Facts and advice for stomach ailments direct from paediatricians. Diarrhea and vomiting in children are almost always due to gastric disease, a viral infection which is also called stomach flu, winter vomiting illness or gastroenteritis. The gastrointestinal virus is highly contagious and is found in many with both diarrhea and vomiting. It is especially contagious with direct contact. The incubation period for gastric disease varies between different viruses from one to four days.
How Stomach Disease spread
In every person suffering vomiting and diarrhea, this could be due to lots of stomach ailments. The most common gastrointestinal virus in Sweden is calicivirus, which is divided into noro- and sapoviruses. They cause what is called winter sickness, as they are most common in winter. But the infections are year-round. The Public Health Authority follows the state of calicivirus in Sweden.
The virus is transmitted through direct contact, or from viruses spread through vomiting or diarrhea on hands or clothes, on food that you eat, or other objects you touch. To reduce the risk of infection as much as possible, hand wash, hand wash, hand wash. After visiting the toilet and changing nappies. After vomiting and handling dirty laundry. Before eating food and cooking. Handwash is not effective against viruses, so it is soap and water that applies. And paper towels. Perhaps my best bet is to prevent the spread of infection in the family: wash the towels at 60 degrees and place them in the wardrobe until everyone is healthy.
Stomach flu incubation time
The incubation period for gastric disease varies between different viruses. Winter intestinal disease is caused by norovirus or sapovirus. For norovirus, the incubation time is about one day, for sapovirus 1.7 days. Rotavirus has about 2 days incubation time while astrovirus has 4 days incubation time.
Did you get infected before the winter sickness outbreak?
No, you do not get infected before the winter sickness outbreak, but the problem is that you do not know when it will break out until when you first vomit. And then you definitely get infected. As an adult, you might run away and vomit controlled, thus minimizing the infection. But a child will vomit where it is, and infect others.
How long do you suffer with stomach upsets?
You are definitely infected as long as you have vomiting and diarrhea and a general recommendation worth following is that you are home from school and work for up to 48 hours after the last symptoms were showing. It is worth noting, however, that it is possible to secrete gastrointestinal virus significantly longer than that in the stool, but there is nothing you can do about it.
How do you know it is a stomach upset?
In the case of sudden intensive vomiting, diarrhea and fever, the diagnosis is not so difficult, it would appear to be stomach flu. If the child only has diarrhea and fever but no vomiting, it is probably also the stomach flu
Just vomiting, is it stomach upset?
Only vomiting can indicate a stomach illness, but it doesn't have to be. If there is stomach upset in the environment and the vomiting comes quickly, perhaps along with fever, then it is probably a viral stomach illness.
Watch out for the combination of vomiting and headaches. Certainly, headaches can be a symptom of dehydration due to a stomach upset. But it can also be a sign of increased pressure in the brain, so if headaches are a defining symptom - seek medical attention urgently for assessment.
A single vomiting incident can be a stomach ailment, but it's hard to be sure. You can make an overall assessment of the circumstances when deciding how long you isolate the child from kindergarten etc.
Fever and CRP for stomach flu
Often, but not always, you have a fever in cases of a stomach upset. The fever can sometimes be high, and then it becomes extra important to get fluids. CRP may be normal (<5) or elevated, sometimes markedly elevated. A CRP over 50 in a child with stomach disease and bloody diarrhea may indicate a bacterial cause, but, for example, adenovirus often gives CRP over 100. It is often pointless to test CRP in a child with gastric disease when the diagnosis is clear anyway.
Vomiting in children with diabetes
Vomiting in children with diabetes is acid poisoning (diabetes ketoacidosis) until proven otherwise. Check blood sugar and ketones. Then follow instructions from your diabetes clinic regarding giving insulin if the ketones are high. If the ketones are not dropping properly or you are unsure - seek emergency care. Maybe you have an emergency phone number to call your diabetes pediatrician. Otherwise, seek emergency care. If the child is unresponsive, call an ambulance.
If your child begins to vomit intensively after a period of being very thirsty, peeing and drinking a lot, then it can be a new case of diabetes. Seek emergency medical care immediately to examine it and get emergency treatment. Acid poisoning diabetes is a life-threatening but treatable condition.
Treatment of gastric disease
In cases of stomach ailments, the only thing you have to remember is that the child gets enough fluid. It is so important that we have our very own post on it.
Medication for stomach upset
Fluid replacement is the most important medicine for stomach upsets. In the ER you often receive a remedy for vomiting called Zofran or Ondansetron. It is not formally approved as a remedy for winter sickness, but often prevents vomiting effectively. It is on prescription and there is no tradition of buying it for home use in Sweden.
In copious diarrhea it is good to give a diarrhea medication. For small children Hidrasec is recommended, which reduces the secretions from the intestine. It is on prescription but quite new to the Swedish market and you may therefore need to ask your doctor if it is appropriate to buy it.
In the case of abundant diarrhea in older children and teenagers, the non-prescription Loperamide (Dimor or Imodium) can also be given, but this should not be given to smaller children due to the side effect risk.
How long does stomach flu last?
A viral stomach illness can last for anywhere from one day to three weeks. If you have ample diarrhea, it may be worth asking for a prescription of Hidrasec to reduce intestinal losses if the stomach illness appears to be prolonged. But if you don't, you just have to wait. If you need to wait for more than a week, you may have to ask for a medical certificate from the health center or perhaps a doctor.
Prevent stomach upsets
It is not easy to prevent winter sickness. But keeping yourself and the children at home with stomach upsets and 48 hours after is a good start. Not meeting obviously infected people is another good tip. If you are sick you should not cook for others if possible (difficult if you are single, but otherwise it is often possible). Use paper towels and plastic gloves that you throw away when handling vomit and stools.
There is a vaccine for stomach upset that can be given to infants, the rotavirus vaccine. Since it was introduced into the Swedish BVC program, the number of children who need to be cared for in hospitals due to diarrhea and severe gastric illness has decreased significantly.