The dreaded stomach bug just went through our house. We got a text from our boys’ school this past week “just a head’s up, we have seen a tummy bug going around.” So, this weekend we were bracing for it, but nothing can truly prepare you to witness your toddler projectile vomit unexpectedly. 

I thought this would be a good time to share some information about the “stomach bug.” What is it? How contagious are we talking? And how the heck do you manage it? Even with my medical background, I still feel like it’s anxiety inducing to manage this – especially in young kids. 

People sometimes refer to this as the “stomach flu.” This is not the same flu that we talk about when we recommend flu vaccines. Those vaccines protect against respiratory illnesses caused by Influenza viruses. The stomach “flu” is not caused by Influenza viruses. Your flu shot does not prevent these illnesses. Just wanted to clear that up. 

What is the stomach bug?

The medical term for a stomach bug is gastroenteritis. Most often the cause of this is a virus. We talk about rotavirus – that can severely affect babies – 6 months to 2 years old generally (that is why the oral vaccine is given to infants – it protects against rotavirus). Norovirus is another culprit – this is one you often hear of causing cruise ship outbreaks. Yikes. Astrovirus, sapovirus and enteric adenovirus are other common causes. 

It doesn’t change our management to know what virus is causing your child’s symptoms. There isn’t a routine test we order in the office to say “yup, this is sapovirus.” Now, I will say if symptoms last longer than expected or there are other red flag symptoms then further testing may be indicated. We can talk more about that later.

Unfortunately these viruses can be highly contagious. So how do they spread? The formal description is “fecal-oral” transmission. I’ve always hated that description – it sounds so gross. But, essentially, kids go to the bathroom, probably have poor hand washing, then they share a toy or item with another kid. That kid then inevitably puts their hand in their mouth and there you have it, a “tummy bug” preschool outbreak. 

The hard thing about these bugs is they can spread in patients who are asymptomatic. The window from exposure to symptoms can be anywhere from 12 hours to 10 days! Once symptoms develop, they can be expected to last anywhere from 3 to 9 days. General rule of thumb, once you observe symptoms – your child should be kept away from other kids until they have been without symptoms for 48 hours. 

Symptoms

Management

Just like when we talk about any other illness – like RSV here, fluids, fluids, fluids are important! It’s crucial that adequate hydration is maintained. Now, in the setting of vomiting, you don’t want to be aggressively pushing fluids. Your child should have some “stomach rest,” basically, periods of a few hours with minimal oral intake. Once, they are able to take something – you could just start with a few teaspoons of liquid. 

Wash your hands often. You don’t want to be catching this bug yourself! And unfortunately you kind of just have to let this thing ride. You pray it’s short lived and you make sure you are stocked up on laundry detergent. There will be extra loads of laundry in your future. 

There aren’t any helpful over the counter medications. Avoid giving your child any kind of anti-diarrheal medication. Sometimes, we use anti-nausea medicine for kids – but that is a prescription you would have to discuss with your doctor.

Red Flag Symptoms

Ok, so you are letting it ride. But when should you call your pediatrician? A general rule of thumb, if your child is under 6 months and has had more than 24 hours of vomiting or diarrhea outside of their norm – touch base with your doc.

If your child is having intractable vomiting and you are concerned about their hydration status, check in with your doctor. Depending on how severe it is, you may even consider an emergency room evaluation at that point.

If your child continues to have diarrhea for 5 or more days, I would also recommend checking in with your doctor. They may want to run additional tests.

So what happened to us?

We got extremely lucky with this most recent stomach bug. Noah, our youngest was the only one affected. He had 1 terrible episode of vomiting and then 2 days of diarrhea. He’s just been extremely cranky and has had a decreased appetite. Praying he’s just about through with symptoms now. Somehow our oldest has not gotten sick. Also just hoping he’s not going to have some delayed symptom onset.

Until the next illness in our house…take care of yourselves and wash your hands!

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