What is norovirus infection? Learn about the symptoms, contagious period, and treatment for this common viral illness that causes vomiting, diarrhea, chills, and body aches.

Understanding Norovirus Infection

Norovirus is a highly contagious viral illness that is one of the most common causes of gastroenteritis, or inflammation of the stomach and intestines. It is often referred to as the “stomach flu,” though it is not related to the influenza virus. Norovirus can cause severe vomiting, diarrhea, body aches, and other unpleasant symptoms that typically last for 1-3 days.

Symptoms of Norovirus Infection

The primary symptoms of norovirus infection include:

• Vomiting
• Diarrhea
• Nausea
• Abdominal pain or cramps
• Fever
• Headache
• Body aches

Symptoms usually appear 12-48 hours after exposure to the virus and can be quite severe, leading to dehydration if fluids are not replaced. In most cases, the illness resolves on its own within 1-3 days.

How Norovirus Spreads

Norovirus is highly contagious and can spread quickly through close contact with infected individuals or by consuming contaminated food or water. The virus is transmitted primarily through the fecal-oral route, meaning it can be spread by touching surfaces or objects that have been contaminated with norovirus particles from an infected person’s stool or vomit.

People with norovirus are most contagious from the moment they begin experiencing symptoms until at least 3 days after their symptoms have resolved. However, the virus can sometimes be shed for up to 2 weeks after recovery, so it’s important to practice good hygiene even after feeling better.

Treating Norovirus Infection

There is no specific medication to treat norovirus infection. The primary focus of treatment is managing the symptoms and preventing dehydration. This typically involves:

• Drinking plenty of fluids, such as water, broth, or electrolyte-rich sports drinks
• Getting plenty of rest
• Avoiding solid foods until vomiting and diarrhea have subsided
• Taking over-the-counter medications to relieve fever, body aches, and other symptoms

In severe cases where dehydration is a concern, intravenous fluids may be necessary. Antibiotics are not effective against norovirus, as it is a viral infection. Most people recover within 1-3 days without requiring medical treatment.

Preventing the Spread of Norovirus

To prevent the spread of norovirus, it’s important to practice good hygiene, including:

• Washing your hands frequently with soap and water, especially after using the bathroom, changing diapers, and before eating or preparing food
• Disinfecting surfaces that may have been contaminated with vomit or diarrhea
• Avoiding food preparation if you are experiencing norovirus symptoms
• Staying home from work or school until at least 48 hours after your symptoms have resolved

Norovirus can be a miserable experience, but with proper management of symptoms and prevention of transmission, most people recover quickly and without complications. If you have severe or persistent symptoms, it’s always best to consult with a healthcare professional.

Differentiating Norovirus from Other Illnesses

Norovirus can be easily confused with other gastrointestinal illnesses, such as food poisoning or the flu. The key differences are:

• Food Poisoning: Typically caused by bacteria or toxins in contaminated food, with symptoms appearing within 1-2 days of exposure.
• Influenza (Flu): Characterized by respiratory symptoms like cough, sore throat, and stuffy nose, in addition to fever and body aches.
• Norovirus: Primarily causes gastrointestinal symptoms like vomiting and diarrhea, with minimal respiratory symptoms.

If you’re unsure about the cause of your symptoms, it’s best to consult a healthcare provider for proper diagnosis and treatment.

When to Seek Medical Attention

Most cases of norovirus can be managed at home with rest and fluids. However, you should seek medical attention if you experience any of the following:

• Severe dehydration (excessive thirst, dizziness, dark urine, etc.)
• Persistent vomiting or diarrhea lasting more than 2 days
• High fever (over 101°F or 38.3°C)
• Blood in your vomit or stool
• Severe abdominal pain
• Symptoms that are especially severe or concerning, especially in young children, older adults, or those with weakened immune systems

Seeking prompt medical attention can help prevent complications and ensure you receive the appropriate treatment for your condition.

Vomiting, Diarrhea, and Body Aches, OH MY!

There is nothing worse than waking up in the middle of the night with vomiting, body aches, diarrhea, and fever. Is it the flu? Food poisoning? Norovirus? The only way to know for sure is to see a physician. However, this article can help you better understand your symptoms and offer more information about some common illnesses that are characterized by body aches, vomiting, fever, and diarrhea.

Illnesses That Cause Vomiting, Fever, and Diarrhea

Vomiting, fever, diarrhea, and body aches are often caused by gastroenteritis.

Gastroenteritis is an intestinal infection marked by nausea or vomiting, abdominal cramps, watery diarrhea, and sometimes fever. According to the Mayo Clinic, “The most common way to develop viral gastroenteritis — often called stomach flu — is through contact with an infected person or by ingesting contaminated food or water. ”

There are several conditions that can lead to gastroenteritis, including food poisoning, norovirus, and rotavirus.

Some common bacterial food poisonings include:

• Botulism. Symptoms begin within 18-36 hours of eating contaminated food and can consist of drooping eyelids, double vision, difficulty swallowing, labored breathing, vomiting, and diarrhea.

• E. coli. Symptoms include vomiting, diarrhea, headache and aching muscles. In children, E. coli could cause kidney failure.

• Listeriosis. Symptoms include diarrhea, fever, fatigue, nausea and vomiting, cramping, and back pain. If left untreated, listeriosis can lead to meningitis.

• Salmonellosis. Symptoms can include cramping, nausea, vomiting, diarrhea, fever, headache, chills, and bloody stool. Salmonellosis can be fatal in individuals with weakened immune systems and in infants.

Norovirus is one of the most common causes of viral gastroenteritis. Common symptoms include:

• Stomach pain

• Vomiting

• Body aches

• Diarrhea

• Fever

• Headache

Rotavirus is most common in young children and infants. Symptoms usually appear within 2 days of exposure to rotavirus and include:

• Fever

• Vomiting

• Diarrhea

• Abdominal pain

If you are experiencing vomiting, body aches, fever, and diarrhea, a FastMed Urgent Care medical professional can see you any day of the week. Our clinics are even open late, so finding the time to come in is a breeze. Check in now!

Diarrhea – familydoctor.org

Do I have coronavirus? Call a doctor if you have these symptoms

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According to the Centers for Disease Control and Prevention, here are some steps you can take if you think you have coronavirus.

USA TODAY

In the new day of the novel coronavirus, a dry cough is no longer merely a dry cough. Your misbehaving allergies could be at fault, but maybe this new pathogen has taken up residence in your body. How to know?

Here are nine actions recommended by health experts and the U.S. Centers for Disease Control and Prevention to get information about your health if you feel ill over the next few weeks or months.

Take a deep, cleansing breath. If you’re congested, do the best you can. If you are developing COVID-19, the upper-respiratory illness that results from infection by the novel coronavirus, you are most likely going to recover. Be calm.

Do an inventory of symptoms. Dry cough is one. Are you also short of breath? Do you have a fever? Normal body temperature is 98.6 Fahrenheit, and anything above 100 degrees is considered a fever. These symptoms mean you’re sick with something.

Other flu-like symptoms of COVID-19 include chills, body aches, sore throat, headache, diarrhea, nausea, vomiting and runny nose.

What does the coronavirus do to a body?: Everything to know about the infection process

Live coronavirus updates:: Death toll surges, schools close and a warning – CDC says no large gatherings for 8 weeks

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Social distancing matters. Here is how to do it and how it can help curb the COVID-19 pandemic.

USA TODAY

The Ohio Department of Health says “emergency warning signs” for COVID-19 in adults include difficulty breathing, persistent pain or pressure in the chest, confusion or an inability to wake up, or bluish lips or face.

Call your doctor immediately. Unless you are having critical problems (more on that later), do not go into the nearest emergency department. Call your usual medical provider before seeking care. If you have a scheduled appointment sometime soon, call the doctor’s office to report you have symptoms of COVID-19. The doctor’s staff can then protect themselves and others in the office from infection.

If you do not have a relationship with a primary care doctor, call your local health department. If you have private insurance, your carrier keeps a directory of primary care doctors in its network.

Do not leave your house unless under doctor’s orders. While you are sick, stay home from work and everywhere else unless you visit your doctor or are under instructions to report to a hospital. For 80% of people infected with the novel coronavirus, the most serious result is a mild cold. Still, if you must leave your house, that’s the time that you should wear a face mask so that you do not exhale droplets with the virus and infect others.

Tell your doctor everything. Report any travel or an area with widespread or community contagion on COVID-19. Report any contacts with anyone who later tested positive for the novel coronavirus. The doctor most likely will test you for other viruses like the flu before testing you for COVID-19.

Get tested – if and when one is available. There still are too few test kits to do the blanket coverage of the population that would allow researchers to track how the novel coronavirus is spreading. Right now, Ohio can test only about 1,000 people, and the sickest people are getting tested first. More tests are in manufacturing pipelines, and more laboratories are processing results. But you may be well again by then.

You need a doctor’s order to get the novel coronavirus test. If your symptoms are mild, your doctor may send you home to manage symptoms without a test. If you don’t get better in a few days, speak again to your doctor, who may then send you to the hospital.

Getting tested and also going into isolation. To be more specific, stay in one room of your home, with one person at most taking care of you, and use a separate bathroom, if you can. Limit your contacts even with people you live with. No outside-the-house trips except to the doctor. Avoid public transportation, ride-shares or cabs.

Isolation: Tom Hanks offers a Mr. Rogers-inspired coronavirus isolation update from Australia

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We answer the often searched question: “What are the symptoms of coronavirus versus the flu?”

USA TODAY

The test will give you a name for your condition. But there’s no treatment for COVID-19 and no cure. Most people will tough it out on the couch like the flu. Public health authorities urge people to step up disinfection around the home, especially wherever a sick person is staying.

In the 20% of cases that end up in the hospital, most recover as well. Still, mortality for COVID-19 is estimated at about 2%, much higher than flu.

Take part in public health. The local health department will follow up with people who are tested for the novel coronavirus or develop COVID-19. Health workers will ask about everyone you’ve come in contact with so they can follow up.

Keep your pets safe. The CDC recommends limiting contact with pets and other animals while you are sick with COVID-19. While no one has reported passing COVID-19 to a pet, “It is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus.”

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Symptoms of COVID-19 | HealthLink BC

Symptoms of COVID-19 are similar to other respiratory illnesses including the flu and common cold. Symptoms may vary from person to person. Some people may experience mild symptoms, while others have more severe symptoms.

Key symptoms of COVID-19 include:

• Fever or chills
• Cough
• Loss of sense of smell or taste
• Difficulty breathing

Other symptoms may include:

• Sore throat
• Loss of appetite
• Extreme fatigue or tiredness
• Headache
• Body aches
• Nausea or vomiting
• Diarrhea

Sometimes people with COVID-19 have mild illness, but their symptoms may suddenly worsen in a few days. Children have similar but milder symptoms to adults.

To learn more about symptoms of COVID-19, visit the BC Centre for Disease Control: Symptoms page.

If you have symptoms

If you have COVID-19 symptoms, use the BC COVID-19 Symptom Self-Assessment Tool to help you decide if you need further assessment or testing.

If you need testing, visit the BC Centre for Disease Control: Testing for COVID-19 page to find a COVID-19 collection centre near you.

You need to self-isolate while you wait for your test result so you don’t potentially spread COVID-19 to others. To learn more about self-isolation, who should self-isolate and ending self-isolation, see Self-Isolation and COVID-19.

To learn more about what to do if you are sick, how to prevent spreading it and what to do if you need medical care, visit: the BC Centre for Disease Control: If you have COVID-19 page.

Some of the symptoms associated with COVID-19 are common to other conditions. For more information on what you can do if you have symptoms, see:

You can manage many of the symptoms that are common with COVID-19 at home. Drink lots of fluids, get plenty of rest and use a humidifier or hot shower to ease a cough or sore throat.

Some symptoms can also be signs of other medical issues and you may need to seek medical care. If you are unsure whether to seek care or get tested, contact your health care provider or call 8-1-1. If you or someone in your care is having severe difficulty breathing, severe chest pain, having a hard time waking up, feeling confused or losing consciousness, you should seek emergency medical care by calling 9-1-1 or going to your nearest emergency department.

If you have general health questions or concerns, contact HealthLinkBC (8-1-1) at any time, day or night. If it becomes harder to breathe, you can’t drink anything or feel much worse seek urgent medical care at an urgent and primary care centre or emergency department. If you or someone in your care has chest pains, difficulty breathing or severe bleeding, call 9-1-1 or your local emergency number immediately.

If you are a priority population

Most people recover from coronaviruses on their own. However, some people may have a higher chance of developing a more severe illness or complications due to other health conditions. These are called priority populations and specific precautions and treatment may be needed to keep these people safe.

Find more information about priority (and vulnerable) populations:

Common questions about COVID-19

Find more information about symptoms and other common questions about COVID-19, see:

Find more information about COVID-19 and how to protect yourself, your family and your community, see Coronavirus disease (COVID-19).

Last updated: March 21, 2020

The information provided above has been adapted from the BC Centre for Disease Control’s COVID-19 BCCDC: Symptoms page , accessed December 17, 2020, and the Public Health Agency of Canada PHAC: Coronavirus disease (COVID-19): Symptoms and treatment accessed April 21 2020.

Sore Throat, Diarrhea? | Norton Children’s Louisville, Ky.

Sore throat, diarrhea, runny nose, vomiting, headache or all of the above? Did your child have the flu? Stomach bug?

Sometimes what we call the flu really is a stomach bug, and vice versa. How can you tell the difference?

“Many people use the term ‘flu’ to refer to a wide range of illnesses,” said Rachel Alexander, APRN, nurse practitioner with Norton eCare. “With influenza, we tend to have more upper respiratory symptoms but can have stomach issues as well, making you feel very ill.”

Related: Concerned your child has COVID-19?

Sore throat, fever?

The flu is a contagious respiratory illness caused by the influenza virus. It infects the nose, throat and sometimes lungs.

Symptoms of the flu can include:

• Fever
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headache
• Chills
• Fatigue
• Sometimes diarrhea and vomiting

People with flu spread the virus through tiny droplets when they cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. The flu virus also can live on surfaces such as shopping carts and doorknobs.

Germs make their way into the body and can lead to illness when someone gets the virus on their hands, then touches their eyes or mouth.

Antiviral medication can treat flu symptoms. It is most effective if taken within the first 24 to 48 hours of flu symptoms and will help lessen the severity.

If your child has the flu and symptoms worsen, it may warrant immediate medical attention. Some of those symptoms include:

• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
• Fever with a rash

Norton eCare

If your child has symptoms of either virus, Norton eCare providers are available 24/7 to discuss and provide a treatment plan through an online video visit. Video visits are available for children ages 2 and older.

Diarrhea, throwing up?

Medically speaking, a gastrointestinal virus often is associated with norovirus and is not the same as the flu virus.
Symptoms of norovirus can include:

• Diarrhea
• Throwing up
• Nausea
• Stomach pain
• Sometimes fever, headache and body aches

Symptoms usually develop 12 to 48 hours after exposure, and most people will experience the symptoms for one to four days.

Unfortunately, the only treatment for a norovirus stomach bug is supportive care that includes drinking plenty of fluids, eating a bland diet and resting. The virus has to run its course. If the virus lingers past four days or your child’s symptoms worsen, seek medical attention.

A common concern with both illnesses can be dehydration, so it’s important to drink lots of fluids.

“Fluid intake and rest are important with any virus,” Alexander said. “We recommend that you avoid caffeinated drinks, drinks high in sugar and dairy products if you are experiencing vomiting and diarrhea.”

If your child has symptoms of either virus, Norton eCare providers are available 24/7 to discuss and provide a treatment plan through an online video visit. Video visits are available for children ages 2 and older for a $40 fee.

Norton Children’s Medical Group

Symptoms & Causes of Viral Gastroenteritis (“Stomach Flu”)

In this section:

What are the symptoms of viral gastroenteritis?

The symptoms of viral gastroenteritis include

What are the symptoms of dehydration?

Symptoms of dehydration, the most common complication of viral gastroenteritis, may include the following in adults

• extreme thirst and dry mouth
• urinating less than usual
• feeling tired
• dark-colored urine
• decreased skin turgor, meaning that when a person’s skin is pinched and released, the skin does not flatten back to normal right away
• sunken eyes or cheeks
• light-headedness or fainting

If you are the parent or caretaker of an infant or young child with viral gastroenteritis, you should watch for the following signs of dehydration

• thirst
• urinating less than usual, or no wet diapers for 3 hours or more
• lack of energy
• dry mouth
• no tears when crying
• decreased skin turgor
• sunken eyes or cheeks

Seek care right away

In most cases, viral gastroenteritis is not harmful. However, viral gastroenteritis can become dangerous if it leads to dehydration. Anyone with signs or symptoms of dehydration should see a doctor right away. A person with severe dehydration may need treatment at a hospital.

Viral gastroenteritis symptoms may be similar to the symptoms of other health problems. Certain symptoms may suggest that a person has a different health problem.

The symptoms listed below may suggest that an adult or child has a severe case of viral gastroenteritis, dehydration, or a more serious health problem instead of viral gastroenteritis.

Adults

Adults with any of the following symptoms should see a doctor right away

• change in mental state, such as irritability or lack of energy
• diarrhea lasting more than 2 days
• high fever
• vomiting often
• six or more loose stools in a day
• severe pain in the abdomen or rectum
• stools that are black and tarry or contain blood or pus
• symptoms of dehydration

Adults should also see a doctor if they aren’t able to drink enough liquids or oral rehydration solutions—such as Pedialyte, Naturalyte, Infalyte, and CeraLyte—to prevent dehydration or if they do not improve after drinking oral rehydration solutions.

Older adults, pregnant women, and adults with a weakened immune system or another health condition should also see a doctor right away if they have any symptoms of viral gastroenteritis.

Infants and children

If an infant or child has signs or symptoms of viral gastroenteritis, don’t hesitate to call a doctor for advice. Diarrhea is especially dangerous in newborns and infants, leading to severe dehydration in just a day or two. A child with symptoms of dehydration can die within a day if left untreated.

If you are the parent or caretaker of an infant or child with any of the following signs or symptoms, seek a doctor’s help right away

• change in the child’s mental state, such as irritability or lack of energy
• diarrhea lasting more than a day
• any fever in infants
• high fever in older children
• frequent loose stools
• vomiting often
• severe pain in the abdomen or rectum
• signs or symptoms of dehydration
• stools that are black and tarry or contain blood or pus

You should also seek a doctor’s help right away if a child has signs or symptoms of viral gastroenteritis and the child is an infant, was born prematurely, or has a history of other medical conditions. Also seek a doctor’s help right away if the child is not able to drink enough liquids or oral rehydration solutions to prevent dehydration or if the child does not improve after drinking oral rehydration solutions.

If a child has signs or symptoms of a viral gastroenteritis, don’t hesitate to call a doctor for advice.

What kinds of viruses cause viral gastroenteritis?

Many different viruses can cause viral gastroenteritis. The most common causes of viral gastroenteritis include

• norovirus. Norovirus is the most common cause of viral gastroenteritis. Symptoms usually begin 12 to 48 hours after you come into contact with the virus and last 1 to 3 days.²
• rotavirus. Symptoms usually begin about 2 days after you come into contact with the virus and last for 3 to 8 days.³Vaccines can prevent rotavirus infection.
• adenovirus. Symptoms typically begin 3 to 10 days after you come into contact with the virus and last 1 to 2 weeks. ⁴
• astrovirus. Symptoms typically begin 4 to 5 days after you come into contact with the virus and last 1 to 4 days.^5,6

Norovirus causes infections in people of all ages. Rotavirus, adenovirus, and astrovirus most often infect infants and young children, but they can also infect adults.

Viruses may cause viral gastroenteritis any time of the year. In the United States, norovirus, rotavirus, and astrovirus are more likely to cause infections in the winter.

Do flu viruses cause viral gastroenteritis (“stomach flu”)?

Although some people call viral gastroenteritis “stomach flu,” influenza (flu) viruses do not cause viral gastroenteritis. Flu viruses cause infections of the respiratory system, while viral gastroenteritis is an infection of the intestines.

Are viruses the only cause of gastroenteritis?

No. While viruses cause viral gastroenteritis, bacteria, parasites, and chemicals may cause other kinds of gastroenteritis.

When gastroenteritis is caused by consuming foods or drinks contaminated with viruses, bacteria, parasites, or chemicals, this is called food poisoning.

How does viral gastroenteritis spread?

Viral gastroenteritis spreads from person to person through contact with an infected person’s stool or vomit.

If you have viral gastroenteritis, viruses will be present in your stool and vomit. You may spread the virus in small bits of stool or vomit, especially if you don’t wash your hands thoroughly after using the bathroom and

• touch surfaces or objects used by other people
• prepare or serve foods and drinks for other people
• shake hands with or touch another person

Infected people who do not have symptoms can still spread viruses. For example, norovirus may be found in your stool before you have symptoms and up to 2 weeks after you recover.²

Norovirus is especially contagious, meaning that it spreads easily from person to person. Norovirus can live for months on surfaces such as countertops and changing tables. When an infected person vomits, the virus may become airborne and land on surfaces or on another person.

Viral gastroenteritis may spread in households, day care centers and schools, nursing homes, cruise ships, restaurants, and other places where people gather in groups.

If water comes into contact with stools of infected people, the water may become contaminated with a virus. The contaminated water can spread the virus to foods or drinks, and people who consume these foods or drinks may become infected. People who swim in contaminated water may also become infected.

References

[2] Norovirus: clinical overview. Centers for Disease Control and Prevention website. https://www.cdc.gov/norovirus/hcp/clinical-overview.html. Updated February 13, 2013. Accessed August 31, 2017.

[3] Rotavirus: clinical information. Centers for Disease Control and Prevention website. https://www. cdc.gov/rotavirus/clinical.html. Updated August 12, 2016. Accessed August 31, 2017.

[4] Boyce TG. Overview of gastroenteritis. Merck Manual: Professional Version website. https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastroenteritis/overview-of-gastroenteritis Updated May 2017. Accessed August 31, 2017.

[5] Cohen MB. Bacterial, viral, and toxic causes of diarrhea, gastroenteritis, and anorectal infections. In: Podolsky DK, Camilleri M, Fitz G, et al. eds. Yamada’s Textbook of Gastroenterology. 6th edition. John Wiley & Sons, Ltd.: 2016:1196–1248.

[6] Garza JM, Cohen MB. Infectious diarrhea. In Wyllie R, Hyams J. Pediatric Gastrointestinal and Liver Disease. 4th edition. Philadelphia, PA: Saunders: 2011:405–422.

Gastroenteritis – causes, symptoms, treatment

Gastroenteritis is the irritation of the digestive track caused by a viral, bacterial, or parasitic infection. Symptoms include diarrhoea, vomiting, and abdominal pain. Treatment mainly involves symptom relief and fluid replacement.
Gastroenteritis is also known as a tummy bug, stomach flu, intestinal flu, food poisoning, and traveller’s diarrhoea.

It is a common condition, mainly because the microbes that can cause gastroenteritis are easily spread via contaminated food or water, and through person-to-person contact. The infection causes the digestive tract to become irritated, which results in diarrhoea and other symptoms such as vomiting and abdominal pain and cramping.

Causes

The most common cause of gastroenteritis is a viral or bacterial infection, and less commonly parasitic infection.

The most common causes of viral gastroenteritis are norovirus and rotavirus. Escherichia coli (E. coli), Salmonella and Campylobacter are the most common causes of bacterial gastroenteritis. Parasitic gastroenteritis is usually caused by Giardia.

Viral gastroenteritis is the most frequent cause of gastroenteritis outbreaks, which occur when groups of people are affected at the same time and place.

Norovirus outbreaks can affect both children and adults, while rotavirus mainly affects infants and children.

The people most at risk of gastroenteritis are:  

• Infants and young children, who have an immature immune system
• The elderly, who have less efficient immune systems, and especially those living in nursing homes
• Children in day care, school children and students living in dormitories
• Anyone with a weakened immune system, such as people with HIV/AIDS or receiving chemotherapy
• Travellers.  

Signs and symptoms

The main symptom of gastroenteritis is diarrhoea, which is when your bowel movements (faeces or stools) become watery and you need to go to the toilet frequently and urgently.  Although diarrhoea is the primary symptom of gastroenteritis, there are many other causes of diarrhoea. 
Additional symptoms and signs of gastroenteritis may include:   

• Nausea and vomiting
• Abdominal pain and cramping
• Mild fever and chills
• Loss of appetite
• Headache and muscle aches
• Tiredness and general body weakness
• Incontinence (loss of control over bowel motions)
• Poor feeding in infants.

Depending on the cause, symptoms may appear within one to three days after infection and can range from mild to severe. Symptoms usually last one or two days, but occasionally may persist for up to ten days.

You should see your doctor if your symptoms last more than about five days and/or increase in severity, your symptoms go away but come back, your stools become bloody or pussy, you have constant abdominal pain, or if you develop dehydration. 
Dehydration can arise from the excessive loss of fluid from the body, which can occur quickly with gastroenteritis. 
The signs and symptoms of dehydration include:  

• Extreme thirst
• Not having urinated in the past eight hours or passing only a small volume of urine 
• Urine that is dark in colour and smelly 
• Dry lips and mouth, and a lack of tears
• Cold hands and feet
• Sunken cheeks or eyes
• Dizziness, lethargy, floppiness
• In infants, dry nappies (for longer than 4-6 hours) and/or a sunken fontanelle (the soft spot on the top of a baby’s head)
• Skin that ‘tents up’ when pinched.

Signs of dehydration in anyone, especially infants and children, the elderly and people with weakened immune systems, are reasons to see a doctor immediately. 

Diagnosis

Gastroenteritis is usually diagnosed by the symptoms that it produces, primarily diarrhoea. However, if the symptoms are severe or persistent, your doctor may take a stool (faeces) sample to identify the cause of the gastroenteritis.

Stool samples may be taken during outbreaks of gastroenteritis, such as those occurring on cruise ships and in hospitals and nursing homes, to identify the virus or bacteria that has caused the outbreak. Also, identifying patients with similar histories of food or drink they have recently consumed often helps to determine the source of the outbreak. 

Treatment

Most people with gastroenteritis recover within several days without the need for medical treatment, as long as they stay properly hydrated. To help keep yourself comfortable and prevent dehydration while you recover, try the following:  

• Stop eating solid foods to let your stomach settle
• Avoid dairy products, caffeine, alcohol, nicotine
• Avoid sugary, fatty or highly seasoned foods
• Drink plenty of liquid every day, taking small, frequent sips, including clear thin broths or soups, diluted non-caffeinated sports drinks (e. g. Powerade or Gatorade), and rehydration formulas (e.g. Gastrolyte) that are available without prescription from a pharmacy
• Ease back into eating slowly with bland easy-to-digest foods such as, crackers, toast, bananas, rice and potatoes
• Make sure that you get plenty of rest
• Avoid taking non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and diclofenac, for pain relief as they can make your stomach more upset
• Paracetamol (e.g. Panadol) can be taken for fever and abdominal pain but it should be used cautiously.

For infants with gastroenteritis, let the baby’s stomach rest for 15 to 20 minutes after vomiting or a bout of diarrhoea, then offer small amounts of liquid. Let the baby nurse if being breast-fed. If you are bottle-feeding, offer a small amount of an oral rehydration solution or regular formula.

Anti-diarrhoeal medications, such as Imodium, can be taken to slow the diarrhoea. In most cases, however, it is better for the body to clear itself of the virus or bacteria causing the gastroenteritis.

Use of antibiotics is also usually avoided because they are not effective against viruses, and their overuse contributes to the development of antibiotic-resistant strains of bacteria. 

Prevention

The following actions can be taken to avoid getting and spreading gastroenteritis:  

• Frequent and thorough hand washing, especially before eating or preparing food, and after going to the toilet or contact with an infected person
• Ensure that children wash their hands frequently and thoroughly
• Avoid direct contact with infected individuals, if possible
• Stay home from work and keep children away from day-care or school until symptoms have gone
• Washing the clothing, bedding, and toys of an infected person
• Cleaning and disinfecting kitchen surfaces, especially after working with raw meat or chicken, or eggs
• Avoid eating undercooked foods, especially meat, chicken, and fish
• Avoid drinking untreated water
• Avoid eating raw meats, fish, and shellfish unless you are sure that they have been freshly prepared and are from a reliable source
• Thoroughly wash any fresh produce, such as fruits and vegetables
• Have your infant or child vaccinated with a rotavirus vaccine, which can prevent gastroenteritis caused by rotavirus
• Drink only bottled or boiled water and avoid ice cubes when travelling, especially in developing countries.  

A vaccine for rotavirus is available free for New Zealand babies.  The oral vaccine – Rotarix – is given in two doses (at the 6-week and 3-month immunisation visits) to reduce the incidence or severity of rotavirus infection which is a very common cause of gastroenteritis in infants and young children.  

Further information and support

Healthline
Free phone: 0800 611 116
Website: www.healthline.govt.nz

Plunket
Free phone: 0800 933 922
Website: www.plunket.org.nz 

References

Mayo Clinic (2014). Viral gastroenteritis (stomach flu) (Web Page). Rochester, NY: Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/viral-gastroenteritis/symptoms-causes/syc-20378847 [Accessed: 16/02/18]

Ministry of Health (2017). Guidelines for the management of norovirus outbreaks in hospitals and elderly care institutions (Web Page). Wellington: New Zealand Government Ministry of Health. https://www.health.govt.nz/publication/guidelines-management-norovirus-outbreaks-hospitals-and-elderly-care-institutions [Accessed: 16/02/18]

Ministry of Health (2018). Rotavirus (Web Page). Wellington: New Zealand Government Ministry of Health. https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/rotavirus [Accessed: 16/02/18]NHS Choices (2017). Gastroenteritis (Web Page). Redditch: National Health Service (NHS)

England. https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gastroenteritis [Accessed: 16/02/18]

O’Toole, M.T. (Ed.) (2013). Gastroenteritis. Mosby’s Dictionary of Medicine, Nursing & Health Professions (9th ed.). St Louis, MI: Elsevier Mosby.

Reviewed: February 2018

Memo for a pregnant woman

Memo for a pregnant woman about actions in case of influenza, acute respiratory infection, new coronavirus infection COVID-19

Influenza is an acute infectious disease. The duration of the incubation period for influenza is from several hours to 7 days, most often 2-3 days.

The disease begins acutely with a sharp increase in body temperature to 38 ° C and above and severe symptoms of intoxication (chills, headache, aching joints, pain in muscles and when moving the eyeballs).Further (sometimes after a few days), symptoms of respiratory tract damage (dryness of the mucous membranes of the nose and mouth, sore throat, chest pain, dry cough, shortness of breath) join. With the flu, there may be symptoms of an upset gastrointestinal tract: nausea, vomiting, diarrhea.

The new coronavirus infection COVID-19 often has the same symptoms as the flu. Unlike influenza, the incubation period for this infection is from 2 to 14 days, on average – days.In the initial stages of the disease, sense of smell and taste may disappear, catarrhal symptoms are mild, most patients note severe weakness, shortness of breath, dry cough without phlegm. Disorders of the gastrointestinal tract are common with COVID-19.

Pregnant women, elderly and frail people, small children are at high risk of severe and complicated forms of influenza. Their disease often has a very rapid (within a few hours) development of the disease.With the new coronavirus infection COVID-19, pregnant women are also prone to severe forms, but the course of this infection in children can be very mild and asymptomatic.

It should be remembered that self-medication or late seeking specialized medical care leads to the development of severe life-threatening complications.

In the absence of timely treatment started, a pregnant woman is at risk of developing complications from the lungs, kidneys, heart and brain, premature birth, thrombosis and thromboembolism, placental abruption, gestosis and other obstetric complications.Intrauterine infection of the fetus with the influenza virus in the early stages can lead to developmental abnormalities or miscarriage, in later periods – to intrauterine fetal death, death of a newborn baby after birth, or the development of serious diseases in him. The effect of the new coronavirus infection on the fetus has not yet been studied.

The Ministry of Health of the Russian Federation has developed effective regimens for the treatment of influenza and the new coronavirus infection COVID-19 in pregnant women with safe drugs that are selected individually by a doctor, so do not self-medicate!

When to see a doctor immediately:

1.Sudden onset of the disease: an increase in body temperature to 38 ° C and above, muscle pain, aching joints, headache, severe weakness.

2. Cough, shortness of breath, sore throat, chest pain, runny nose. A cough with streaks of blood in the sputum is especially dangerous!

3. Nausea, vomiting, diarrhea.

4. Abdominal pain, increase or decrease in blood pressure, bleeding from the genital tract of any intensity, discharge of amniotic fluid, change in fetal movements (violent or weak).

If you are sick, you should immediately contact the registry of the territorial polyclinic or call an ambulance at your home and be sure to inform your local obstetrician-gynecologist of the antenatal clinic about the disease by phone.

If you are offered hospitalization, do not refuse hospital treatment. Home treatment does not allow time to identify complications and monitor the development and condition of the fetus.In case of an acute infectious disease, you should not visit the clinic or antenatal clinic on your own – medical assistance will be organized for you by mobile teams of medical workers.

If you have had contact with a patient with influenza or a new coronavirus infection COVID-19, you should consult with your local doctor as soon as possible and inform your local obstetrician-gynecologist about this to prescribe preventive measures.

Observe preventive measures for infection with influenza and the new coronavirus infection COVID-19: stay at home in self-isolation, do not visit public places (public events, entertainment centers, shops, pharmacies, hospitals, etc.)) unless absolutely necessary.

If you have sick relatives at home, especially – small children and the elderly – do not hesitate to seek medical help. Try to completely isolate from them or contact the sick person as little as possible. Wear and change individual disposable medical masks every 2 hours, often wash your hands with soap and treat them with an antiseptic, ventilate the room. Wet cleaning of the premises is required at least 2 times a day.

Use rinsing of the nasal passages and gargling with preparations based on sea salt, use prophylactic ointments or nasal drops based on interferon 3-4 times a day. Your doctor will recommend other drugs to prevent influenza when you come into contact with a sick person.

REMEMBER!

Only timely access to medical help will save the life and health of mothers and children.

Rotavirus infection: treatment and symptoms.Norovirus

“Norfolk Agent”

For several years we have become accustomed to the fact that after the winter cold, influenza and parainfluenza viruses raise their heads. This year, after the cold weather, viruses that cause intestinal infection have revived. We heard “ norovirus infection ”, “ rotavirus infection ”. We asked the family doctor, pediatrician Lolita Sorge to help deal with this.

Noroviruses, together with rotaviruses, are the main cause of intestinal infections in children.Initially, noroviruses and rotaviruses were not distinguished at all and everyone was diagnosed with rotavirus infection, especially since the manifestations of these viral infections are similar.

Norovirus was first isolated in 1972, it happened in the United States, in the city of Norfolk. The first name for the virus was “Norfolk Agent”. Norovirus is a type of enterovirus. They are highly contagious: only 10-100 particles of the virus are enough to infect a person. Even the smallest dust particles with norovirus cause disease.The virus is very viable: wet cleaning with conventional detergents and alcohol-containing agents does not ensure its destruction, the virus is resistant to drying, freezing, heating up to 60 degrees, and dies only from chlorine-containing disinfectants.

Rotaviruses were first discovered in 1973 in the epithelial cells of the duodenal mucosa of children with acute gastroenteritis. Reproducing in epithelial cells, viruses destroy cells, which leads to impaired absorption of simple sugars and enhances intestinal motility.When rotaviruses enter the large intestine, they interfere with the absorption of water, which leads to diarrhea. They are distinguished by excellent resistance to environmental conditions and do not perish either in the refrigerator, or in chlorinated or holy water.

Both infections affect all age groups. Norovirus is especially dangerous for physically weak people, the elderly and children. Rotavirus is dangerous for very young children – up to two years old.

The routes of infection with both infections are similar. You can get infected by eating unwashed vegetables or fruits, by drinking liquids containing viruses.Rotavirus often enters the body along with dairy products, which is associated with the special specifics of their production. But most often the transmission of the virus occurs from a sick person to a healthy person through household items or by airborne droplets. People infected with norovirus can infect others during the height of the disease and within the next 48 hours, while those infected with rotavirus are infectious to others from the very first day until the moment of complete recovery. Therefore, at the slightest suspicion of the presence of an infection in one of the family members or others, it is worth minimizing communication with him as much as possible, up to complete isolation for the entire period of the illness.

As you know, small children pull all the objects they find with their mouths. This is not so dangerous if it happens at home, as the child is playing with clean toys. But this situation can arise on the street, playground, sandbox and other places. In this case, naturally, no one will give guarantees regarding the cleanliness of the surrounding objects. In addition, children are often in a team: kindergartens, schools, various circles, where any infection spreads quickly enough.

The first signs of illness in norovirus infection appear 24-48 hours after infection, and with rotavirus, they can appear in a day or five days.

With norovirus , it all starts with severe nausea, turning into vomiting, but there is no fever, and most believe that it is food poisoning. After the regulation of nutrition, the patient becomes better. Only weakness remains. And after a few days – vomiting again, diarrhea appears, subfibril body temperature, muscle and headaches may appear. That is, the norovirus manifests itself in a wave-like manner, on the rise. This infection is not immediately diagnosed. Dehydration of the body occurs not so much due to vomiting, but because of the toxic substances secreted by the norovirus.

With rotavirus infection in children , the disease is pronounced from the very first days of its appearance. Signs of the disease are the same as with any intestinal infection: diarrhea, vomiting, fever, sometimes up to 39 degrees. Unlike norovirus infection, where vomiting comes to the fore, with rotavirus – diarrhea and high fever. Vomiting may appear later. Diarrhea and vomiting can quickly lead to dehydration. Children are often characterized by a change in the color and consistency of the stool: on the first day it is liquid and acquires a yellow color, and on the second and third day it becomes clay-like and gray-yellow.

The baby loses appetite, the child becomes lethargic and drowsy. He may have a red throat, a runny nose. Very young children, who still cannot explain that they are in pain, become very irritable and whiny. A separate symptom in such babies is a rumbling in the stomach.

Symptoms of rotavirus infection in adults are not so pronounced: appetite decreases, diarrhea appears, abdominal pain, fever rises. In most cases, vomiting does not bother the patient, although there are exceptions to this rule.

Infection is very easy to confuse with ordinary poisoning. But ordinary poisoning passes after two to three days, while rotavirus infection can be eliminated no earlier than five to seven days after its appearance.

Determining the type of virus that caused the intestinal infection is not of great importance, since the treatment of such diseases is usually carried out in the same way. But if there is a need for this, then you can donate blood to determine the type of virus by PCR or ELISA.

We will tell you about the treatment of children and the prevention of infections next time.

Rotaviruses interfere with the absorption of water, leading to diarrhea. They are distinguished by excellent resistance to environmental conditions and do not perish either in the refrigerator, or in chlorinated or holy water.

To the topic

Principles of treatment of infections in adults. In most cases, norovirus infection in adults does not require treatment, since this type of infection has the ability to self-restrict, and the disease goes away without any complications. The main recommendation for this ailment is to consume enough fluid to prevent dehydration. The volume of fluid that a patient must drink in the first six to eight hours of illness is approximately 80 milliliters per kilogram of body weight for adults. Antiemetic drugs are prescribed to ease severe nausea or vomiting.

With rotavirus infection, the main goal of treatment is to eliminate the unpleasant symptoms of the disease.

1.Heat. It is worth considering that the virus that provokes the appearance of the disease dies only at 38 degrees. That is why you should not bring down the temperature until it reaches 39 degrees. If necessary, you can use any of the available antipyretic drugs, be sure to observe the dosage indicated in the instructions.

2. Elimination of diarrhea. For this purpose, you can start taking antidiarrheal drugs twice a day. The treatment period should be at least five days.This also applies to those cases when the symptoms of the disease disappeared earlier than the specified period of time.

In addition to all of the above, it is necessary to take such drugs for rotavirus infection, which will contribute to the early restoration of the intestinal microflora. The dosage and duration of treatment in each case are determined by the doctor, so it is worth listening to all the recommendations.

Material prepared by Irina NIKONENKO and Ksenia LALETINA

Dangerous infectious diseases abroad

When traveling to foreign exotic countries, you need to know that in some of them there is a real possibility of contracting infectious diseases, such as plague, cholera, yellow fever and Ebola fever, malaria.In the countries of South America, Africa and Asia, people suffer from diseases that are practically not found in Europe. We invite you to familiarize yourself with the most common exotic diseases.

Cholera remains one of the most common diseases in hot countries. It is found both in Africa, Brazil, Mexico, Peru and other states, which are still little developed by Russian tourists, and in the more popular resorts of India and Turkey. Cholera outbreaks are recorded even in the CIS countries.

Cholera is an acute infectious disease characterized by the development of massive diarrhea with rapid loss of extracellular fluid and electrolytes. The incubation period is from several hours to 5 days (usually 2-3 days). The source of Vibrio cholerae is only a person. Cholera pathogens enter the human body through the mouth along with contaminated water or food. However, most often people become infected through water, into which cholera pathogens enter together with the infected feces of a sick person.Many bodies of water, especially in underdeveloped countries, can be polluted by sewage. You can become infected with cholera by swallowing water while bathing, as well as eating vegetables, fruits, washed with contaminated water.

Plague – an acute natural focal infectious disease, characterized by severe intoxication, fever, lesions of the skin, lymph nodes, lungs, the ability to take a septic course. Refers to especially dangerous infections.

Plague affects rodents (rats, ground squirrels, murine rodents), and fleas that parasitize on them can infect humans.

Plague periodically appears in all countries of the world, except Australia and Antarctica. In Asia, Africa, North and South America, and on the oceanic islands, there are about 50 states on whose territory natural foci of plague have been discovered or suspected.

If the infection occurs through a flea bite or contact with infected rodents, then the person becomes ill with bubonic forms of plague, in which there is an increase in lymph nodes.If plague treatment is started too late, it is not uncommon for the patient to develop pneumonic plague.

Sometimes infection with plague occurs through airborne droplets as a result of a person’s contact with a carrier of the pneumonic form of plague. The pulmonary form is a more serious disease and is extremely dangerous to others. Therefore, if symptoms such as hemoptysis, intense fever, chills, headache appear, you should immediately consult a doctor.

The incubation period usually lasts 3-6 days, in the pulmonary form it is reduced to 1-2 days, in the vaccinated it can be extended to 8-10 days.

Yellow fever – an acute arbovirus disease transmitted by mosquitoes, characterized by fever, severe intoxication, thrombohemmoragic syndrome, kidney and liver damage. The virus enters the human body when bitten by an infected mosquito.

Endemic foci are vast territories of South America (Bolivia, Brazil, Colombia, Peru, Ecuador, etc.), as well as equatorial Africa.

The incubation period of the disease ranges from 3 to 6 days.

The disease begins suddenly with a severe headache, severe pain in the lower back, back, limbs. Body temperature by the end of the 1st day reaches 39-40 ⁰ C and higher. There is hyperemia and puffiness of the face, swelling of the eyelids, injection of the vessels of the sclera and conjunctiva. On the 2nd day, excruciating thirst, nausea, repeated vomiting of mucus, and then bile join. Further cyanosis, jaundice may appear. The disease is very difficult and often leads to the death of the patient.

If you are going to visit these countries, be sure to get vaccinated against yellow fever, as this is the only effective way to prevent infection.

Ebola is an acute viral highly contagious disease characterized by a severe course, high mortality and the development of hemorrhagic syndrome.

The incidence is recorded in the tropical rainforest zone of West and Central Africa. There is a continuing activation of the natural foci of the Ebola fever, the expansion of the area and its expansion beyond the African continent.

A sick person is a danger to others. The virus can spread through direct contact with the blood or secretions of a patient, as well as through contact with objects of an infected person. Most often, the Ebola virus is spread through relatives and friends, as they are in close contact when caring for sick people. Going to the African continent, it is important to be prudent – you should not be in close contact with the locals, as well as with monkeys and chimpanzees.

The incubation period lasts from 4 to 6 days. The disease begins acutely, among the first symptoms: an increase in body temperature to 39-40 ° C severe headache, muscle pain, diarrhea, abdominal pain, dry cough and stitching pains in the chest, rash, skin peeling, nosebleeds, bloody vomiting , uterine bleeding.

Individuals returning from countries with reported cases of Ebola should seek medical attention by telephone if any of the above symptoms appear.

Malaria is a group of protozoal vector-borne diseases in humans, the pathogens of which are transmitted by mosquitoes. The source of infection is a person (sick or parasite carrier).

A person is infected by the bite of an infected mosquito, as well as by blood transfusion of a patient with malaria.

The malaria situation is especially difficult in the countries of tropical Africa and Southeast Asia.

In Russia, cases of importation of malaria are recorded annually, mainly from Tajikistan and Azerbaijan.

In non-immune persons who fell ill for the first time, the disease begins with a prodrome – malaise, weakness, headache, aches in the back, limbs. In most cases, typical attacks of malaria are preceded by a 2-3 day increase in body temperature to 38-39 ⁰ C.

After the chill, the fever begins. The face turns red, the skin of the body is dry and hot. Patients complain of thirst, nausea, increasing tachycardia, bloating, loose stools, increased sweating.

In addition to clinical signs, the diagnosis is confirmed by the presence of plasmodia in the blood.

Salmonellosis: symptoms, treatment, prevention

Salmonellosis is a type of food poisoning, an infectious disease caused by bacteria from the genus salmonella. Infection most often occurs when eating poor-quality or stale foods containing this bacterium. The occurrence of salmonellosis is most susceptible to children under the age of 1 year. Infection in this case occurs when feeding a child using an unboiled bottle.An adult can get the disease by eating chicken eggs, milk, meat, butter. There are known cases of mass illness of salmonellosis with the use of cakes and pastries sold in the store, made with the addition of chicken eggs contaminated with bacteria to the dough.

The insidiousness of salmonellosis lies in the fact that the main causative agent of the disease, which has entered the food product, does not alter its appearance in any way, does not affect its taste. The presence of salmonella in a particular food product can only be determined using laboratory tests.Cases of fatal outcome of salmonellosis are known to medicine.

Symptoms

This disease is characterized by general symptoms of food poisoning:

• prolonged diarrhea, accompanied by severe cutting pain in the abdomen, flatulence. A large amount of mucus is present in the patient’s feces, blood can be observed. The urge to empty the bowels can occur up to 10 times a day or more;
• nausea, profuse and prolonged vomiting. Vomiting with salmonellosis can last for several days, even if the stomach is completely empty.This vomiting can dehydrate the body. Therefore, all necessary measures should be taken in time to prevent the occurrence of serious consequences;
• Lack of appetite. In the first days of treatment, the patient is advised to eat only vegetable broth or consume one liquid – water, tea or natural juice;
• Headache, fever, chills, aching bones and joints, general weakness of the body.

The incubation period for Salmonella lasts about 4 days.It is during this period of time that the first signs of poisoning appear. Salmonellosis in newborns is accompanied by severe anxiety of the child, lack of sleep, frequent bowel movements, and vomiting. If you suspect any food poisoning, the patient must be isolated from the rest of the family, since all intestinal infections are highly contagious.

Treatment

Diagnosis of the disease includes a laboratory study of the patient’s feces to establish the main pathogen, a blood test.In addition, an analysis of the food that the victim has recently consumed (if possible) is carried out.

Salmonellosis should be differentiated from many intestinal infections, primarily from cholera.

The basis of treatment is antibiotics, which in the first days of the patient’s stay in the hospital are injected into his body intravenously, then with the help of intramuscular injections or tablets. The drug is selected taking into account the patient’s condition, his age, whether he has contraindications to treatment with this or that drug.In addition to antibacterial drugs, vitamins and probiotics are prescribed. A patient diagnosed with salmonellosis needs to drink as much fluids as possible. In the event that dehydration of the body does occur, saline solutions are prescribed. For example, Regidron.

The course of antibiotic treatment for salmonellosis lasts from 6 to 9 days. After completion of the main therapy, it is necessary to pass a repeated analysis of feces and blood.

Prevention

Many food poisoning can be avoided if the necessary rules and sanitary standards for food preparation are observed:

• Thoroughly rinse fruits, vegetables, as well as meat and offal used for cooking with water;
• when buying products in a store, pay attention to their expiration date;
• Store food in the refrigerator;
• Do not use expired products for food or for cooking;
• wash hands before preparing food;
• Thoroughly wash dishes and kitchen utensils;
• Do not use one knife for cutting vegetables and meat;
• Wash hands after using the toilet, returning home from the street, before starting a meal.

Also, in order to avoid contracting salmonellosis, you should not buy ready-made food in open street stalls, shops, eat in unreliable catering places. Often the main source of salmonellosis is sold by weight salads with the addition of mayonnaise, cakes and pastries decorated with cream. It is best to refuse the use of such products and prepare food at home, observing the necessary sanitary standards.

Infectious Mononucleosis – Cabinet of Infectious Diseases – Departments

Clinic.patients with the disease begins acutely, there is a significant increase in temperature, headache, weakness, muscle and joint pain, sleep and appetite are disturbed. There may be mild chills that alternate with increased sweating. From the first days of the disease, pain in the throat worsened, which intensifies when swallowing. At the same time, hyperplasia of the lymph nodes and difficulty in nasal breathing are observed. The most vividly listed symptoms become pronounced by the 4-5th day of illness; in the same period, an increase in the size of the liver and spleen is determined, atypical mononuclear cells appear in the blood.
In some cases, there may be a subacute onset of the disease with prodromal phenomena: against the background of general malaise, subfebrile body temperature, mild catarrhal changes in the upper respiratory tract are noted.
In some patients, the leading complaint is abdominal pain, more often in the right iliac region, sometimes nausea and vomiting, bloating, stool retention or diarrhea are observed.
The disease can develop unnoticed; at the same time, the first symptom that makes the patient see a doctor is an enlarged lymph node

However, the most characteristic symptoms of infectious mononucleosis are: fever, tonsillitis, generalized lysradenopathy and hepatosppenomealia.

The temperature response is very variable and can persist from 1-2 days to 3 weeks or longer. In 1/3 of patients in the first days, the body temperature is subfebrile and clearly rises to 38 “C and higher only by the end of the first week of the disease. Higher and prolonged fever is noted in adults and older children. In some patients, there is two- and three-wave fever with periods of apyrexia of several days The average duration of fever is 6-10 days
There is no typical temperature curve for infectious mononucleosis.The body temperature decreases more often lytically, which coincides with an improvement in the general condition and a decrease in the severity of other symptoms of the disease. It should be noted that after the main wave of fever, subfebrile body temperature often persists.
The temperature reaction is combined with other symptoms, primarily with changes in the pharynx. A slight hyperemia in the pharynx and hyperplasia of the tonsils are observed in many patients from the first days of the disease. Often these changes are combined with damage to the nasopharynx.Clinically, this is manifested by difficulty in nasal breathing and a nasal tone of voice. At the same time, there is a significant swelling of the palatine tonsils, which may come into contact with each other. If it is possible to examine the posterior wall of the pharynx, then its edema and hyperemia with symptoms of hyperplasia of the lymphoid tissue are found; in some patients, the back wall of the pharynx may be covered with thick mucus. 3-4 days after the onset of the disease, loose, curdled deposits of various sizes appear on the tonsils, which can be easily removed with a spatula.In some cases, plaque can be localized on the back of the pharynx, at the root of the tongue, and even on the epiglottis. Changes in the pharynx are accompanied by fever. The duration of the lesion of the pharynx is 10-15 days; with timely and adequate treatment, angina passes faster.
In patients with removed tonsils, the reaction of the lymphoid tissue of the pharynx manifests itself in the form of an increase in the lateral ridges and granules of the posterior pharyngeal wall.
Temperature reaction and changes in the pharynx are combined with the development of lymphadenopathy.Often all the lymph nodes are enlarged, but the most pronounced is the increase in the cervical lymph nodes, especially those located along the posterior edge of the sternocleidomastoid muscle; they can be in the form of a chain or a package. In children of younger preschool age, lymph nodes can form large conglomerates up to 4-6 cm in diameter. In school-age children and adults, lymph nodes increase up to 2-3 cm, creating a “scalloped” outline of the contours of the neck. Sometimes adults may have a slight swelling of the lymph nodes that goes unnoticed.
Enlarged lymph nodes almost do not cause pain, are not soldered between themselves and the surrounding tissue. On palpation, they are “juicy”, densely elastic, mobile. Periadenitis, skin redness and suppurative processes are never observed. Swollen lymph nodes may be the first sign of illness. Streets suffering from chronic tonsillitis, early enlargement of the lymph nodes located at the corner of the mandible.
At the same time, other groups of lymph nodes – axillary, cubital and inguinal (less often – mesenteric or mediastinal) can be enlarged.With an increase in mediastinal lymph nodes, patients may be disturbed by cough, pain in the heart of varying intensity and duration.
The enlargement of the lymph nodes persists for 1-2 weeks, and sometimes moderate lymphadenopathy is observed for 1.5-2 months more.
On the 3rd-4th day of illness, the liver and spleen are enlarged. Hepatomegaly is accompanied by a feeling of heaviness in the right hypochondrium, weakness, decreased appetite, sometimes nausea, less often vomiting. Moderate hyperbilirubinemia, increased activity of ALT, thymol test are often noted.l, the number of lymphocytes, monocytes and plasma cells increases, peculiar atypical mononuclear cells appear, characterized by large polymorphism in shape and structure.

In most cases, atypical mononuclear cells are found in the blood in the early days of the disease, but especially their number increases at the height of the disease. Less often, the appearance of mononuclear cells can be noted on the 8-11th days of the disease. These cells persist for several weeks, but gradually their number decreases.
Among “white blood” cells, the proportion of mononuclear cells ranges from 10 to 50% and more. In some cases, at the height of the disease, all mononuclear cells can be atypical, and their number correlates with the severity of the disease.
Infectious mononucleosis in most patients ends with recovery after 2-4 weeks. However, in some patients, lymphadenopathy, hepatosplenomegaly, atypical mononuclear cells in the blood persist for a long time, which indicates a protracted, and possibly chronic course of the infection.The latter is characterized by persistent lymphadenopathy and EBV-hepatitis, splenomegaly, interstitial pneumonia, bone marrow hypoplasia, and sometimes uveitis.

Disseminated (septic) EBV infection occurs on the background of severe immunosuppression in AIDS patients, during organ transplantation and is characterized by poor outcomes.
Complications of infectious mononucleosis occurring against the background of immunodeficiency can be by their nature: hematological (autoimmune hemolytic anemia, thrombocytopenia, granulocytopenia, rupture of the spleen), cardiological (pericarditis, myocarditis) and neurological (meningitis, meningoelitis, meningoelitis).
Diagnostics. Clinical diagnosis of infectious mononucleosis using hemogram data does not allow definitive verification of the etiology of the disease. For this, immunochemical (ELISA) and molecular biological (PCR, RT-PCR, hybridization) diagnostic methods are currently used. The previously widely used heteroagglutination reactions – Paul-Bunnel, Hoff-Bauer, Lovrik-Wolner have largely lost their significance.
Treatment. Patients with moderate, severe and complicated forms of infection are hospitalized in an infectious diseases hospital.
Patients on outpatient treatment are recommended to bed rest, a gentle diet, oral care (rinsing with furacilin solution, iodinol, sodium bicarbonate, etc.), multivitamins with trace elements, herbal remedies with antioxidant and immunostimulating effects (echinacea, licorice root Icelandic tsetraria, coats of arms of arin).

At febrile body temperature, antipyretic drugs (Panadol, paracetamol, etc.) are prescribed. Desensitizing therapy is performed.Antibiotics are used only when complicated by a secondary bacterial infection (follicular, lacunar tonsillitis, pneumonia). Prescribe antibiotic therapy taking into account the suspected pathogen. In case of infection of the oral cavity, macrolides, penicillins, tetracyclines are used, if necessary in combination with trichopolum, taking into account the possible streptococcal and anaerobic nature of the complication.
It is not recommended to use chloramphenicol and sulfa drugs due to their adverse effect on bone marrow hematopoiesis.

Of the antiviral drugs active against EBV, acyclovir is used at a dose of 800 mg 5 times a day orally or 5 mg / kg every 8 hours intravenously.
If AC is ineffective in severe cases of the disease, vidarabine is prescribed at a dose of 7.5-15 mg / kg / day intravenously in a large volume of isotonic solution (1.5-2.5 l) or foscarnet 60 mg / kg 3 times a day intravenous drip followed by a transition to the introduction of the drug at a dose of 90-120 mg / kg / day.
The use of lobucavir, brivudine and cidofovir for this infection is being investigated.
The administration of cortikosteroid hormones is undesirable.
Prevention. Hospitalization of patients is carried out according to clinical indications. Anti-epidemic measures in the outbreak are not carried out. After the transferred infectious mononucleosis, the patient is undergoing dispensary observation by an infectious disease specialist and a hematologist for 6 months, with obligatory laboratory examination (hemogram, liver function tests).
Since the acute phase of HIV infection has a symptom complex similar to infectious mononucleosis, it is recommended to test convalescents for HIV after 3 and 6 months.

90,000 Influenza | GBUZ Chebulinsky District Hospital

What to do if you get sick: The flu.

How do you know if you have the flu?

The likelihood of influenza is high if some or all of these symptoms are present:

– high temperature

– cough

– sore throat

– runny nose or stuffy nose

– aches in the body

– headache

– chills

– feeling tired

– sometimes diarrhea and vomiting

It is important to note that not every person with the flu will have a high fever.

What if you are sick?

If you become ill with flu-like symptoms during the flu season, you should stay at home and avoid contact with other people while awaiting medical attention. Most people with influenza (h2N1) 2009 develop mild illness and do not need medical attention or antiviral drugs like seasonal flu.

However, people who are more prone to complications from the flu should consult with their healthcare professional if they have flu symptoms during the season.These categories of people include:

-Children under 5 years old, but especially children under 2 years old

– People aged 65 and over

– Pregnant women

People with:

– Cancer

-Diseases of the blood (including abnormal erythrocyte disease)

-Chronic pulmonary disease [including asthma or chronic obstructive pulmonary disease (COPD)]

– Diabetes

– Heart disease

– Renal disorders

– Liver disorders

– Neurological disorders (including the nervous system, brain or spinal cord)

– Neuromuscular disorders (including muscular dystrophy and complex sclerosis)

– Weakened immune system (including people with AIDS)

The development of a serious illness is possible in healthy people due to influenza, therefore anyone who is concerned about their health should consult their doctor.

These are some of the warning signs that anyone should seek immediate medical attention for.

What are the alarming symptoms?

For children

– Rapid or labored breathing

– Gray or bluish leather

– Refusal to drink enough

– Severe or persistent vomiting

– Unwillingness to wake up or lack of activity

– Excited state in which the child resists when picked up

– Some relief of flu symptoms that later recur with fever and increased cough

Adults

– Difficulty breathing or shortness of breath

– Pain or pressure in the chest or abdomen

-Sudden dizziness

– Confusion of consciousness

– Severe or persistent vomiting

– Some relief of flu symptoms that later recur with fever and increased cough

Are there medications for 2009 flu (h2N1)?

Yes.There are antiviral drugs that your doctor can prescribe for both seasonal flu and 2009 h2N1 flu. These drugs can get you back on your feet quickly and can also prevent serious complications. During this flu season, antiviral drugs are used primarily to treat people with severe illness, including those requiring hospitalization; and – for the treatment of people who are at greatest risk of serious complications from the flu.Your healthcare provider will decide if antiviral drugs are needed to treat your condition. Until now, most people with 2009 h2N1 influenza have developed mild illness and did not need medical attention or antiviral drugs, as is the case with seasonal flu.

How long should I stay at home if I am sick?

At least 24 hours after the disappearance of fever, unless medical attention is sought.

Your fever should go away without the use of an antipyretic agent. You must stay at home and avoid going to work, school, traveling, shopping, or attending social events or public gatherings.

What should I do when I am sick?

Stay as far away from others as possible so as not to infect them. If you need to leave your home, for example, to get medical attention, wear a face mask if you have one, or cover your mouth when you cough or sneeze with a handkerchief.Also, wash your hands often to avoid spreading the flu to others.

How to distinguish influenza from acute respiratory viral infections

– What symptoms can be used to determine that a person has the flu?

– If a person has several or all of the symptoms, chances are good that they have the flu. Symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, feeling tired, sometimes diarrhea and vomiting.But not every person with the flu has a high fever.

– What should a person do if they recognize the flu?

– If you fall ill with flu-like symptoms, you must stay at home and avoid contact with other people while awaiting medical attention.

– When should you call an ambulance or a doctor?

– If the child has rapid or labored breathing, the skin is gray or with a bluish tinge, if the child refuses to drink enough, he has severe and persistent vomiting, unwillingness to wake up or lack of activity, an agitated state about which the child resists when taken on hands, and if there is some relief of flu symptoms, which later return, accompanied by a fever and increased cough.

– When should an adult seek help?

– Adults should seek medical attention if they have difficulty breathing or shortness of breath, pain or tightness in the chest and abdomen, sudden dizziness, confusion, severe or persistent vomiting. You also need to see a doctor if a person feels better, but then the symptoms of the disease return, accompanied by fever and a severe cough.

– What drugs can be used to fight the flu?

– Yes – antiviral drugs.These drugs can quickly get you back on your feet and prevent serious complications. Antiviral drugs are used to treat people with any form of illness, including those requiring hospitalization, and those who are at greatest risk of serious complications from the flu. Your doctor will decide if antiviral drugs are needed to treat the condition.

– If a person is still ill, how long will he stay at home?

– It is recommended that you stay at home for at least 24 hours after the fever disappears, unless you seek medical attention.Your fever should go away without using an antipyretic agent. You must stay at home and not go to work, school, travel, shop, or place social events and public gatherings.

– How can you improve immunity so that the virus does not cripple your health?

– Go out into the fresh air more often, hiking strengthens the immune system. Be sure to ventilate the areas at home and at work. Oxygen is needed for the immune system to function properly, as well as the cardiovascular system and brain function.Move, move and move again. Treat chronic diseases in a timely manner. Healthy sleep – you need to sleep at least 7-8 hours a day. Chronic lack of sleep and just poor sleep have a very negative effect on the immune system. Improve blood circulation, take a contrast shower daily. This will strengthen the immune system and help keep yourself in good shape. But remember that there are contraindications for this procedure, such as heart disease, blood problems and high blood pressure.