As the weather gets cooler, fall diarrhea has recently returned to the clinic. Fall diarrhea, also known as rotavirus enteritis, is an acute gastrointestinal infection caused by rotavirus that affects infants and young children from 6 months to 2 years of age, and can occur throughout the year, but is more frequent in the fall and winter, so it is also known as “infantile fall diarrhea”. It is often caused by group A rotavirus.
The incubation period of autumn diarrhea is usually 2 to 3 days. The main clinical manifestation is diarrhea with yellow watery stools, egg-flake soup-like, without mucus or pus and blood, with high volume each time, usually 5-10 times/day, and in severe cases more than 20 times/day. Most of the disease is often accompanied by fever and vomiting at the beginning, and fever and vomiting often precede diarrhea, with body temperature ranging from 37.9 to 39.5℃, with 39℃ being the most common. Some children may develop respiratory symptoms such as cough and runny nose in the early stage. Other accompanying symptoms include abdominal distension, abdominal rumbling, abdominal pain and nausea, vomiting, hypoactive urination, depression and convulsions. In severe diarrhea, isotonic dehydration, metabolic acidosis and electrolyte disorders may occur, and very few children may die due to dehydration and complications such as pneumonia and toxic myocarditis. The duration of diarrhea caused by rotavirus infection is relatively short, usually within 1 week, and most of them are self-limiting. Rotavirus diarrhea is a self-limiting disease, there is no specific treatment drugs, the main thing is to give rehydration and other supportive and symptomatic therapy to correct the child’s dehydration and acidosis. For mild or moderate dehydration without severe vomiting, the child can be treated in an outpatient clinic and corrected by oral rehydration solution, commonly known as oral rehydration salts (ORS), which is recommended by the World Health Organization and can be given as water, or by adding 2-3 g of sodium chloride to 500 ml of rice soup instead of ORS. For severe dehydration or severe vomiting, intravenous fluids can be used to correct dehydration and acidosis. In addition to fluid therapy, oral intestinal toxin adsorbents (e.g. montelukast) and/or regulators of normal intestinal flora (e.g. Mammazine, Pauleon, Befida, etc.) can be administered. Fall diarrhea can easily be followed by lactose intolerance, so when fall diarrhea occurs, it is recommended to stop breastfeeding and regular formula and give lactose-free formula to the child, and for older children, a diet such as rice soup can be given. In addition, autumn diarrhea is often accompanied by high fever at the beginning of the illness, so in addition to giving the child antipyretic medication, attention must be paid to hydration (oral rehydration salts, etc.), otherwise it is difficult to reduce the fever. Also, children with fall diarrhea have intestinal dysfunction and are prone to intussusception, which is manifested by jam-like bloody stools, watermelon water-like stools, accompanied by paroxysmal crying, vomiting, or depression, etc. They need to be alert.
Rotavirus is highly contagious and can survive for several weeks in soil, water, toys, food, clothing, air droplets, etc. The pathogen is transmitted mainly through the gastrointestinal tract, i.e., via the fecal-oral route, but also reported to be transmitted via the respiratory tract. Infants and children can be infected through contact with contaminated water, food, hands, toys, daily necessities, air droplets, etc. It can also be transmitted through person-to-person contact.
Knowing how autumn diarrhea spreads, it is then how we can prevent autumn diarrhea infection. Pay attention to ventilation in the room, wash hands regularly, and pay attention to dietary hygiene. Disinfect the objects used by the child, and take the child to public places less often during the high epidemic season (autumn and winter), especially to prevent cross-infection in hospitals.