It's that time of year. It seems like everyone's sick. I am usually lucky and manage to only get a cold or two. Last year, I think I had the flu. That was pretty miserable, but still not the the worst that could happen. In my mind, the worst has to be the so-called "stomach flu," which really isn't the flu at all (I like saying I had a "stomach thing"; it seems more accurate). I had been lucky enough to avoid this monster for a whole 8.4 years and had begun to think I could continue to avoid it indefinitely. Not so. The thing caught up with me this year, a day after my birthday-- Happy birthday to me!-- and lasted through December 31st-- Happy New Year to me, too!
When the clouds of darkness finally lifted and could muster the energy to have a thought in my brain, I had the same thoughts that I think most people have when they are struck with the stomach thing: Why was I sick? Was it something I ate? A virus? Am I contagious? I think there is a lot of confusion about this, so I'd like to take this opportunity to try to put all of the information I could find about acute gastroenteritis in one place, so that you all can refer to it as needed (hopefully not often!).
Acute gastroenteritis may be caused by a non-influenza virus or, it may be caused by a type of bacteria. Bacterial infection is often the result of contaminated food. In this case, we would call the illness food poisoning. Usually, people assume that a stomach bug is either a virus or food poisoning. What many people don't realize is that food poisoning can also be caused by a virus. In fact, 58% of foodborne illness is caused by a Norovirus (the kind that frequently runs through cruise ships). One in 6 Americans is sickened with foodborne illness each year, so the odds are pretty high that what you assume is a virus you caught from another person may actually be food poisoning.
I have compiled a list of the most common causes of food poisoning and viral gastroenteritis, along with their symptoms, duration, and likely sources. Unfortunately, you will probably never know what caused your illness, but if you have a compulsion to self-diagnose (like I do), have at it!
Food Poisoning Causes
Norovirus (58% of all foodborne illness)
Symptoms: Nausea, vomiting, diarrhea, abdominal pain, malaise, and low grade fever 1-2 days after exposure
Duration: 24-60 hours
Sources: Any food handled by an infected person; touching contaminated surfaces; direct contact with an infected person
Salmonella (11% of all foodborne illness)
Symptoms: Diarrhea, fever, and abdominal cramps 12-72 hours after infection
Duration: 4-7 days
Sources: Beef, poultry, milk, or eggs, but any food may become contaminated. Raw eggs may lurk in homemade Hollandaise sauces, salad dressings, mayonnaise, or cookie dough.
Campylobacter (10% of all foodborne illness)
Symptoms: diarrhea (may be bloody), cramping, abdominal pain, nausea, vomiting and fever 2-5 days after exposure.
Duration: Usually 2-5 days; can take up to 10 days
Sources: Raw or undercooked poultry, unpasteurized milk, or cross-contaminated food
Staphylococcus (9% of all foodborne illness)
Symptoms: Nausea, retching, vomiting, stomach cramps, and diarrhea within 1-6 hours of eating contaminated food
Duration: Typically 1 day; sometimes up to 3 days
Sources: Foods made by hand that require no cooking (ex. sliced meat, puddings, pastries, and sandwiches); high-salt foods are also vulnerable.
**Staph food poisoning is the result of toxins, which cannot be destroyed by heat.
Viral Gastroenteritis Causes
Norovirus (See above)
Rotavirus (most common in infants and young children)
Symptoms: Fever, vomiting, diarrhea, and abdominal pain
Duration: 3-8 days
Treatments
Regardless of whether you have a bacterial or viral infection, the treatment is the same. For the most part, all you can do is wait it out. You may take products like Tums or Pepto Bismol to try to calm the stomach, but avoid antidiarrheal medications (like Immodium). Over-the-counter antiemetics (like Emetrol) are appropriate to control vomiting and prevent excessive fluid loss. In some cases, pediatricians may even prescribe antiemetics in children who are vomiting a lot.
The primary concern whenever you or your child is experiencing diarrhea and/or vomiting is dehydration. It is very important to replace lost fluids. You should start replacing fluids as soon as symptoms start (as tolerated), by sipping small amounts of water or soda frequently. Oral rehydration solutions (such as Pedialyte) are good to have on hand. Be on the lookout for signs of extreme dehydration. These include:
- excessive thirst and dry mouth
- dark urine or little or no urine
- skin that, when pinched, does not quickly return to its original place
- severe weakness, dizziness, or lightheadedness
For more information about when to call a doctor, see this entry at the MayClinic website.
Prevention
Viruses that cause gastroenteritis are very contagious. To prevent spreading them (or contracting them in the first place), practice good handwashing and keep your hands away from your face. Alcohol-based solutions are not enough, as they do not destroy all noroviruses. Soap and water is best! When you are sick, make sure you wash your hands thoroughly after using the bathroom and disinfect all surfaces with a bleach-based solution. Close the lid on the toilet before flushing and disinfect the lid afterwards. You should consider yourself infectious from the moment you feel sick until at least 3 days after you recover. Do not prepare food for anyone during this time.
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