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| Volume 1, Issue 19 | JANUARY 2005 |
| Inside This Issue | |||||
| 1 | |||||
| 1 | Gastroesophageal Reflux Disease (GERD) | ||||
| 2 | Updates and Announcements | ||||
Medical Information Fact Sheet
Viral gastroenteritis is an intestinal infection caused by several viruses. Viral gastroenteritis is highly contagious and causes millions of cases of diarrhea each year.
Anyone can get viral gastroenteritis and most people will recover with no complications. Viral gastroenteritis can become serious for people who cannot drink enough fluids to replace what is lost from vomiting and diarrhea. This includes infants, young children, the elderly, and people with weak immune systems.
Symptoms:
The main symptoms of viral gastroenteritis are watery diarrhea and vomiting. Headache, fever and abdominal pain may also be present. The symptoms may appear within hours or a few days following infection. The symptoms usually last one to two days, but can last as long as 10 days.
The viruses that cause viral gastroenteritis damage the cells in the lining of the small intestine. Four types of viruses cause most cases of viral gastroenteritis.
• Rotavirus is the leading cause of gastroenteritis in children 3-15 months of age. Children with rotavirus have vomiting and watery diarrhea for 3-8 days, along with fever and abdominal pain. Symptoms of rotavirus infection appear 1-2 days after exposure. In the United States, rotavirus infections are most common November through April.
• Adenovirus types 40 and 41 cause gastroenteritis mainly in children younger than 2 years of age. Infections occur year round. Vomiting and diarrhea appear about one week after exposure.
• Caliciviruses cause infection in persons of all ages. Caliciviruses are transmitted from person to person and also through contaminated food or water-especially oysters from contaminated waters. In addition to vomiting and diarrhea, people infected with Caliciviruses may have muscle aches. The symptoms appear within 1 to 3 days of exposure.
• Astrovirus also infects primarily infants, young children and the elderly. The virus is most active in the winter months. Vomiting and diarrhea appear within 1 to 3 days of exposure.
Viral gastroenteritis is often mistakenly called “stomach flu,” but it is not caused by the influenza virus and it does not infect the stomach. Also, viral gastroenteritis is not caused by bacteria or parasites.
Viral gastroenteritis is highly contagious. The viruses are often transmitted on unwashed hands. People can get the viruses through close contact with infected individuals, such as sharing their food, drink or eating utensils, or by eating food or beverages that are contaminated with the virus. People who no longer have symptoms may still be contagious, since the virus can be found in the stool for up to two weeks after they recover from their illness. People can become infected without having symptoms, and they can still spread the infection.
Outbreaks of viral gastroenteritis can occur in child care settings, schools, nursing homes, cruise ships, camps, dormitories, restaurants and other places where people gather in groups. If you suspect that you were exposed to a virus in one of these settings, you may want to contact your local health department, which tracks outbreaks.
If you think that you have viral gastroenteritis you may want to contact your doctor, although most people don’t bother. Doctors generally diagnose viral gastroenteritis based on the symptoms and the physical exam. The doctor may ask for a stool sample to test for rotavirus or to rule out bacteria or parasites as the cause of the infection.
Most cases of viral gastroenteritis resolve over time without specific treatment. Antibiotics are not effective against viral infections. The primary goal of treatment is to reduce the symptoms, and prompt treatment may be needed to prevent dehydration.
In viral gastroenteritis, the combination of diarrhea and vomiting can cause dehydration. The symptoms of dehydration are• Excessive thirst
• Dry mouth
• Little or no urine or dark yellow urine
• Decreased Tears
• Severe weakness or lethargy
• Dizziness or lightheadednessIf you notice any of these symptoms, you should talk to your doctor. Mild dehydration can be treated by drinking liquids. Severe dehydration may require intravenous fluids and hospitalizations. If untreated dehydration can be life threatening.
You can take several steps to help relieve symptoms of viral gastroenteritis.• Allow your gastrointestinal tract to settle by not eating for a few hours.
• Sip small amounts of clear liquids or suck on ice chips if vomiting is still a problem.
• Give infants and children oral rehydration solutions to replace fluids and loss of important salts and minerals, known as electrolytes.
• Gradually reintroduce food, starting with bland, easy-to-digest foods, like toast, broth, apples, bananas, and rice.
• Avoid dairy products, caffeine and alcohol until recovery is complete.
• Get plenty of rest.
Prevention is the only way to avoid viral gastroenteritis. There is no vaccine available. You can avoid it by
• Washing your hands thoroughly after using the bathroom or changing diapers.
• Washing your hands thoroughly before eating.
• Disinfecting contaminated surfaces.
• Not eating or drinking foods or liquids that might be contaminated.
Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back, or reflux, into the esophagus.
When refluxed stomach acid touches the lining of the esophagus, it causes and burning sensation in the chest or throat called heartburn. Occasional heartburn is common but does not mean one has GERD. Heartburn that occurs more than twice a week may be considered GERD, and it can eventually lead to more serious health problems.
Anyone, including infants, children, and pregnant women can have GERD.
The main symptoms are persistent heartburn and acid regurgitation. Some people can have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning and trouble swallowing. One may feel like they have food stuck in their throat or like they are choking or their throat is tight. GERD can also cause a dry cough and bad breath.
GERD in children
GERD in children can cause repeated vomiting, coughing and other respiratory problems. Children’s immature digestive systems are usually to blame and most infants outgrow GERD by age 1. If concerned, speak with the child’s doctor. The doctor may recommend strategies for avoiding reflux, like burping an infant several times during feeding or keeping the infant upright for 30 minutes after feeding. If the child is older the doctor may recommend that the child avoid sodas with caffeine, chocolate and peppermint, spicy foods like pizza, acidic foods and fried or fatty foods. Avoiding food 2-3 hours before bed may also help. The child may need to sleep with head raised. If these changes do not work, the doctor may prescribe medications. In rare cases, surgery may be needed.
No one knows why people get GERD. Some factors that may contribute to GERD include: hiatal hernia, alcohol use, overweight, pregnancy and smoking. Also many spicy, fatty, fried and acidic foods are associated with reflux events.
Depending on the severity of GERD, treatment may involve lifestyle changes, medications or surgery.
Lifestyles changes may include quitting smoking and drinking, weight loss, eating smaller meals, and wearing loose-fitting clothes. Also not lying down for 3 hours after a meal and raising the head of your bed 6-8 inches.Medications may be purchased over the counter or prescribed. Work with your doctor to determine which medication regimen is best for you.
If the medications and lifestyles changes do not work than surgery may be an option.
Treatment is important since GERD may have long term effects on the esophagus including inflammation, bleeding and ulcers. Over time cancer can develop. Also asthma, chronic cough and pulmonary fibrosis may be aggravated by GERD.
References
National Digestive Diseases Information Clearinghouse (NDDIC). (2003, April). Viral Gastroenteritis. Retrieved on January 13, 2005 from the World Wide Web: http://digestive.niddk.nih.gov/ddiseases/pubs/viralgastroenteritis/index.htm
National Digestive Diseases Information Clearinghouse (NDDIC). (2003, June). Heartburn, Hiatal Hernia and Gastroesophageal Reflux Disease (GERD). Retrieved on December 28, 2004 from the World Wide Web: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.htm
HCPCFC PROGRAM UPDATES and ANNOUNCEMENTS!!!
We would like to welcome Florem Hill to the program. She is based in the Temecula CPS office and will be covering the West Corridor Region.
Welcome!
Editor: Kristen Thompson, PHN, and Nicole Boyd, PHN
Contributors: Michelle Haynes, PHN, MBA, Assistant Nurse Manager and Judy Earp, MHA, Director of Public Health Nursing.
