NEWS

Stomach bugs hit home

Linda Lombroso
llombros@lohud.com

Stomach bugs can be a nightmare — especially when they're as unpleasant as shigellosis, the bacterial infection sweeping through communities in Rockland County, or norovirus, the bug that sickened hundreds in Rye last May.

Gastroenteritis, the official name for illnesses that irritate the stomach and intestines, can be caused by bacteria or viruses, and with many symptoms that overlap — diarrhea, abdominal pain, nausea, vomiting — it's often difficult to tell which bug is at fault, said Dr. Sandra Kesh, an infectious disease specialist with WESTMED in White Plains.

"If you're not getting better after two or three days, or if you have anything concerning, like high fever or bloody diarrhea, those would be indications to get medical attention," Kesh said. People who can't keep down liquids, as well as the very young, the elderly and anyone with a weakened immune system, also should see a doctor early on.

Though viral gastroenteritis is not treated with antibiotics, some cases of bacterial gastroenteritis may benefit from antibiotic treatment, she said.

Even if you don't have symptoms, you could still be incubating the infection and expose a baby to whooping cough, says Dr. Sandra Kesh, an infectious disease specialist with WESTMED.

Common forms of viral gastroenteritis

• Norovirus (80 percent of cases occur from November to April, and often spread through day-care centers, cruise ships and nursing homes)

Symptoms: Nausea, diarrhea, vomiting, stomach pain, fever, headache, body aches

How it's transmitted: From an infected person, through contaminated food and water, by touching contaminated surfaces

How long it lasts: One to three days

How long it's contagious: During the illness and for a few days after you recover

Rotavirus (most common among infants and young children, from December through June; oral vaccines are available for babies but don't provide full immunity from the virus, the Centers for Disease Control and Prevention says)

Symptoms: Severe watery diarrhea, often with vomiting, fever and abdominal pain; loss of appetite

How it's transmitted: Fecal-oral route; can be picked up from contaminated hands, objects, surfaces, water

How long it lasts: Three to eight days

How long it's contagious: Children can spread the virus even before they have symptoms. They're also contagious for up to three days after they stop having diarrhea.

Alcohol-based sanitizers are a good first step, but soap and warm water are the best way to keep hands free of infection, say health experts.


Common forms of bacterial gastroenteritis

Shigellosis (caused by bacteria called Shigella)

Symptoms: Diarrhea (sometimes bloody), fever, stomach cramps; nausea and vomiting also possible, with seizures in some children under 2

How it's transmitted: Fecal-oral route; can be picked up from contaminated hands, objects, surfaces, wading pools, fountains

How long it lasts: Five to seven days

How long it's contagious: The bacteria are present in the stool of people who are sick, and can linger for up to two weeks after symptoms disappear. Children should not return to school or day care until they have two negative stool samples done 24 hours apart.

Salmonellosis (caused by Salmonella)

Symptoms: Diarrhea, fever, abdominal cramps

How it's transmitted: Generally acquired from contaminated food; can be transmitted from reptiles and from the feces of household pets

How long it lasts: Four to seven days; more serious cases may require hospitalization

Is it contagious? Though infection with salmonella is less commonly spread through person-to-person contact, it can occur, Kesh said.

Campylobacteriosis (caused by Campylobacter)

Symptoms: Diarrhea (sometimes bloody), cramps, abdominal pain, fever

How it's transmitted: Most cases occur from eating raw or undercooked poultry, or from cross-contamination; fecal-oral transmission means it's also possible to get it from contaminated hands and surfaces

How long it lasts: About one week

How long it's contagious: Infected people can pass the bacteria in their stool for up to a week

E. coli infection (caused by Escherichia coli, a form of bacteria)

Symptoms: Some types of E. coli infection can cause stomach cramps, bloody diarrhea and vomiting; some infections can be severe or life-threatening

How it's transmitted: Often from eating contaminated food or raw milk; also can be acquired from changing diapers, contact with the stool of infected people, or eating food prepared by someone who did not wash his or her hands after using the bathroom

How long it lasts: Five to seven days

How long the bacteria stays in the body: Can be found in stool for several weeks after symptoms are gone

Source: Centers for Disease Control and Prevention

Wash your hands for at least 20 seconds, rubbing with soap and warm water, to help prevent the spread of infection.

Tips to prevent common viral and bacterial stomach bugs

Wash hands. Passing your hands under a few sprinkles of water won't do it. Wet hands with clean running water, hot or cold, apply soap and work into a lather. Scrub all parts of hands for 20 seconds (two rounds of the "Happy Birthday" song). Rinse and dry with air or a clean towel.

Avoid touching contaminated surfaces. Be aware that elevator buttons, doorknobs and water fountain handles may be contaminated.

Be careful in the kitchen. Wash fruits and vegetables, cook shellfish before eating. Don't prepare food if you're sick and for three days after you recover.

Alcohol gels. Their efficacy against norovirus is uncertain but between hand-washings they might help. They shouldn't be a substitute for soap and water.

Clean surfaces. Use bleach-containing disinfectant wipes or a solution of 5-25 tablespoons of household bleach per gallon of water to wipe down bathrooms, kitchen and "high-touch" surfaces such as doorknobs, phones, light switches, hand rails.

Wash laundry. Immediately remove clothing or bedding that might be contaminated with vomit or fecal matter. Handle carefully to avoid spreading the virus. Wash in detergent at the longest cycle length and machine dry.

Sources: USA Today, Centers for Disease Control and Prevention