What Causes Diarrhea in Small Children?
The main cause of diarrhea in children under 5 years of age is rotavirus that causes gastroenteritis – an inflammation of the inner layer of the stomach and small intestine.
Symptoms of Stomach Flu
Symptoms of a rotavirus infection resemble influenza – from here the term stomach flu. There is no connection between stomach flu and influenza, though. Symptoms of stomach flu (viral diarrhea) include:
- Fever, headache, followed by..
- ..watery diarrhea and vomiting that appear 1-2 days after the infection and usually last for 3-8 days (1).
- Symptoms of dehydration: drowsiness or restlessness, thirst (which may not necessary be present!), decreased urination or, in severe cases, sunken eyes, sunken fontanel, and decreased consciousness.
- In the Western world, rotavirus diarrhea is usually a mild disease, but in some parts of Africa, Middle and South America and south Asia over 1 million of children dye from it each year, mainly from dehydration.
How is Stomach Flu Spread?
Rotavirus is spread by stool-contaminated hands and surfaces, usually through daily care centers, mostly in the winter. Food borne and water borne infection are also possible, but droplet infection is less likely. The stool of infected children is highly contagious several days before diarrhea onset, and for up to 10 days after diarrhea has stopped. In some children and adults, the infection may show no symptoms but their stool is still contagious.
Diagnosis of Stomach Flu
A doctor can give a diagnosis on the basis of symptoms. In doubtful cases a stool test for rotavirus may be done.
Other causes of diarrhea in small children:
- Acute viral diarrhea may also be caused by other viruses: adenovirus, enteroviruses, noroviruses, influenza virus, measles (in non-vaccinated children), and so on.
- Intestinal parasites, like giardia or Entamoeba hystolytica (from contaminated drinking water) usually cause mild, but prolonged (weeks) diarrhea; diagnosis is by stool test for ova and parasites (O&P test).
- Bacterial infection due to food poisoning .
- Early introduced solid food, change of diet, overfeeding, drinking a lot of fruit juices (toddler’s diarrhea).
- In fructose malabsorption - diarrhea and bloating appear several hours after fructose-rich meal.
- Malnutrition due to starvation, intestinal parasites, lack of vitamins or minerals, like zinc, in the food.
Treatment of Stomach Flu
Diarrhea usually heals on its own within a week. Often the only treatment needed is fluid replacement using non-prescription rehydration solutions available in drug stores.
If diarrhea does not stop in 5 days, a child appears irritated or drowsy (symptoms of dehydration) or can not ingest food or fluid, doctor has to be visited promptly since intravenous fluid might be needed.
Stomach Flu Prevention and Vaccines
The risk of infection may be reduced by washing hands before eating and cleaning stool-contaminated surfaces. A child with diarrhea should stay at home and a healthy child should be taken off daily care during a rotavirus epidemic.
An oral vaccine RotaTeq, which prevents diarrheal disease in over 70% of rotavirus infections, is available in the United States and Canada. A vaccine is given in the first year of life in three doses together with other childhood vaccines; no serious side effects are known (2). A comparable vaccine Rotarix is available in Europe and some other countries.
Can Rotavirus Diarrhea Affect the Child Several Times?
Subsequent infections are usually of decreasing severity since immunity strenghten after each bout.
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Article reviewed by Dr. Greg. Last updated on February 17, 2010