Viral Infections, Intestinal

Intestinal viruses are highly contagious. They can be transmitted through direct contact, water or food. Outbreaks are most common in overcrowded situations with poor hygiene, but they can occur in any school or day-care setting.

WHAT HAPPENS DURING AN INTESTINAL VIRAL INFECTION?
After entering the body (usually through the mouth), the virus multiplies and penetrates the intestines. Viral particles affect the surface layer of cells lining the intestine. Damage to these cells interferes with digestion and causes intestinal upset, which resolves once the virus leaves the body.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS AN INTESTINAL VIRAL INFECTION?
While bacterial and parasitic infections tend to start with diarrhea, the first symptom of infection with an intestinal virus is generally vomiting. After a day or two, vomiting may subside, but diarrhea—sometimes severe—then develops. Depending on the virus responsible for the infection, fever may or may not be present.

IS MEDICAL ATTENTION NECESSARY?
Even if all symptoms point to an intestinal virus, you still should consult a doctor because a number of other, more serious disorders can cause vomiting and diarrhea. Also, it is critical to avoid the complication of dehydration.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS AN INTESTINAL VIRAL INFECTION?
Diagnosis of an intestinal virus usually is made on the basis of symptoms after more serious illness is excluded. If the child is a newborn or has some chronic illness, the doctor will order laboratory tests to identify the infectious organism. In these cases, medical attention is particularly crucial.

WHAT TREATMENTS ARE AVAILABLE?
Treatment consists mainly of preventing dehydration—the major risk associated with intestinal virus infection. To make sure the child stays well hydrated, the pediatrician may recommend a commercially prepared solution such as Pedialyte or a home remedy, such as Gatorade or a flat soft drink. The goal, in either case, is to keep fluid and minerals in the child's system, even if the child is vomiting.

Antidiarrheal drugs are not recommended because vomiting and diarrhea are the body's defense mechanisms against infection and they should not be blocked.

Breast-fed babies with gastroenteritis usually can continue to nurse, but formula-fed infants should temporarily switch to clear liquids, such as Pedialyte, until symptoms subside. Some infants develop temporary intolerance to the sugar in milk (lactose) as a result of an intestinal virus infection. To detect such an intolerance, formula should be reintroduced slowly and at half strength (i.e., twice as much water as is normally used) for the first day or so after recovery. If lactose intolerance develops, the baby will need to drink a lactose-free formula for about four weeks.

CARING FOR A CHILD WITH AN INTESTINAL VIRAL INFECTION

• Make sure the child receives sufficient fluids to prevent dehydration.

• Offer extra fluids (diluted juices, weak iced tea, flat soda and similar drinks) to breast-fed babies, even though nursing continues.

• Avoid giving the child solid food until the symptoms have subsided.

PREVENTING INTESTINAL VIRAL INFECTIONS
The best prevention is to observe good hygiene:

• Encourage hand washing, especially after going to the bathroom and before eating.

• Discourage sharing eating utensils.

• Promptly dispose of diapers and other contaminated items.

GETTING HELP
Call your doctor if your child:

• Vomits repeatedly.

• Has three or more episodes of diarrhea in a short time.

• Develops fever and other symptoms along with a digestive upset.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.