By Sue Hubbard, M.D.
Another on call weekend just completed, it seems that gastroenteritis, also known as the "tummy bug" or "stomach flu," is still hanging around.
I walked into a lot of exam rooms with tired parents and kids, all of whom had been vomiting and having diarrhea, not elements of a fun family weekend. The most likely culprit is norovirus.
Norovirus causes about 21 million cases of "gastro" per year and leads to about 70,000 hospitalizations. While you can get norovirus at any time of the year, it's most common during the winter - and it seems to be lingering into 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 percent of cases of acute gastroenteritis in children younger than age 5 were due to norovirus. That compares to 12 percent 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're 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 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 the child had vomited; and guess what, we saw them again.).
Once vomiting has stopped, you can start some bland solid foods like crackers, soup, or noodles, and then advance to other foods. I recommend staying away from dairy for a day or two, as I think this may lead to more cramping. Since kids do love dairy products, think macaroni, no cheese; or Gatorade or Pedialyte rather than milk with meals.
The problem with norovirus is that it's easily spread via hands, surfaces and maybe even the air. Studies have shown that even after using hand sanitizer, norovirus may still be present. The U.S. Centers for Disease Control and Prevention 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, researchers are now working on a vaccine for norovirus. In the meantime, we need to pray for warmer weather so we can all get outside and stop spreading these viruses around!
Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show. Submit questions at www.kidsdr.com
This was printed in the July 28, 2013 - August 10, 2013 Edition