Mountain View Voice

News - February 16, 2007

Stomach bug hits children, elderly

Abrupt illness sending many to the emergency room

by Sue Dremann

A stomach illness similar to the norovirus often found on cruise ships and in nursing homes is sending hundreds of Bay Area children to emergency rooms and urgent-care centers, according to public health officials.

The "stomach flu," which began earlier than expected this year, is causing children and adults to become very sick with vomiting, diarrhea and high fever. Dozens of children are being admitted to hospitals for rehydration after fluid loss from the illness, medical professionals said.

"It's a nasty bug," said Joy Alexiou, spokeswoman for the Santa Clara County Department of Public Health.

The highly contagious disease is causing acute gastric enteritis, an inflammation of the stomach and small intestine. Symptoms include vomiting, diarrhea, fever, some stomach cramping, headache, muscle aches and general fatigue. The illness often begins suddenly within 24 to 48 hours after exposure, but can appear after only 12 hours, according to the Centers for Disease Control.

Children and adults afflicted with the illness have diarrhea several times a day, in some cases leading to dehydration, which can especially affect children, according to Dr. Bernard Dannenberg, medical director of pediatric and emergency medicine at Stanford/Lucile Packard Children's Hospital.

The emergency room's normal case load is 30 to 40 children daily, but the stomach bug has raised that number by as much as one-third, he said. Sometimes, whole families are coming in sick.

"We had a new record last Sunday [Feb. 4]. Sixty-six children came into the emergency room. Nearly half had the stomach flu," he said.

"It's one of the most common infectious diseases. In the last four weeks, 20 to 30 percent of all kids coming in to urgent care have the [stomach flu]," said Dr. Janet Volpe, medical director of Palo Alto Medical Foundation's Pediatric Urgent Care Clinic. That translates to five to 12 patients per urgent-care physician per day, she said.

One to two children at urgent care are being hospitalized each day due to dehydration. They range from older infants to young teens, whose immune systems may already be weakened by a previous cold or ear infection, she added.

Without testing, it is hard to tell if the illness is caused by a virus or bacteria, but Dannenberg said the evidence points to a virus. Volpe added that an estimated 50 percent of gastroenteritis is caused by rotavirus, a common virus well known to produce symptoms of stomach flu, but which isn't related to flu or influenza at all.

There is some speculation that the illnesses may be due to norovirus, a group of highly contagious viruses notorious because of their prevalence on cruise ships and senior-care facilities, where large numbers of people can become very ill quickly.

Outbreaks of norovirus were seen in the senior-care community a few months ago, Dannenberg said. Each year, many local senior-care facilities experience the disease. In 2006 in Santa Clara County, 43 senior facilities reported outbreaks, according to Alexiou. More than 1,000 people were affected.

But Dannenberg stressed he has no knowledge of any Department of Infectious Diseases studies that would verify that the current illness is caused by norovirus.

Although symptoms can be dramatic and patients feel very ill, the stomach virus is not life threatening, he said. If a patient has diarrhea with blood or mucus, is listless or refuses to take fluids over an extended period, they should be taken to urgent care or the emergency room, Dannenberg said.

To help prevent dehydration, ill persons should be given frequent, small amounts of water or ice chips. In most cases, the symptoms will last one to two days, but general weakness and malaise can last up to 10 days, according to the CDC.

The best way to control the disease is through scrupulous cleanliness. The disease is spread through eating contaminated foods, touching contaminated surfaces and putting a hand or finger into one's mouth or having direct contact with someone who has the illness. Patients are generally contagious for three days and, in some cases, for up to two weeks after recovery.

INFORMATION:

For prevention, the Centers for Disease Control and area medical professionals recommend:

* Wash hands frequently

* Carefully wash fruits and vegetables and steam clams and oysters before eating them

* Disinfect contaminated surfaces immediately after an episode of illness using a bleach-based household cleaner

* Carefully dispose of stool and vomit in a toilet and be cautious when removing diapers from children who may have diarrhea

* Air out enclosed spaces

* Immediately launder clothes and bedding after an episode of illness

* Dispose of food eaten by a sick person. Do not let them prepare food for three days after they recover from the illness

Sue Dremann is a staff writer for the Palo Alto Weekly, the Voice's sister paper.

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