What you may not know is that to this day, diarrhoea remains the second leading cause of death among children under 5 years of age, with rotavirus diarrhoea being the most serious.
It is not an exaggeration to call rotavirus a child killer in 2008, accounting for an estimated 450 000 deaths from rotavirus infection in children under 5 years of age worldwide, accounting for 37% of child deaths due to diarrhoea and 5% of under-five deaths.
Rotavirus is highly contagious and can survive outside the body for a few hours to several months. In the stool of acute patients, the number of viruses contained in each gram of stool exceeds 100 billion, and children can excrete the virus before symptoms appear, and it lasts until 10 days after the symptoms appear, so it is easy to spread to each other in families and kindergartens.
Children infected with rotavirus, once the incubation period of 1-7 days has passed, often presents with fever and vomiting. About half of the children will have a fever, but most of them are low-grade, but about 1/3 of the children will be over 39 degrees, and most children will vomit. Fever and vomiting last for 1-2 days and then begin to appear like stool, which can be 10-20 times a day, but diarrhea generally lasts 3-8 days to get better.
Although it is a self-healing disease, it still kills so many children every year because rotavirus enteritis is highly contagious and has a high incidence, diarrhea can lead to dehydration shock, prolonged diarrhea can be complicated by malnutrition, and a small number of severe cases can lead to systemic reactions.
Although most children recover on their own after about a week, this process is enough to make many parents panic. For example, the fever shown at the beginning, when there are no other symptoms, may be judged by parents as a cold, and then give the child cold medicine. If you have vomiting, you have to worry about whether you have eaten something bad and start giving your child antiemetics. After that, the child began to have diarrhea, watching the child keep poofing, many parents began to feel stuffy again, and then began to Smecta Mommy love together, and even antibiotics were taken together.
It is true that it is difficult for all parents to calm down in the face of their children's illness, hoping that all symptoms are away from the child, so that he is away from all pain, but many things do not go well. Even in the United States, children under the age of 5 will basically be infected by rotavirus, 4/5 of them will have rotavirus enteritis, so most children are difficult to dodge rotavirus, and there is currently no effective antiviral drugs, like colds, mainly rely on their own good, whether you are anxious or not, there is not much way to shorten the process of illness.
You may also notice that rotavirus enteritis shows fever, vomiting, diarrhea symptoms are not specific, other enteritis may also have these symptoms, according to the process and season of onset, doctors may have a general judgment, but if there is no relevant pathogen testing, they can not determine whether it is, let alone parents themselves, fortunately, all diarrhea response principles are similar.
For rotavirus enteritis, because there are no effective antiviral drugs, the goal of treatment is not to cure it, but to help the child carry the process of illness and wait for his own well. Just like the storm has come and you can't stop it, all you can do is hold your house and don't get blown down by the storm.
Because rotavirus enteritis causes a child to lose a lot of water and electrolytes in a short period of time, ensuring that the child is not dehydrated is the primary goal, while maintaining the balance of electrolytes and nutrients in the child.
Children need more water and electrolytes per kilogram of body weight than adults, so children are more likely to become dehydrated. During mild to moderate dehydration, your child may be tired or irritable, thirsty, dry lips, mildly sunken eye sockets, inelastic skin, cold extremities, and low urination. When the child is severely dehydrated, he may be apathetic, comatose, do not drink water, and his eye socket is deeply sunken, which is very dangerous.
The judgment of dehydration signs has a certain subjectivity, inexperienced doctors will not be accurate, parents have the advantage of accompanying their children more time, more observation time and more durable, in addition to better understanding of the child's usual condition than the doctor, better comparison when sick, but it is still difficult to rely on parents to accurately judge the degree of dehydration, and the progress of dehydration may be very fast, if it is found that the child's mental reaction is not right and less urine or other bottomless conditions must go to the hospital in time, so as not to delay the condition.
Mild to moderate dehydration can be rehydrated by oral administration, with oral rehydration salt mixed with water for the child to drink, not only can replenish water, but also replenish electrolytes, the third generation of rehydration salt, that is, hypotonic rehydration salt, is very cheap and safe, is recommended by WHO, it is not recommended that parents adjust salt water for their children to drink. Severe dehydration should be prevented as much as possible, and once it occurs, it is important to go to the hospital as soon as possible.
If your child does not vomit frequently, bloating, etc., oral rehydration salts can be taken and normal eating can usually be tried. Prolonged diarrhea may affect the villi of the intestines, but the intestines still have the function of absorption.
Once the dehydration has been almost corrected with rehydration, the usual breastfeeding or formula feeding can be resumed as soon as possible, without dilution, although oral rehydration salts are encouraged between feedings. Rice, bread, lean meat, yogurt, fruits, vegetables, as long as you have an appetite and are willing to eat, you can also eat as usual. However, fruit juices, colas and other high-sugar and high-fat foods should be avoided during diarrhea to avoid aggravating diarrhea.
In addition, diarrhea is prolonged and sometimes secondary to lactose intolerance. If the baby drinks formula or milk after diarrhea, and has symptoms such as stomach pain, flatulence, diarrhea, etc., then it may be secondary lactose intolerance. This phenomenon will gradually recover on its own with the recovery of the intestine, young children during the recovery period, breastfeeding can still try to continue breastfeeding, formula feeding babies can consider temporarily using lactose-free formula, and older children, such as after 2 years old, do not need to consider special formula, you can consider calcium fortified soy milk, yogurt to temporarily replace ordinary milk to ensure calcium intake.
In terms of drugs, children with domestic diarrhea generally eat montmorillonite, which is mainly used in Europe, Asia and Africa, and some low-quality studies believe that it can shorten the duration of diarrhea. At present, some studies believe that probiotics, including lactobacillus, bifidobacteria, Saccharomyces bralardii, etc., can help restore the intestinal microecology and shorten the time of diarrhea, but the current evidence is not so sufficient.
The evidence for the effects of montmorillonite and probiotics on diarrhea is not so strong, but no obvious side effects have been found, and although the use is somewhat controversial, it can be used if you want. On the contrary, there is good evidence that some drugs are effective, such as zinc supplements, which are currently shown to significantly reduce the degree of diarrhea in children in developing countries, shorten the duration of diarrhea, reduce the proportion of severe cases, and may also reduce the chance of diarrhea recurrence, which is also recommended by the World Health Organization and UNICEF, but is rarely used in China. So if the child has diarrhea or after diarrhea, you can give the child zinc for 10-14 days, 10mg/day for children under 6 months, 20mg/day for children over 6 months, zinc sulfate, zinc acetate and zinc gluconate.
Of course, diarrhea is not all caused by rotavirus infection, even rotavirus infection Some children are very critical, and even have neurological symptoms, even in the United States there are children who die because of rotavirus infection, so not all children are suitable for observation and treatment at home.
In addition to observing the dehydration mentioned earlier, you should also pay attention to other conditions, such as continuous frequent vomiting, especially when spitting out yellow-green things, you should be vigilant against intestinal obstruction, when blood in the stool, you should also be alert to intussusception, bacterial enteritis, etc., children have repeated fever when they have diarrhea, but also consider bacterial enteritis, whether to use antibiotics to follow the doctor's advice.
Diarrhea because of abnormal bowel movements, often accompanied by abdominal pain, but mostly not serious, if persistent abdominal pain, especially with a fixed tender area, but also to be alert to other infections in the abdominal cavity such as appendicitis, because appendicitis in infants and young children may be very atypical, sometimes even manifested as diarrhea, these need to go to the hospital for the doctor to identify. Popular science is only to transmit knowledge, can never replace the doctor's face-to-face diagnosis and treatment, parents encounter their own bottomless things, or go to the hospital early.
Rotavirus was once called the "virus of democracy" because whether you were born in a rich or poor country, whether you were born in a temperate or tropical region, you are basically infected a few years after birth, and it is democratic and fair to every child. But since the rotavirus vaccine, the outcomes of children in poor countries and children in rich countries are very different, because severe cases are basically first-time infections, vaccination does not mean that they will not be reinfected, but it is equivalent to completing the initial infection, will produce protective antibodies, and the symptoms of reinfection are very mild or even asymptomatic.
Rotavirus is transmitted via the fecal-oral route because it is highly contagious and it is difficult to completely prevent infection by paying attention to hygiene and other measures, but children in developing countries with relatively poor sanitation are infected earlier than children in developed countries. In addition, most other childhood diarrhoea is also related to diet and hygiene, which is why most children die from diarrhoea in Africa and South Asia.
In addition to vaccination against rotavirus, breastfeeding, maintaining a child's nutritional balance, good dietary hygiene, and washing children's hands frequently are also the main ways to prevent diarrhea. Instead of waiting for their children to have diarrhea, parents should usually give them prevention.