Over the last couple of days there have been several articles come out about Gastroenteritis, particularly in children. Over a hundred children have presented weekly to public health facilities with vomiting, diarrhoea and fever symptoms of Gastroenteritis here in Jamaica. It is not unusual during the last months of the year for Gastroenteritis to be common, it can be particularly harmful for younger children and babies, so it is important to be able to identify and manage the signs and symptoms and most importantly, know when to seek medical help. This alert from the Jamaican Ministry of Health and Wellness from 2017 is still relevant today.
What is Gastroenteritis?
Gastroenteritis is the inflammation of the stomach and intestines. Inflammation here speaks to the body’s response to harmful stimuli, such as a virus, bacteria or parasite called pathogens. When this inflammation occurs, while it is useful to fight against infection (in this case), it disrupts the normal function of the stomach and intestines leading to multiple episodes of loose stool- called diarrhoea or vomiting.
Gastroenteritis can be caused by several pathogens, the most common is a virus called rotavirus and the rest of this article will be focused on this. The overall prevention strategies covers most causes of Gastroenteritis.
How Do I Get Gastroenteritis?
There are several ways that you can get Gastroenteritis:
- Faeco- oral: this simply means putting unwashed hands in your mouth that may be contaminated with stool (poop) from someone who has the virus.
- Putting your hands in your mouth after touching contaminated objects or surfaces.
- Eating contaminated foods and beverages.
How Do I Prevent Gastroenteritis?
If you look at how Gastroenteritis is transmitted, it is easy to see how to prevent it. We can also see why children, who often put everything in their mouths, are so likely to get Gastroenteritis.
- Washing hands properly with soap and water is a mainstay way of prevention,
- Ensuring food is properly cooked and water is from a clean source
- Cleaning surfaces well
are ways of preventing transmission and spread of Gastroenteritis.
There are two vaccines available for rotavirus, however, like the Covid 19 vaccine, it doesn’t prevent you from getting the virus, but helps to prevent a severe course of the disease. These vaccines are approved for infants, usually in the first year of life, and not for older children and adults.
These vaccines provide up to 98% protection from a severe course of the illness and up to 87% prevention against rotavirus illness on a whole. The data quoted is from the CDC read more here.
Speak to your primary care doctor or paediatrician for more information on vaccines.
What are the Symptoms of Gastroenteritis?
Symptoms of Gastroenteritis are diarrhoea, vomiting and fever. Persons may also have abdominal pain, cramping, fever, chills, nausea, fatigue and loss of appetite.
Due to the diarrhoea and vomiting, it is important to look out for signs of dehydration, because these cause you to lose water. Dehydration is the major cause of death from gastroenteritis and it is important to know how to identify the signs of dehydration, especially in babies and children so medical help can be sought urgently.
Signs of dehydration include but are not limited to:
- increased thirst
- dry mouth and skin
- light headedness.
The following signs of dehydration require immediate medical attention:
- little to no urination
- extreme thirst
- no tears
- sunken eyes
- decreased responsiveness
- trouble breathing
- rapid breathing and heartbeat
Read more here.
How Do I Treat Gastroenteritis?
There is no medication for Gastroenteritis, the number one goal is to prevent dehydration, which means keeping up with volume lost from vomiting and diarrhoea. Gastroenteritis caused by a virus is usually self limiting, what this means is, it will run its course. Persons should not take medication to stop the diarrhoea unless prescribed by a doctor.
It is important to replace fluids lost with oral rehydration solution or other liquids such as water and coconut water. Avoid sweet drinks as this can actually make the diarrhoea worse! For babies who are breastfed, replace losses with breast milk. Persons should drink fluids slowly, frequently and in small amounts to prevent worsening of nausea.
Other things to do are eat bland foods and slowly reintroduce ‘regular’ food as the symptoms subside and until the illness has run its course, avoid dairy products, alcohol and caffeine.
For the fever, antipyretics (anti fever) medication can be taken and tepid sponging used to lower the temperature. Tepid sponging is the act of sponging lukewarm water for up to 30 minutes in an attempt to decrease body temperature. Avoid cold water, ice and rubbing alcohol. Stop if shivering occurs.
Before taking or giving medication speak with a doctor or pharmacist regarding its use, especially for young children and ensure you read and follow the instructions appropriately.
Children and adults should stay home until symptoms are all gone to prevent the spread of Gastroenteritis.
When to See a Doctor?
There are red flags that signal go get medical attention NOW. Dehydration is easy and affordable to treat, but can be life threatening if not addressed quickly. Signs of severe dehydration, as stated above, are all cause to seek urgent medical assessment and treatment.
Other signs signifying urgent care is needed are blood in stool or vomit, frequent diarrhoea and vomiting preventing adequate replacement of fluids by mouth and symptoms persisting after a week.
If symptoms do not improve, seek medical attention.
Regardless of whether or not any of these things are occurring, I think it’s important to seek medical advice once you are concerned or unsure. Primary care physicians can often give reassurance and guidance on the treatment of adults and children who are experiencing signs and symptoms of Gastroenteritis and can more accurately access dehydration.
As we close off the year, we must also remember it is cold, flu and gastroenteritis season and we should use prevention strategies to avoid illness, and early treatment to help avoid severe courses of illness. When in doubt seek medical advice from your primary care physician or otherwise appropriate.
Dr. Samantha Johnson
Disclaimer: This article is not intended to replace seeking medical attention and serves only for informational purposes. Speak to your medical doctor if you have any questions or concerns regarding you or your relative.
Featured image taken from Chegg.com