This winter we have seen both more influenza (the real flu) and more vomiting illness that turns out most of the time was likely from Noro virus. Typically in children, vomiting and diarrhea is caused by rotavirus. The rotavirus vomiting and diarrhea (usually called gastroenteritis) is typically a few days of vomiting followed by up to a week or more of severe diarrhea (watery, non-bloody stool). The Noro virus we are experiencing is causing more severe vomiting, but thankfully the vomiting is usually limited to just a day or two and the diarrhea is typically mild. If your child is very young or the vomiting very severe, then we probably should see them in the office (definitely need to be seen if lethargic, listless or not very responsive). Keeping your child hydrated (clear fluids or breast milk for those breast feeding) is the key. We do now have medication to stop the vomiting, so plan to come in if the vomiting is severe.
Here is the story, as seen in the Consultant:
A new strain of norovirus has reached the United States after moving between Australia and the United Kingdom, the CDC reported, accounting for 53% of norovirus outbreaks in the US in the last 4 months of 2012.
GII.4 Sydney, first found in March of 2012, appears to have replaced GII.4 New Orleans, the previously dominant strain of norovirus.
The new strain appeared right on schedule, according to the CDC.
“During the past decade, new GII.4 strains have emerged every 2–3 years, replacing previously predominant GII.4 strains,” they wrote.
Roughly half of the reported cases of the new strain were transmitted with direct person-to-person contact, although 20% of cases were foodborne.
GII.4 strains are, in general, associated with higher mortality rates than other strains of norovirus.
Noroviruses are the leading cause of epidemic gastroenteritis in the United States, with most hospitalization and death occurring in elderly patients, young children, and the immunocompromised.
“Proper hand hygiene, environmental disinfection, and isolation of ill persons remain the mainstays of norovirus prevention and control,” they concluded.