Health officials in Anguilla have noticed an increased number of cases of gastroenteritis from late February this year. Individuals from all parts of the island are affected. The severity of gastroenteritis varies – with some individuals only having a few symptoms, but others, especially children and the elderly, developing severe complications. If these complications are not managed professionally serious consequences might occur.
What is viral gastroenteritis?
Viral gastroenteritis, also known ‘stomach flu’, is an intestinal infection marked by watery diarrhoea, abdominal cramps, nausea or vomiting, and sometimes fevers. Many viruses can cause this disorder, but Norovirus is a common cause and it is suspected to be the causative agent in this recent bout of viral gastroenteritis in Anguilla. The most common way to develop viral gastroenteritis is through contact with an infected person or by ingesting contaminated food or water. If you are otherwise healthy, you will likely recover without complications. For infants, older adults and people with compromised immune systems, viral gastroenteritis can be deadly.
What are the symptoms of viral gastroenteritis?
Symptoms and signs might vary from one individual to another, but common symptoms include the following:
• Watery, usually non-bloody diarrhoea. Bloody diarrhoea usually means you have a different, more severe infection
• Abdominal cramps and pain
• Nausea, vomiting or both
• Occasional muscle aches or headache
• Low-grade fever
Depending on the cause, viral gastroenteritis symptoms may appear within one to three days after you are infected – and can range from mild to severe. Symptoms usually last just a day or two, but occasionally they may persist as long as 10 days. These symptoms are similar to those of bacterial gastroenteritis which is usually caused by such organisms as Clostridium difficile, salmonella and E. coli.
When to see a doctor
Not everyone who develops viral needs to see a doctor or need to be admitted to hospital. If you are an adult, call your doctor if:
• You are not able to keep liquids down for 24 hours
• You have been vomiting for more than two days
• You are vomiting blood
• You are dehydrated. Signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
• You notice blood in your bowel movements
• You have a fever above 104 F (40 C)
For infants and children
See your doctor right away if your child:
• Has a fever of 102 F (38.9 C) or higher
• Seems lethargic or very irritable
• Is in a lot of discomfort or pain
• Has bloody diarrhea
• Seems dehydrated. Watch for signs of dehydration in sick infants and children by comparing how much they drink and urinate with how much is normal for them
Call your baby’s health care provider right away if your baby:
• Has vomiting that lasts more than several hours
• Has not had a wet diaper in six hours
• Has bloody stools or severe diarrhoea
• Has a sunken soft spot (fontanel) on the top of his or her head
• Has a dry mouth or cries without tears
• Is unusually sleepy, drowsy or unresponsive
Treatment
There is often no specific medical treatment for viral gastroenteritis. Antibiotics are not effective against viruses, and overusing them can contribute to the development of antibiotic-resistant strains of bacteria. Treatment initially consists of preventing dehydration and supportive measures. Oral rehydration fluids are successfully used in most cases – a few cases will need intravenous fluids and or hospitalization.
Parents are advised not to give their child with gastroenteritis plain water. Water is not absorbed well and would not adequately replace lost electrolytes. If you do not have oral rehydration fluids, fresh coconut water is a good substitute. Avoid giving your child apple juice for rehydration — it can make diarrhoea worse.
Avoid giving your child over-the-counter anti-diarrhoeal medications unless advised by your doctor. They can make it harder for your child’s body to eliminate the virus.
Prevention
Prevention measures are vital in the management of viral gastroenteritis. The best way to prevent the spread of intestinal infections is to follow these precautions:
• Wash your hands thoroughly. And make sure your children do, too. If your children are older, teach them to wash their hands, especially after using the toilet. It is best to use warm water and soap and to rub hands vigorously for at least 20 seconds, remembering to wash around cuticles, beneath fingernails and in the creases of the hands. Then rinse thoroughly. Carry towelettes and hand sanitizer for times when soap and water are not available.
• When you are sick, do not prepare food or care for others. You should not prepare food for others or provide healthcare while you are sick – and for at least 2 to 3 days after you recover. This also applies to sick workers in schools, daycares, and other places where they may expose people to norovirus.
• Use separate personal items around your home. Avoid sharing eating utensils, glasses and plates. Use separate towels in the bathroom.
• Keep your distance. Avoid close contact with anyone who has the virus, if possible.
• Disinfect hard surfaces. If someone in your home has viral gastroenteritis, disinfect hard surfaces, such as counters, faucets and doorknobs, with a mixture of two cups of bleach to one gallon of water.
• Check out your child care centre. Make sure the centre has separate rooms for changing diapers and preparing or serving food. The room with the diaper-changing table should have a sink as well as a sanitary way to dispose of diapers.
• Wash fruits and vegetables and cook seafood thoroughly. Carefully wash fruits and vegetables before preparing and eating them. Cook oysters and other shellfish thoroughly before eating them. Be aware that noroviruses are relatively resistant. They can survive temperatures as high as 140°F and quick steaming processes that are often used for cooking shellfish. Food that might be contaminated with norovirus should be thrown out. Keep sick infants and children out of areas where food is being handled and prepared.
• Adults who are sick should not prepare food or care for others for at least 2 or 3 days after they recover.
Conclusion
Viral gastroenteritis is an inflammatory infection of the intestines. The excessive vomiting and diarrhoea associated with it can lead to several complications such as dehydration. This can be a serious problem for the very young, elderly and those individuals whose immune response is compromised. There is no effective treatment for viral gastroenteritis, so prevention is key. In addition to avoiding food and water that may be contaminated, thorough and frequent hand-washings are your best defense.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
