Another on call weekend just completed, and it seems that gastroenteritis, also known as the “tummy bug” or “stomach flu” (whatever term you want to use) which causes vomiting and diarrhea, is still around. I walked into a lot of exam rooms with tired parents and kids all of whom had been vomiting and having diarrhea, not a fun weekend for a family at all. The most likely culprit is norovirus.
Norovirus causes about 21 million cases of “gastro” per year and leads to about 70,00 hospitalizations. You can get norovirus at any time of the year but it is most commonly seen during the winter, and it seems to be hanging around into early spring this year. This has been a particularly bad year for norovirus as there was a new “strain” so even more people seemed to get sick. That includes my own husband!
Norovirus is the leading cause of gastroenteritis in pre-school children. In a recent study, about 21% of the cases of acute gastroenteritis in children younger than 5 were due to norovirus. That compares to 12% due to rotavirus which used to be the primary cause of viral gastroenteritis. Since the introduction of rotavirus vaccine over 5 years ago the rates of rotavirus disease have steadily been dropping, and now norovirus has taken its place! You know those viruses, they are smart.
Norovirus causes inflammation of the lining of the stomach and intestines resulting in severe nausea, vomiting and diarrhea. These symptoms begin soon after exposure and typically last 1-3 days. Many children will also run a low grade fever (around 101) and complain of tummy cramps.
The only treatment is symptomatic: begin frequent sips of clear liquids after vomiting and no solid foods while vomiting (not even a cracker or the pretzels I saw one mother give her child soon after they had vomited, guess what, we saw them again).
Once the vomiting has stopped you can start some bland solid foods like crackers, or soup, or noodles and then advance to other foods. I recommend staying away from dairy for a day or two as well, as I think this may lead to more cramping, and you know kids love dairy products. (think macaroni, no cheese, or Gatorade or Pedialyte rather than milk for dinner).
The problem with norovirus is that it is easily spread via hands, surfaces and maybe even the air. Studies have shown that even after using hand sanitizer there may still be norovirus present. Surfaces may be contaminated as well, and the CDC recommends using bleach or hydrogen peroxide to wipe off surfaces. (I took bleach to our bathroom after my husband was so sick, TMI perhaps?).
The good news is that researchers are now working on a vaccine for norovirus, but in the meantime, we need to pray for warmer weather so we can all get outside and stop spreading these viruses around!