Sore throat with difficulty and pain when swallowing

Discharge from the nose


A high fever with chills every 2 or 3 days


Jaundice (yellow color of the eyes, skin, and mucous membranes)

Jaundice (yellow color of the skin and eyes)

Muscle stiffness in the abdomen

Slow reactions or no reactions

Constipation (in adults) or diarrhea (in children)

Difficulty swallowing

Difficulty breathing

Blurred vision

Changes in the cervix

Catarrhal phenomena


Cough (usually dry)

Conjunctivitis and discomfort from exposure to bright light

A red, patchy rash that does not go away or change color with pressure (not always)

Red, puffy eyes with thick, purulent discharge in the first 2 weeks of life

Bleeding between menstrual cycles or after sex in women

Bleeding between menstrual cycles or menstrual irregularities (less common)

A membrane that adheres tightly to the underlying tissues of the mouth, tonsils, throat and / or nose and interferes with breathing

Sputum with blood

Dark urine (like cognac)

Muscle cramps

Violations of the mental cycle in women

Low temperature

Low temperature (up to 38οC for 2 days, approximately)


Unusually cold hands and feet or chills

Unusual vaginal discharge that may be thick and green or yellow

Unusual discharge from the penis, vagina, or anus

Unusual discharge from the penis, which may be white, yellow, or green

Low temperature (not always)

Night sweats

Dehydration (lack of fluid in the body, dry tongue and skin)

Discoloration of feces (like putty)

One or more, small or large, flat or cauliflower outgrowths on the genitals and around the anus (papillomas)

One or more (usually painless) round small sores (chancres) that are usually located on the genitals, including the mouth, anus, or vagina


Swollen glands in the neck

Swollen lymph nodes, such as in the neck, armpits

Individual or grouped, small blisters of fluid in or around the genitals, anus, and mouth that burst and develop painful sores

Lack of appetite

Pressure rise


Loss of appetite (in children)

Loss of appetite and weight

Weight loss

Weight loss (rare)

Hair loss in different places (rare)


Swollen lymph nodes

Spasmodic coughing attacks

Irritable reactions

A diffuse rash, most often on the palms and soles of the feet, although it can appear elsewhere


Vomiting (usually in children)

Vomiting and refusing to eat

Vomiting after a coughing fit

Sharp pain when urinating

Stiff neck

Traffic phobia (sensitivity to bright light)

Whistling when breathing

Great weakness, fatigue

Great fatigue

Strong headache

Bluish complexion


Weakness and tiredness


Sleepiness and refusal to wake up


Spasms (rare)

Chewing muscle spasms

Confusion of consciousness

Dry cough

Dry cough at first at night

Rash (face, cervix, upper limbs, body, lower limbs)

Rash (for about 5 days, first on the face, then on the body and back, and then on the upper and lower extremities)

Pale pink rash (roseola)

Rash in the form of blisters with transparent contents and itching of the skin of the body, face and scalp (under the scalp)

Rash on the body


Temperature (rare)

Temperature 38oC and above

Temperature for several weeks

Temperature rises at irregular intervals and does not decrease


Nausea, vomiting, diarrhea

Difficult to reduce high temperature (39-40oC)

Enlargement of one or more salivary glands, usually the parotid, on one or both sides of the head


Persistent diarrhea

Persistent cough

Rapid breathing

Rapid breathing or difficulty breathing

Hoarse voice

Feeling of heaviness in the right upper abdomen

The above catalog includes symptoms associated with a number of infectious diseases.Select one or more symptoms for information on relative infectious diseases. The results are by no means a diagnosis.

Rotavirus infection

Rotavirus infection is an acute infectious disease caused by rotaviruses and characterized by lesions of the gastrointestinal tract, symptoms of general intoxication, and dehydration.

The causative agent – rotaviruses – contain RNA, are subdivided into two antigenic variants, are resistant to the external environment.

Sources of infection – a sick person or a virus carrier. The transmission routes are contact-household, alimentary. A pronounced autumn-winter seasonality is characteristic.

Reproduction and accumulation of rotaviruses occurs mainly in the upper parts of the gastrointestinal tract, where there is a direct damage to the cells of the intestinal epithelium of the small intestine. After a disease, a short-term immunity is formed. Large losses of fluid and electrolytes are characteristic, which leads to dehydration of the I-III degree.

The incubation period lasts from 15 hours to 7 days (usually 1-2 days). The disease begins acutely or gradually. In most patients, symptoms of respiratory tract damage (coughing, nasal congestion, hyperemia of the palatine arches and the posterior pharyngeal wall) are simultaneously detected. A detailed picture of the disease is formed within 12-24 hours from the onset of the disease. Vomiting is a mandatory symptom of the disease. It appears on the first day and lasts 2-3 days. Intoxication is insignificant. Characterized by profuse, liquid, watery stools without admixture of mucus, or sometimes with a small amount of filamentous mucus, without blood.Diarrhea persists for up to 5-7 days. Abdominal pains are cramping in nature and do not have a clear localization. A more severe course is usually caused by a layer of secondary infection. With severe intoxication and low-grade fever, pain in the epigastric region, vomiting, and diarrhea appear. Rarely, vomiting is repeated on the 2-3rd day of illness. All patients have abundant watery stools with a pungent odor, sometimes cloudy-whitish feces may resemble the feces of a cholera patient. There is a loud rumbling in the abdomen.The urge to defecate is of an imperative nature, there are no false urges. In some patients, an admixture of mucus and blood is found in the feces, which always indicates a combination of rotavirus disease with a bacterial infection (shigellosis, escherichiosis). In such patients, there is a more pronounced fever and intoxication. With profuse loose stools, dehydration may develop; in 95-97% of patients, dehydration is I or III degree, in children sometimes severe dehydration with decompensated metabolic acidosis is observed.Acute renal failure and hemodynamic disorders are possible here. Palpation of the abdomen is accompanied by soreness in the epigastric and umbilical regions, rough rumbling in the right iliac region. The liver and spleen are not enlarged.

The diagnosis is established on the basis of complaints, clinical and laboratory data. Differential diagnosis is carried out with cholera, dysentery, escherichiosis, intestinal yersiniosis.

Treatment. Diet therapy (limiting milk, dairy and carbohydrate-rich foods).The basis is pathogenetic methods of therapy, primarily the restoration of fluid and electrolyte losses. Saline solutions are recommended, which are given to drink in small doses every 5-10 minutes. In addition to saline solutions, you can drink other liquids (tea, fruit drink, mineral water without gases). Prescribe enterosorbent therapy (polyphepan, smecta), enzyme therapy (pancreatin, mezim-forte, festal.creon). Prescribing antibiotics is contraindicated. The prognosis is favorable.

Prevention of rotavirus infection is reduced to the following measures:

  1. compliance with the rules of personal hygiene;
  2. the use of boiled, bottled water;
  3. washing vegetables and fruits before drinking with running water, and for small children – with boiled water;
  4. Thorough heat treatment of necessary food before consumption;
  5. short-term storage of perishable food in the refrigerator;
  6. do not accumulate debris;
  7. to monitor the maintenance of cleanliness in the apartment.