It’s the mid-autumn season again, and there are gradually more children suffering from autumn diarrhea, how can parents prevent and treat it?
I. Overview The so-called autumn diarrhea refers to the diarrhea that occurs in the season of October to November, with the most common age of onset being 6 months to 3 years old. The main culprits of autumn diarrhea are rotavirus, ECHO virus and coxsackievirus, and there is no specific medicine for rotavirus. Autumn diarrhea has three main clinical features, namely, cold, vomiting, diarrhea.
Second, the epidemic trend The disease is epidemic or small epidemic, fecal-oral transmission, but also through the respiratory tract infection and disease. Incubation period l to 3 days. It occurs mostly in infants and children aged 6 to 24 months, and is rare in those over 4 years of age. The onset of the disease is rapid, often accompanied by fever and upper respiratory tract infection symptoms, without obvious signs of poisoning. There may be vomiting at the beginning of the disease, which often precedes diarrhea. The stools are frequent, voluminous, watery, yellow watery or egg-like stools with a small amount of mucus, without fishy odor. The disease is a self-limiting disease, the natural course of about 3 to 8 days.
Third, the main features and performance of autumn diarrhea
The main features of autumn diarrhea: first vomiting and then diarrhea, may be accompanied by fever, stool is watery or egg-flake soup-like, the course of the disease is self-limiting, even with drugs can not significantly change the course of the disease, symptoms
1, the onset of the disease is rapid, often accompanied by cold symptoms at the beginning, such as cough, nasal congestion, runny nose, half of the children will also have a fever (common in the early course of the disease), generally low fever, rarely high fever;
2, the number of stools increases, about 10 times a day, white, yellow or green egg-flake soup-like stool, with a little mucus, no fishy smell; laboratory tests are mostly abnormal or show indigestion.
3, half of the affected children will vomit. Most vomiting symptoms occur at the beginning of the course of the disease, usually no more than 3 days.
4. Heavy diarrhea may show symptoms of dehydration, such as pronounced thirst, reduced urine output, and irritability;
5. The course of the disease is self-limiting, generally 5-7 days, and the duration of diarrhea may be longer in malnutrition, rickets and frailty.
IV. Treatment
Children suffering from autumn diarrhea can shorten the course of the disease and recover quickly with a reasonable diet and appropriate medication, which will have little impact on the health of the child. If not treated properly, it is often complicated by dehydration, acidosis and electrolyte disorders, which can endanger the child’s life in serious cases; or lead to prolonged illness, resulting in malnutrition and affecting the child’s growth and development. Therefore, it is necessary for parents to know some home treatment and care methods for pediatric diarrhea.
The principles of treatment for diarrheal diseases are
① prevention of dehydration.
② correction of dehydration.
③continuation of diet.
④Rational use of medication. According to the above principles, children with mild disease and no obvious dehydration are treated at home, and the following measures can be taken. Serious cases need to be treated in hospital.
1. The child should receive enough liquid by mouth to prevent dehydration.
The following fluids can be used.
① Rice soup with salt solution: Preparation: 500ml of rice soup (1 mineral water bottle) + 1.75g of fine salt (half of a flat beer bottle cap); or 25g of fried rice flour (about two full porcelain spoons) + 1.75g of fine salt (half of a flat beer bottle cap) + 500ml of water boiled for 2 to 3 minutes. Prevention of dehydration: first give 20～40ml/kg, a small number of times orally, within 4 hours, and later at any time orally, give as much as you can drink.
② Sugar and salt water: Preparation: 500ml of plain water (1 mineral water bottle) + 10g of cane sugar (2 small spoons) + 1.75g of fine salt (half of a flat beer bottle cap). Dose serving method is the same as above.
③ Oral rehydration salt (ORS) solution (caution for newborns), age <2 years, should provide ORS solution 500ml per day; age 2 to 10 years, should provide ORS solution 1000ml per day; age >10 years, ORS solution can drink how much to give how much, should provide ORS solution 2000ml per day. current commercially available rehydration salt mostly belongs to hypertonic salt, a packet can be flushed 1000ml, appropriate Children under 2 years of age should be fed with a small spoonful of ORS fluid every 1 to 2 minutes, while older children can drink directly from a cup. If the child vomits, stop for 10 minutes and then slowly feed the child (one spoonful every 2 to 3 minutes); if the diarrhea does not stop after the ORS liquid is used, feed the child some of the liquid mentioned in the above principles or see a doctor.
2. Give the child enough food to prevent malnutrition
If the child is breastfed, continue breastfeeding and extend the interval between feedings. If the child is not breastfed, within 6 months of age, the child can continue to be fed with milk or milk products for daily consumption, diluted with milk (or goat’s milk) plus an equal amount of rice broth or water, and gradually return to a normal diet after the diarrhea improves, or with yogurt, or with a milk-cereal mixture, which can be replaced with lactose-free milk powder if available. If the child is more than 6 months old, give the usual diet that the child is used to, such as porridge, noodles or rice, vegetables, fish or minced meat, etc., from little to much. Moderate amounts of fresh fruit juice or fruit may be given for potassium supplementation. These foods should be well cooked, ground or mashed to make them easily digestible. Older children can be fed nutritious and easily digestible foods. Avoid greasy foods
3.Optional drugs.
① Micro-ecological regulating agents: the purpose is to restore the normal intestinal flora and rebuild the natural biological barrier protection of the intestine. Commonly used are Bifidobacterium, Bacillus cereus, Lactobacillus acidophilus and Streptococcus faecalis, etc.
②Intestinal mucosa protective agents: adsorb pathogens and maintain the normal absorption and secretion function of intestinal cells; interact with intestinal mucus glycoprotein to enhance its barrier effect to prevent the attack of pathogenic microorganisms. Such as montelukast.
③ Appropriate zinc supplementation, at home and abroad are advocating that children with diarrhea are given zinc supplementation, which can shorten the course of the disease. It should be noted that autumn diarrhea should not take antibiotics, antibiotics for autumn diarrhea is not effective, abuse is not only not beneficial, but may cause dysbiosis aggravate diarrhea.
4. If the child does not improve in 3 days, or if any of the following symptoms appear within 3 days, a doctor should be consulted: increase in the number and amount of diarrhea; inability to eat normally; frequent vomiting; fever; obvious thirst; blood in the stool; obvious decrease in urine volume.
V. Prevention
1. Promote breastfeeding, avoid weaning in summer, and change the type of diet. Add complementary foods at the right time and in the right amount, feed reasonably, do not be too full of milk food, do not enter the indigestible food.
2, pay attention to dietary hygiene, wash hands before and after meals, and disinfect food utensils.
3.Pay attention to climate change, add and remove clothes and blankets in time to avoid heat or cold.
4.Do a good job in isolation treatment and fecal disinfection of patients with diarrhea.
5.Avoid long-term abuse of antibiotics to prevent enteritis caused by dysbiosis.
6.The air in the sick room should be fresh and circulating, and the temperature should be appropriate.
7, pay attention to disinfection and isolation of children with infectious diarrhea.
8.Control diet, reduce milk food appropriately, frequent vomiting should be fasted for 8-12 hours, and gradually resume a small amount of easily digestible food as the condition improves. After the initial healing, attention should be paid to the regulation of diet.
9, vaccination rotavirus vaccination. 6 months to 3 years old baby, annual vaccination rotavirus live vaccine to prevent rotavirus diarrhea (autumn diarrhea). The vaccination is given once a year from July to September, before the onset of the autumn diarrhea epidemic season.