Back-to-school time is the time when children are unavoidably exposed to dozens of other children, as well as dozens of viruses and bacteria. Children, like the elderly, and those with lowered immunity, are particularly susceptible to common and emerging infections.
Acute gastroenteritis, an inflammation of the mucosa of the stomach and intestines, as a result of a virus, is a common illness in children, resulting in 1.5 million outpatient visits, 200,000 hospitalizations, approximately 300 deaths, in the United States alone. In developing countries, an estimated 2 million children under 5 years old die from acute diarrhea each year.
Dr. Paul Roberts, local Pediatrician, recently revealed the facts of ‘Gastroenteritis in Children’ at the recent Doctors Hospital Distinguished Lecture Series event, held in the Hospital’s conference room. As stated by Dr. Roberts "Most infectious organisms are transmitted by unwashed hands. The best way to prevent viral gastroenteritis is to handle food properly and wash hands thoroughly after using the toilet". Rotavirus, a viral infection of the digestive tract, which leads to acute gastroenteritis, is the most common cause of severe diarrhea in infants and young children.
Rotavirus is highly infectious and is spread by the vomit or feces of an infected person through person-to-person contact, for example, shaking hands with someone who has been sick and has the virus on their hands, contaminated surfaces, or contaminated food or drink. There may also be the possibility of infection being spread through aerosol particles when people vomit.
In most cases, spread occurs from a person who has symptoms. Some people can pass on the infection without symptoms, particularly in the first 48 hours after recovery. The infection usually starts with fever and vomiting, followed by diarrhea. The diarrhea can be mild to severe and generally lasts 3-9 days. Illness usually begins 3 days after exposure.
During the first few years of life, a child typically has several rotavirus infections. The highest rates of gastroenteritis are generally in children under two years of age, who are also at the greatest risk for severe disease. Nearly all children will be infected with rotavirus by age five.
Children gradually develop immunity against different strains of the virus after several infections. Most children with rotavirus diarrhea recover on their own, but some children become very ill with severe vomiting, diarrhea, abdominal pain, and loss of fluids (dehydration). Children with severe diarrhea can lose body fluids very quickly and may need to be hospitalized for special therapy to replace fluids and restore chemical balance. The seriousness of infection generally decreases with the number of infections. First infections tend to be the most severe. Rotavirus is particularly a problem in child-care centers.
"Severe infection, rotavirus gastroenteritis, is the leading cause of severe, dehydrating diarrhea in infants and young children worldwide" said Dr. Roberts. "Nearly every child is infected with rotavirus by age five and most will develop gastroenteritis, leading to a large number of physician visits, emergency room visits, and hospitalizations, with a few deaths."
Although the Rotavirus vaccine will not prevent gastroenteritis caused by other viruses, it is very effective against rotavirus disease. Studies indicate the vaccine will prevent about 74 percent of all rotavirus cases and about 98 percent of the most severe cases, including 96 percent of rotavirus cases requiring hospitalization. In trials, the vaccine prevented 59 percent of all causes of gastroenteritis hospitalizations, which highlights the important role of rotavirus in severe childhood gastroenteritis.
"This vaccine, Rotarix, will help reduce one of our most common and potentially severe childhood illnesses" explained Dr. Roberts. "The data is very encouraging and shows that very young infants can be effectively protected against the highly contagious rotavirus. The inclusion of a vaccination into routine vaccination schedules would significantly reduce outbreaks."
Rotarix is a two-dose, oral vaccine that can be administered at approximately two and three months of age with the first dose can be given as early as 6 weeks and the second dose before 6 months of age. The vaccine offers early protection against RVGE before the peak incidence of disease at 6-24 months of age.
Other than vaccination, there is no effective way to completely eliminate rotavirus infection or its spread. Washing with soaps or cleansers does not kill the virus but will help reduce the spread of infection. To prevent the spread of all diarrheal diseases, it is important to maintain strict hygienic practices at home and in day-care centers. Wash hands frequently, especially after using the toilet, after helping a child use the toilet, after diapering a child, and before preparing or serving food. To ensure further prevention be sure to regularly disinfect play areas and toys, and make certain that your child obtains the Rotavirus vaccine. According to Dr. Roberts, the goal of treatment is to prevent dehydration. "Fluids and electrolytes (salt and minerals) lost by diarrhea must be replaced. Electrolyte and fluid replacement solutions for children are available in food and drug stores. Remember that juice, soda or water does not replace electrolytes lost from vomiting or diarrhea. Since the risk of dehydration is greater in infants and young children, parents should closely monitor the number of wet diapers changed per day when the child is sick. People with diarrhea who are unable to take fluids by mouth because of nausea may need intravenous fluids. This is especially true in small children" stated Dr. Roberts.
"Additionally, antibiotics do not work for viruses. Call your health care provider if diarrhea persists for more than several days or if dehydration occurs. You should also contact your doctor if the following symptoms are present: blood in the stool, low urine output, nausea, faintness, dizziness, dry mouth, sunken appearance to the eyes, sunken fontanel (soft spot on an infant’s head), or confusion."
School Time Tips for Keeping Your Child & Others from Getting Sick
Encourage frequent hand washing during the school day, especially before and after meals or when using the bathroom.
If your child becomes ill with a contagious infection, it is best to keep him/her home from school to avoid transfer to other students and teachers.
- Austin DWI - New York DWI