Gastroenteritis is distressing enough for adults. In children, there is also the risk of dehydration caused by vomiting and diarrhoea.
What is commonly known as stomach flu causes discomfort due to the ensuing vomiting and diarrhoea, which are often accompanied by tummy pains and fever. More significantly – though infrequently – it can have a detrimental effect on babies and young children.
At KK Women’s and Children’s Hospital (KKH), some 11,700 children were seen at the Children’s Emergency department in the first 10 months of 2011 for gastroenteritis, making up some 8.5 per cent of total emergency cases.
Stomach flu or gastroenteritis refers to an infection of the intestines, explained Dr Tham Lai Peng, Senior Consultant, Emergency Medicine, KKH. “It can be caused by exposure to a virus through person-to-person contact, or contact with a contaminated surface.” Eating contaminated food or drinking sullied water can also cause gastroenteritis.
Children can come into contact with virus-contaminated surfaces (by putting infected toys in their mouths), or be exposed to the vomit or faeces of an infected person (because of unclean hands and food).
Food contaminated with bacteria or toxins, or those that were poorly refrigerated or washed, can also cause it.
The most common cause of gastroenteritis is exposure to viruses. Rotavirus, which causes infections in the intestinal tract, results in a large proportion of hospitalisations due to gastroenteritis.
The rotavirus threat
According to a local hospital-based study led by Professor Phua Kong Boo, Senior Consultant, Gastroenterology Service, KKH, nearly 40 per cent of children under five years old, who were hospitalised at KKH for gastroenteritis between September 2005 and April 2008, were infected by rotavirus.
An Asia-based study found that vaccination is the most effective strategy to protect children against this infection.”
Dangers of dehydration
Gastroenteritis can have severe symptoms and result in serious dehydration in babies and young children if left unchecked. Vomiting, one of the first signs, usually occurs in the first eight to 24 hours, while diarrhoea may last for two to four days, and even up to 14 days. “The risk of dehydration increases if these symptoms are severe and happen together,” said Dr Tham.
“As children, particularly babies, have a weaker immune system, they have a higher risk of getting the disease. They also may develop symptoms faster than adults. More crucially, they are more at risk of dehydration as they have lower blood volume and, so, less of a ‘reserve’.”
Severe dehydration can cause shock and decrease blood circulation, while the loss of essential salts and electrolytes due to vomiting and diarrhoea can lead to seizures. In rare cases, acute kidney failure can result. To prevent dehydration, parents should increase the frequency of milk and liquid feeds, but give these in smaller volumes, using a small spoon or dropper if needed (see sidebar).
Some common signs of dehydration include having a dry tongue and/or lips, said Dr Tham. “There may be lethargy and decreased or no passing of urine for six hours or more. The eyes, as well as the fontanelle – the soft spot in a baby’s head – may also be sunken and the skin may lose elasticity.” She advised parents to look out for these signs and, if present, to seek emergency treatment.
Seek medical attention if :
- There are signs of dehydration
- Stools or vomit are bloody
- The vomit is greenish, which may indicate a blockage of the bowels
- There is persistent abdominal pain
- The child is under six months old
- The child is lethargic or irritable