What are the symptoms of viral gastroenteritis in a 10-year-old child?

From the Guidelines

Viral gastroenteritis in a 10-year-old child typically presents with sudden onset of watery diarrhea, vomiting, nausea, and abdominal cramping or pain, as described in the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1. The child may also experience fever, usually low-grade (around 99-101°F), general malaise, muscle aches, and headache. Symptoms typically last 1-3 days but can persist for up to a week. Dehydration is a common concern and may manifest as decreased urination, dry mouth, sunken eyes, decreased tears when crying, and lethargy. Some key points to consider in the diagnosis of viral gastroenteritis include:

• The World Health Organization defines diarrhea as the passage of 3 or more loose or liquid stools per 24 hours, or more frequently than is normal for an individual person 1.
• Acute watery diarrhea and acute bloody diarrhea are two distinct clinical presentations of infectious diarrhea, each with different etiologies, treatments, and outcomes 1.
• The most common pathogens causing gastroenteritis in children under 5 years old are norovirus and Salmonella enterica subspecies, with norovirus being the leading cause of illness and Salmonella enterica subspecies being the leading cause of hospitalization and death 1. The child might refuse to eat or drink due to nausea or abdominal discomfort. Viral gastroenteritis is highly contagious and spreads through contaminated food, water, or direct contact with an infected person. Treatment focuses on preventing dehydration through oral rehydration solutions like Pedialyte, given in small, frequent amounts, as recommended by the Centers for Disease Control and Prevention 1. Clear fluids should be offered regularly, and the diet should gradually reintroduce bland foods like crackers, toast, bananas, and rice as tolerated. Over-the-counter medications for fever such as acetaminophen (10-15 mg/kg every 4-6 hours) may help with discomfort, but avoid aspirin in children. Anti-diarrheal medications are generally not recommended for children. Some important considerations in the management of viral gastroenteritis include:
• Avoiding dehydration by ensuring adequate fluid and electrolyte intake for replacement and maintenance is the mainstay of diarrheal illness management 1.
• Increasing resistance to antimicrobial agents and risk of worsening illness can result from antimicrobial and antimotility drug use, highlighting the need for appropriate use of these interventions 1. Seek immediate medical attention if the child shows signs of severe dehydration, persistent vomiting, bloody diarrhea, severe abdominal pain, or high fever.

From the Research

Symptoms of Viral Gastroenteritis in 10-year-olds

• The symptoms of viral gastroenteritis in children, including 10-year-olds, typically include diarrhea, vomiting, nausea, fever, and abdominal pain 2, 3, 4.
• Diarrhea is defined as the frequent passage of unformed, liquid stools 4.
• Vomiting and dehydration are common complications of viral gastroenteritis in children 2, 3, 5.
• The severity of dehydration can be evaluated using the four-item Clinical Dehydration Scale, which is based on physical examination findings 3.

Management of Viral Gastroenteritis

• The mainstay of management of acute gastroenteritis is provision of adequate fluids to prevent and treat dehydration 2, 3, 4.
• Oral rehydration therapy is as effective as intravenous rehydration for preventing hospitalization and return to the emergency department in children with mild to moderate dehydration 2, 3.
• Ondansetron may be prescribed to prevent vomiting and improve tolerance of oral rehydration solutions 2, 5.
• Hospitalization and intravenous fluids are recommended for children who do not respond to oral rehydration therapy plus an antiemetic and patients with severe dehydration 3.

Prevention of Viral Gastroenteritis

• Handwashing, breastfeeding, and rotavirus vaccination can reduce the incidence of acute gastroenteritis in young children 2, 3, 4.
• Rotavirus vaccines have been shown to be effective in preventing gastroenteritis in children 4.
• Several norovirus vaccines are currently undergoing clinical trials with promising results 2.