Enteritis in children: beware of dehydration

Sometimes they call it “intestinal flu“: it presents with symptoms such as vomiting, diarrhea, abdominal pain and, in some cases, fever. In fact, it has nothing to do with seasonal flu, other than the period in which most cases occur, namely the winter months.

What are the causes

Enteritis is not a single pathology, but a group of disorders that can be caused by different pathogens, such as viruses or bacteria, which cause inflammation in the stomach or intestines.

Some cases can be caused by bacteria such as Salmonella or Clostridium difficile, but most originate from viral infections of rotavirus, which mainly affects younger children, and norovirus, which mainly infects adolescents and adults.

These are highly contagious viral agents, which are mainly transmitted directly from person to person, by respiratory route, or through the ingestion of infected food or water, but also by contact with contaminated surfaces.

How it is transmitted

The spread from person to person through contamination of the hands is probably the most widespread in community environments, such as nurseries or primary schools: it is due to the fact that these viruses can remain stable in the environment for some time and, therefore, preserve their infectious load when they settle on food or drink.

In canteens and other places intended for mass catering, for example, these viruses can be transmitted when an operator who has contracted the infection handles foods that do not require cooking, such as salad, fruit and other fresh vegetables, without washing their hands thoroughly.

In other cases, the food could be contaminated at the source, by infected waters: this can occur for foods such as seafood, fresh vegetables or berries. There have also been outbreaks where contamination is due to water collection tanks or swimming pools and fountains.

Beware of dehydration!

The disease has an incubation period of about two days and symptoms may continue for about 3-8 days. In most cases, when a mild form of diarrhea develops, sufferers recover without the need for therapy.

However, when vomiting and diarrhea are very consistent and frequent, fluid loss can lead to severe dehydration of the body, a condition that is likely to be dangerous without proper intervention.

Signs of dehydration are:

• reduced urine output
• excessive thirst
• dry mouth
• unusual drowsiness.

How to replenish lost fluids?

Children should be encouraged to drink liquids such as:

• Soups
• rice water
• cereal cooking liquids.

The WHO recommends using the oral rehydration solution, which has been used worldwide for more than 20 years. It is a liquid that contains sodium, potassium, chloride, bicarbonate and glucose. Alternatively, you can use a sugar/salt solution of similar composition, which is prepared by mixing the following ingredients:

Instead, avoid certain foods or drinks that could aggravate diarrhea. Among them:

• drinks with a high sugar content, such as orange juice or packaged fruit juices
• milk
• caffeine and chocolate, which can increase stomach acid.

It is recommended, then, not to stop eating: better small, light and fractional meals (eg 6 meals a day).

Rotavirus: there is a vaccine

When a rotavirus causes enteritis, it is possible that, after the first infection, the virus infects us again. This is because the first contact with the pathogen allows our body to gain only partial immunity, which is therefore not enough to protect us from the development of a new infection. If this happens, the only positive aspect is that it will be in a lighter form.

In 2000, WHO launched a research programme to develop new vaccines against this infection, which are now being developed and evaluated in many countries.

In early 2006, an oral vaccine became available, approved in both the United States and Europe, which allows children to be immunized from the sixth week of life.