Summer Stomach Bugs: Norovirus, Rotavirus or Food Poisoning?

While summertime is typically when we see fewer illnesses in the clinic related to cold and flu season, it's usually when we see more cases of stomach bugs in children.

The most common causes of stomach bugs in the summer include norovirus, rotavirus and food poisoning. While they all have similar symptoms, there are some key distinctions you should know.

Norovirus and rotavirus

Norovirus and rotavirus are both highly contagious, typically spread through contaminated food, water or person-to-person contact. It can also live for weeks on contaminated surfaces.

It can be difficult to tell which illness your child has. Both can cause vomiting, diarrhea and stomach cramps. Typically, symptoms associated with these illnesses will last one to three days.

Norovirus symptoms will typically start anywhere from 12 to 48 hours after exposure and symptoms of rotavirus will generally show up anywhere from one to three days.

Symptoms:

• Vomiting
• Diarrhea
• Low fever
• Headache
• Stomach cramps

Reduce the risk:

• Frequent handwashing with soap and water. Hand sanitizer will not fully kill the virus.
• It's important to keep sick children home until at least 48 hours after symptoms stop.
• Clean surfaces and shared toys with disinfectants that specifically mention they kill norovirus and rotavirus.
• You should wait at least two weeks after symptoms stop before swimming in a public pool because the virus can still spread in stool and contaminate water.
• The rotavirus vaccine is part of the routine infant immunization schedule, given before 8 months old. Older children who didn't get it aren't eligible, but it is very effective for infants.

It's important to note that children can be contagious a day before symptoms appear and they can stay contagious for several days after. That's why these bugs spread quickly in daycares and at family gatherings.

Food poisoning

Food poisoning, on the other hand, is not contagious and will generally present itself suddenly, with symptom duration varying depending on the cause.

Symptoms:

• Nausea
• Vomiting
• Water or bloody diarrhea
• Stomach craps
• Fever
• Headache
• Muscle aches
• Fatigue or weakness

Reduce the risk:

• Wash hands with soap and water for at least 20 seconds before handling food.
• Clean all cutting boards, utensils and counter tops with hot soapy water after preparing raw meat or produce.
• Refrigerate perishable foods within two hours (one hour if it's over 90 degrees outside)
• Use a food thermometer and cook meat to the proper temperature.
• Avoid cross-contamination.
• Don't eat food after the expiration date.
• Store leftovers in shallow containers and refrigerate immediately.
• When in doubt, throw it out.
• Use extra caution at cookouts and potlucks. Hot food should be kept above 140 degrees, and cold food should be kept below 40 degrees.

Usually, a medical provider will look at timing, symptoms and exposure to help determine the cause of the illness.

All three illnesses can be managed at home

• Offer small sips of liquids frequently (Pedialyte, water, diluted apple juice or electrolyte drinks for older kids). Avoid sugary drinks like soda or sports drinks, which could make diarrhea worse. If your child is vomiting, wait 30-60 minutes, then start with 1-2 teaspoons of fluid every 5 minutes and gradually increase.
• Once vomiting stops and your child is hungry, you can try foods like bananas, rice, applesauce, toast and crackers. Gradually return to a normal diet as tolerated.
• Rest is important. Let your child nap as needed.
• Do not give an anti-diarrheal or anti-nausea medication unless prescribed by a doctor.

Warning signs to watch out for and when to seek medical care

• Your child is showing signs of dehydration, which include no urine, dry mouth, no tears and sunken eyes.
• They've got a high fever over 102 degrees Fahrenheit.
• Blood is present in their vomit or stool.
• Vomiting or diarrhea that lasts more than three days.
• They are very lethargic, very fussy, or confused.
• If your child is under six months old and has vomiting or diarrhea.

You can find more information on the Centers for Disease Control and Prevention's (CDC) website.