Several viruses are responsible for viral gastroenteritis, an intestinal infection that causes vomiting, diarrhea, and related symptoms in children. These viruses, which injure the cells that line the small intestine, tend to be quite contagious. Outbreaks can occur in child care centers or after the ingestion of contaminated food such as shellfish, salads, or ice. Often, the food is contaminated by infected food handlers.
Here are 3 of the most prevalent of these viruses.
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Rotaviruses are the most common cause of severe diarrhea in children younger than 2 years. In fact, virtually all children are infected with this virus by 3 years of age. Infections occur most commonly from November through March. Rotavirus infection was once called the “winter vomiting disease.”
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Astroviruses lead to infections that occur mostly in infants and children younger than 4 years. They occur most often during the winter months.
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Caliciviruses can cause infections that are often spread through contact with an infected child or adult, although a route of transmission frequently cannot be determined. Illnesses caused by these viruses occur year-round. Caliciviruses, including the Norwalk-like virus (norovirus), have gotten plenty of attention in recent years, in large part because of outbreaks of Norwalk-like viruses on cruise ships.
Signs and Symptoms
In most cases, viral GI illnesses are not serious, but children can feel quite sick. Youngsters with a rotavirus infection have watery diarrhea, vomiting, a fever, and abdominal pain. These symptoms begin 1 to 2 days after exposure to the virus and usually last for 3 to 8 days. In severe cases, children may become dehydrated. An astrovirus infection produces abdominal pain, diarrhea, vomiting, nausea, fever, and an overall feeling of malaise. In most cases, the symptoms begin 1 to 4 days after the child has been exposed to the virus and last 5 to 6 days. Calicivirus infections are characterized by diarrhea, vomiting, fever, headache, abdominal cramps, and muscle aches. These symptoms begin 1 to 3 days after exposure to the virus and last from 1 day to 2 weeks. In severe cases, your child may need to go to the hospital. Prolonged or severe diarrhea, particularly when accompanied by vomiting, can lead to dehydration. Signs of dehydration include increased thirst, less urine, dry mouth, fewer tears, and weight loss. As dehydration becomes more severe, your child will become cranky and irritable, his eyes will appear sunken, and he 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.
How Is the Diagnosis Made?
Pediatricians usually diagnose viral gastroenteritis by examining the child and evaluating his symptoms. In some cases, your pediatrician may test a stool sample or conduct blood tests, which can eliminate other possible causes of your youngster’s illness. Viral gastroenteritis rarely causes blood to appear in the stools. If you see diarrhea with streaks of blood, you should call your pediatrician.
Treatment
These viral illnesses resolve on their own with time and without any specific treatment. Make your child as comfortable as possible and take steps to prevent dehydration. Encourage him to rest, drink extra fluids, and continue to eat his regular diet. It is important that the fluids contain salt because salts are lost in the diarrhea. Rehydration fluids are sold over the counter, but you can also make these at home. Talk to your pediatrician to be sure you have the correct amount of salt and water. In severe cases, intravenous fluids may be required. If your child is vomiting, continue to offer fluids but give small amounts and more frequent feedings. Be careful with apple juice because too much apple juice is a common cause of diarrhea, even in healthy children. Because these are viral illnesses, the use of antibacterials is not appropriate and may, in fact, make the diarrhea worse. Older children may benefit from antidiarrheal medicines, but only under the advice of your pediatrician.
Prevention
Vaccines to protect children against all of these viral infections are not currently available. The best way to avoid these illnesses is to keep your child away from people with the infection. Do not allow him to share food and eating utensils. Make sure your child washes his hands before eating and after using the bathroom. In 1998, a vaccine for rotavirus was licensed and used for a short time. The vaccine was withdrawn from the market because of a rare side effect. Other rotavirus vaccines are being studied and hopefully will be approved for use in the United States in the near future.
