Vomiting and diarrhea are not pleasant topics to consider, which is why families may be unprepared for the onset of a stomach virus. Simple gastroenteritis, known by many as "stomach flu" or "stomach bug" is very common and very contagious. Although good handwashing habits decrease risk, there’s no way to totally avoid it, especially with children. Parenthood is not for the faint of heart.

Gastroenteritis is a catch-all term relating to stomach upsets. It can be caused by parasites, bacterial infections and food pathogens, which require medical intervention. However, by far, the greatest causes of simple gastroenteritis are viruses, most especially the dreaded Norovirus. Most cases of viral gastroenteritis are self-limiting and will not require a doctor visit.

Usually no warning precedes the first episode of projectile vomiting. You may put your child down for a nap and find them with explosive vomiting an hour later. Low-grade fever, stomach cramps, diarrhea, body aches and headaches are also symptomatic of these viruses.

The sick person should be isolated as much as possible, minimizing contact especially with other children. It’s not uncommon for other family members to be stricken as quickly as 12 hours after exposure to an infected person. The virus remains contagious up to three days after symptoms have resolved, so don’t send children back to school during this seemingly well period. I know this is a problem for working parents. Due to the contagious nature of stomach viruses, asking a grandparent or babysitter to stay with your child is generally not a good idea.

Once you’ve had the virus, you may have temporary immunity for possibly several weeks, after which you can be re-infected upon exposure.

You’ll need supplies on hand to maintain fluid and electrolyte balance, reduce fever, and prevent spread of the illness.

Children dehydrate much quicker than adults and need close monitoring. Although symptoms may be quite severe, they’re usually of short duration, not requiring medical attention. The exceptions are infants, very young children, elderly or immune-compromised individuals, or those with severe symptoms lasting more than a couple of days or with high fevers.

It’s important to reduce high fevers quickly — easier said than done with a vomiting child. Giving acetaminophen or ibuprofen shortly after the child vomits may allow some of the medicine to be absorbed before the next incidence of vomiting. It’s frustrating not knowing how much of the med was absorbed, but safety is important. To err on the side of caution, wait the recommended time for the next dose, even if you think most of it was ejected. Acetaminophen suppositories are an alternative. Check with the pediatrician to see if you can alternate acetaminophen with ibuprofen every three hours, but only for stubborn high fevers, and only for one or two doses. Parents must always be concerned with possible adverse reactions when giving any meds to their child, even, or maybe especially, over-the-counter meds.

Another way to reduce fever is to put the child in a shallow, warm (not cold) bath, and sponge the child’s body as the water cools for 10 to 20 minutes. If a high fever cannot be brought under control quickly or if signs of dehydration become apparent (low urine output, refusal of fluids, lethargy, dry mouth) it’s time to call the doctor. Medication to reduce vomiting or diarrhea may be prescribed. Intravaneous fluids are needed for severe cases.

Having the necessary supplies makes cleanup easier.

Keep in mind before cleaning up the mess that it seems that whoever touches it gets it. Particles of vomit can even become airborne and travel 25 feet. I recommend having a box of exam gloves and face masks in your sick kit and use them every time you enter the sick room. These are readily available in any pharmacy.

The odor of vomit makes many people nauseous. Breathing through your mouth will help.

A pail kept besides the child in bed may work for containing the next episode of vomit. Resin type garbage cans, double lined with plastic bags, work well, too.

Fluid-proof mattress liners for beds, extra sheets and light, easily washable blankets are helpful.

Electrolyte replacement fluids such as Pedialyte and Gatorade, and clear fluids such as flat 7-Up or ginger ale, ginger tea, Jell-O, chicken or veggie broths, sherbet, and ice pops should be offered to the child frequently. Do not give milk or juices.

Once the worst symptoms have abated, the diet can be advanced to simple, bland foods, such as in the BRAT diet (bananas, rice, apples and toast). It may be a week or two before appetite returns to normal.

Sick people should stay out of the kitchen and not prepare food.

Disposable cups, straws, utensils, plates and bowls should be used. Garbage should remain inside the sick room until taken directly outside to the trash daily.

Substitute rolls of paper towels in bathrooms until outbreak is contained.

Wash all potentially contaminated surfaces and items with a bleach solution or steam clean, if possible.

It may seem like the longest week of your life when this particularly nasty virus strikes your family. By taking measures to contain it, hopefully you’ll remain well to care for your children until the virus runs its course. RPM