Gastroenteritis in children

Your child wakes you at 2 a.m. vomiting and feverish. This is not an uncommon scene, as gastroenteritis, often called 'gastro' or 'tummy flu,' is an infection that causes the stomach and intestines to become inflamed. This can lead to fever, stomach cramps, vomiting, and diarrhoea.

Gastroenteritis spreads when someone comes into contact with infected faeces or when contaminated food or water is shared. It is especially common in children under five. In fact, it accounts for approximately 20% of emergency room visits in this age group, meaning that one in every five ER visits among toddlers is due to this condition. The most significant risk is dehydration, which can be dangerous. Dehydration causes the body to lose fluids and salts, which can affect the heart and kidneys.
Acting quickly to spot and treat dehydration can save your child’s life. It is essential to begin treatment within two hours of the onset of symptoms, such as vomiting or diarrhoea, to prevent dehydration.

• Most cases are caused by viruses, especially Rotavirus, followed by Adenovirus and Norovirus.
• Bacteria such as E. coli, Salmonella, and Shigella can also cause gastroenteritis, usually from contaminated food or water.
• Parasites such as Giardia and Cryptosporidium can cause more prolonged gastroenteritis.

Hygiene is important. Make sure food and water are not contaminated and stored correctly. Routine rotavirus vaccination is a crucial preventive measure that significantly reduces the number of severe cases of gastroenteritis in children. This aligns with current paediatric guidelines and provides an effective way for parents to protect their children. For caregivers, it's beneficial to turn hand-washing into an engaging experience for toddlers, making it not only a preventative measure but also a developmental milestone. Encouraging this skill can transform the routine of hygiene into a fun and positive learning activity for young children. Wash your hands after using the toilet and after changing nappies.

Treatment focuses on relieving symptoms. Watch for complications and signs of dehydration, and treat them as needed. Dehydration is the most common problem, so keep your child hydrated with the right oral rehydration solution, as recommended by the WHO and the Department of Health. Offer small amounts of fluids often. If symptoms persist, then take them to the clinic, doctor, or emergency room.

Consider using a simple three-step rehydration checklist to help manage the process efficiently:

• Measure: Assess your child's condition by checking for signs of dehydration, such as dry mouth or reduced urination.
• Offer: Provide small sips or spoonful of oral rehydration solution frequently, making sure to offer it at regular intervals.
• Observe: Monitor for any improvement or signs that the condition is worsening, and seek professional help if needed.

This checklist can help reduce errors during stressful times.

• No urine for more than 4 to 6 hours
• Sunken eyes
• Dry mouth and tongue
• Fast heartbeat and breathing
• A child who is very sleepy or hard to wake
• Blood in the stools
• A fever over 39°C or one that lasts more than 4 hours
• Ongoing vomiting
• A swollen belly
• Cold sweats, or a pale appearance

Always take the child to the nearest clinic or emergency room if you are uncertain. Gastroenteritis is preventable and treatable if started early. So if unsure, always contact your doctor or go to your closest clinic or emergency unit. With prompt care, most kids bounce back quickly, reinforcing the importance of swift action and attentiveness. This ensures a speedy recovery and provides parents and guardians with peace of mind.