November 1, 2022 – Parents beware: if your child is showing signs of an upset stomach, do it Not send them to school or kindergarten.
That’s the take-home message in a new CDC report that found that nearly 90% of outbreaks of acute gastrointestinal infections in schools and childcare facilities result from face-to-face contact.
“Clinicians should encourage parents to keep children away from school for up to 24 hours after symptoms resolve, because virus shedding may continue after symptoms resolve,” says Janine Cory, a spokeswoman for the CDC.
She also encouraged pediatricians to step up good hygiene habits with parents, including ensuring that children stay home when they are ill and that they wash their hands with warm water and soap, as most hand sanitizers are ineffective against the germs most commonly associated with GI breakouts in children.
The report published in the journal paediatricswas based on an analysis by CDC researchers and their colleagues of more than 4,600 outbreaks of acute gastroenteritis — what many people refer to as “stomach flu.” – between 2009 and 2020.
Most outbreaks occurred in schools between October and March and typically involved viral infections. Around 86% of all outbreaks in the study involved person-to-person contact. About two-thirds of all outbreaks during the study period involved strains of norovirus or the Shigella bacterial species.
Symptoms of norovirus infection include diarrhea, vomiting, and abdominal pain, according to the CDC. Shigellosisthe infection caused by Shigella, can cause bloody stools and diarrhea, high fever, severe stomach cramps and sensitivity, and dehydration.
Schools and day-care centers accounted for an average of 457 outbreaks and 15,779 cases per year during the study period. (Outbreaks fell during the COVID-19 pandemic as children stayed home during the lockdown, researchers said.)
While outbreaks in schools were significantly larger than in daycares, the illness lasted longer in daycares. Outbreaks in schools lasted an average of 9 days, while outbreaks in day care centers lasted an average of 15 days. Around 98% of outbreaks can be traced back to at least one visit to the emergency room, the researchers report.
bacterial outbreaks could be more prevalent due to the presence of swaddled children, poor hand hygiene, and the younger ages of children in childcare facilities, the researchers say.
Tim Joos, MD, a Seattle pediatrician and internist, says calls about norovirus infection and shigellosis are a routine part of his day — especially during the school year.
“The expression ‘something’s going on in day care’ is heard every day in clinics and emergency rooms,” he says.
“As practicing clinicians, we are often preoccupied with not seeing the wood for the trees. We often see the needs of the individual patient, but not the broader trends. Thanks to this study, we now have an overview of the gastroenteritis landscape,” says Joos.