Gastroenteritis cases are on the increase

By Carleene Grant-Davis

We are experiencing quite a busy season of viral illnesses! The dengue outbreak is not quite over yet, but here comes another illness, gastroenteritis.

Gastroenteritis is an intestinal infection that causes vomiting, diarrhoea, and related symptoms. Although it occurs in adults as well, children are usually more severely affected. Gastroenteritis is usually caused by viruses, occasionally some cases are caused by bacteria. The viruses are quite contagious and cause damage to the cells lining the intestines.

Rotavirus outbreak

Rotaviruses are the most common cause of gastroenteritis. Most cases of severe diarrhoea in children younger than two years are due to rotavirus. In fact, virtually all children are infected with this virus by three years of age. Infections occur most commonly from November through March. Rotavirus infection was once called the "winter vomiting disease."

Signs and Symptoms

Most cases of gastroenteritis are not serious but children can feel quite sick. Symptoms include:

• watery diarrhoea
• vomiting
• a fever
• abdominal pain

These symptoms begin one to two days after exposure to the virus and usually last for three to eight days. Prolonged or severe diarrhoea, particularly when accompanied by vomiting, can lead to dehydration. Signs of dehydration include:

• increased thirst
• less urine
• dry mouth
• fewer tears
• weight loss

As dehydration becomes more severe, your child will become cranky and irritable, his or her eyes will appear sunken, and he or she may have a faster heart and breathing rate. If dehydration continues, the kidneys will stop working and the heart will not have enough fluid to pump. The blood pressure will drop and your child will go into shock and can die.

What You Can Do

These viral illnesses resolve on their own without any specific treatment. Make your child as comfortable as possible and take steps to prevent dehydration. Encourage him or her to rest, drink extra fluids, and continue to eat his or her regular diet. Babies must continue to have their breast milk or regular formula.

The best fluids to give are plain water, coconut water, breastmilk or formula or freshly made juices with no added sugars. Stay away from commercial juices as they usually contain a lot of sugar which will make the diarrhoea worse.

Fluids with salt

If the diarrhoea is severe or persistent, it is important that the fluids contain salt because salts are lost in the diarrhoea. Rehydration fluids are sold over the counter. Refrain from making your own salts as you may use incorrect amount of salt and water and make the situation worse.

If your child is vomiting, continue to offer fluids but give small amounts (use a teaspoon and give a teaspoon every two to five minutes) and more frequent feedings. If either the vomiting or diarrhoea is severe or persistent, take your child to his or her doctor or the nearest emergency room as they will become dehydrated and will need intravenous fluids.Because these are viral illnesses, the use of antibiotics is not appropriate and may, in fact, make the diarrhoea worse. There is a vaccine available for babies under six months of age that can prevent severe cases of gastroenteritis caused by rotavirus.

Dr Carleene Grant-Davis is a consultant paediatrician and head, Dept of Paediatrics, Cornwall Regional Hospital; email: yourhealth@gleanerjm.com.