Doctors stress fluids are key to fighting gastroenteritis in children
July 18, 2005The winter months in Australia are the peak season for gastroenteritis and with children among the hardest hit, paediatricians want to spread the word that fluids are the key to preventing children from becoming seriously sick and ending up in hospital.
Highly contagious
Infectious gastroenteritis, sometimes called “winter vomiting illness” or “stomach flu”, attacks and inflames the stomach and intestines causing vomiting, diarrhoea and severe abdominal discomfort. A wide variety of viruses, bacteria and parasites cause gastroenteritis, but by far the most common cause in children is rotavirus. Highly contagious, this form of viral gastroenteritis is spread from hand to mouth, sneezing and spitting.
Peak incidence in infants
Children, aged between three months to ten years, are the most susceptible to severe bouts of gastroenteritis, with the peak incidence occurring in infants up to eighteen months.
In rural and remote Australia, gastroenteritis can be more serious, because if the child really gets into trouble, medical help and hospitals can be far away. This is why educating parents and healthcare professionals is seen as the key to effective treatment.
July broadcast for rural and remote health professionals
As a result, The Rural Health Education Foundation is broadcasting a live interactive television program on gastroenteritis to update rural and remote health professionals on the latest ways to deal with sick children, in an attempt to counter their need to come to hospital. Called Paediatric Gastroenteritis, the program features a panel of experts and will screen live on Tuesday 26 July.
Dehydration determines need for hospitalisation
According to one panellist, Canberra Hospital paediatrician Dr Paul Jenkins, “gastroenteritis can really be serious in children because of the high rate of dehydration a child can experience through continual vomiting and diarrhoea. The most important message to parents and healthcare professionals is to make sure the child is given oral fluids as early as possible, because the effect of dehydration is the main factor in determining whether the child needs to go to hospital.
“Once a child has gastroenteritis, parents need to encourage the child to take frequent sips of ‘rehydration fluids’, which are specially blended to counter the loss of electrolytes. They’re available in sachets or liquid form from chemists or health centres in the more remote parts of Australia.
“Keeping a constant eye on fluid loss is important because an infant can get into trouble in six to twelve hours. The tipping point for calling medical help is if the child is still vomiting and the diarrhoea hasn’t begun subsiding by the third day.
“It’s also important people realise just how highly contagious gastroenteritis is. It has a two-day incubation period and starts with a fever, nausea and vomiting. The child will still be infectious five to seven days later, so parents shouldn’t rush their children back to day-care or school too quickly or it will spread like wildfire,” Dr Jenkins says.
Remoteness an added concern
Alice Springs paediatrician, Dr Andrew White agrees: “In rural areas of Australia remoteness is definitely one of our biggest concerns. Here in Alice Springs, the infected child can be over 500 kilometres away from specialised medical help, so we often rely on nurses and Aboriginal health workers in the community clinics to monitor the children carefully, because the delay in getting a plane to pick them up can be critical if things get worse.
“Gastroenteritis also spreads rapidly in Indigenous communities and these children can get weakened very quickly, especially if they are already suffering other background infections or diseases.
“Children who need close watching include very young babies, children who are poorly nourished, and children with other conditions such as cardiac problems. They can get quite sick if they have bad diarrhoea,” Dr White says. “We occasionally have times where a gastroenteritis epidemic is so bad that the hospital has had to cancel all non acute activity in order to cope with the influx of severely affected children requiring hospitalisation.”
About the broadcast
Paediatric Gastroenteritis begins at 8pm eastern standard time on Tuesday 26 July and can be watched via Internet webstreaming from Wednesday 27 July.
Specifically designed for GPs, pharmacists, nurses and allied healthcare professionals, the broadcast is sponsored by the Australian Government Department of Health and Ageing.
Panellists include: Dr Norman Swan, Presenter of the Health Report, ABC Radio National, who is the Chair, with Ms Ella Scott, Clinical Nurse Consultant from the Sydney Children’s Hospital, Dr Hugh Heggie who is a remote area general practitioner from Utopia in the Northern Territory and paediatricians Dr Paul Jenkins and Dr Andrew White.