MC2Charlotte

Its that time of the year when the stomach virus is spreading like wild fire through the community.  During the end of February and the beginning of March, we generally see lots of vomiting and diarrhea.  We do not generally test kids or adults for what virus they may have, unless they are hospitalized.  However, we do know that stomach viruses are HIGHLY Contagious.

 

 
Allow me to illustrate:  when a person vomits or has diarrhea, they shed MILLIONS to BILLIONS of particles.  However, it takes only 10-100 viral particles for a person to catch the illness.  Aaaaand now we are all grossed out.

  

Here are some tips and tricks on how to survive this horror:

PREVENTION

1. Wash hands with soap and water. Hand sanitizers do not help. Teach kids to sing their ABC’s two times through while washing hands to properly kill the crud. (this is 20 seconds)
2. When cleaning bathroom surfaces or diaper changing areas, use a diluted bleach solution.  The “organic” or “non-toxic” solutions without bleach DO NOT  kill the stomach viruses.  You many not want to use bleach on your kitchen counters, but use it anywhere there is vomit, diarrhea, or poo.
3. Clean up vomit and/or diarrhea promptly with soap and water.
4. Keep kids home or stay home if you have vomitted or have had diarrhea within the past 24 hrs.  For example, if a child has diarrhea at 6 pm at night and wakes up without any poop at 6am, he should not go to day care or school that morning.  Please keep kids home until they are symptom free for 24 hrs.  Appearing to be symptom free is not the same as being symptom free.  This is one of the Main reasons the stomach virus spreads like wild fire. I understand parents need to go to work and thus kids have to go to day care, but we must act like a team to reduce the spread.  Parental convenience, many times means spreads lots of illnesses.  Moreover, kids and adults shed the virus for days after the illness has resolved, but most shedding occurs during active illness, which is from start of illness to 24hrs after the illness ends.

TREATMENT – VOMITING

• Most kids vomit for 24hrs, then vomiting stops and diarrhea may appear.
• See a doctor if the vomiting is non stop and the child is appearing dehydrated.
• While the child is vomiting, medications may or may not be indicated.  Speak with your doctor about anti nausea meds.  Most kids do just fine without medication.
• Stop all dairy products until vomiting has resolved for 24-48hrs.
• It the child has several vomiting episodes, here is a way to keep them hydrated based on protocols developed at Children’s Hospital in Philadelphia (CHOP)
  • DEHYDRATION PROTOCOL If your child starts vomiting, implement the following protocol : Alternate water with Colorless Pedialyte or Juice or Home made Gatorade solution (I am not a fan of gatorade and all its chemical and color additives).  Place drinks in small medicine containers and set a timer.  DO NOT offer big glasses or sippy cups and “eye-ball” the amounts.
  • As a General Rule for Kids under 10yrs old Start with:
    • 5ml every 10 min for 1 HR
    • 10ml every 10 min for 1 HR
    • 15 every 10 min for 3 HRs.
    • Then no more drinking restrictions.
    • Advance to Bland/BRAT Diet.
    • NO CHEATING (no matter how much they cry and beg do not let them have as much as they want, cause they will!) CHEATING = vomit. Call your doctor for questions/worsening condition
  • As a General Rule for Kids 10 yrs and older Start with:
    • 10ml every 10min for 1 HR
    • 15ml every 10min for 1 HR
    • 30ml every 10min for 3 Hrs.
    • Still No CHEATING.  Kids start feeling better, they get thirsty, and then start begging or searching for unlimited liquids, which in most cases, leads to more vomit.  Don’t Say You Were Not Warned!!
    • After the 5hrs allow unlimited liquids and stick with a BRAT diet for 24hrs.
• If vomiting recurs, after reintroduction of regular food, go back to the BRAT diet for 2-3 days.  Do not panic, this just means the intestines are not ready for full on digestion.  Keep Lactose/dairy/fried foods out of diet.  Almond milk is a great alternative.

 
 

  

TREATMENT – DIARRHEA

• Expect 5-7 days of diarrhea.
• Never, ever stop diarrhea with medication.  Do not give kids Imodium.  This is not a post about traveler’s diarrhea.
• See a doctor if diarrhea lasts longer then 7-10 days, has blood, or child appears to be dehydrated.
• Expect abdominal cramping, especially after eating. The colon is inflamed and as it tries to digest, it hurts and can cause some gas build up.  See a doctor if the abdominal crams are severe.
• According to the Academy of Pediatrics you can continue on a regular diet while having diarrhea.  However, if the abdominal cramps are persistent, the diarrhea seems to be never ending, remove milk/dairy/lactose/fried foods out of diet until diarrhea has resolved for several days.
• If reintroduction of dairy seems to make diarrhea return, do not panic.  This is Temporary Post-Infectious Lactose Intolerance and it resolves in 2-6 weeks after a diarrheal illness.  Once a body has been tortured by the stomach bug, the intestines shed all the good and bad bacteria/viruses through vomiting and diarrhea.  Once the illness resolves, the intestines have to be repopulated with the bacteria that help with dairy digestion.
• A daily probiotic will help reduce diarrhea symptoms, and in fact it will help prevent seasonal illnesses.  Probiotics Key Points – more then 6 colonies, more then 1 billion units, must be refrigerated.

  

CLEAN UP

1. Alternate layers of  large bath towel and bed sheet on bed to make clean up easy in case of blow outs in the middle of the night.
2. Layer pool towels around the bed on the floor, because no one makes it to the trash can or toilet in the middle of the night.
3. Remove vomit off the carpet and then spray smelly area with vinegar and water solution.  Then Sprinkle baking soda.  Once it’s all dry, vacuum it right up.
4. Hard surfaces should be cleaned up with soap and water and diluted bleach solutions.  Bleach kills the virus.  “Non-toxic”, essential oil cleaners do not kill the viruses.

When to Seek Medical Care – if your parental instincts tell you to see the doctor, then do it.  If the child appears dehydrated, do it.  If the diarrhea/vomit has blood in it, do it.

 

In Good Health,  Ana-Maria Temple, MD