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Nathalie Thibault's bachelor's degree in Microbiology and master's degree in Immunology make her a germ and immune system specialist. Since the birth of her two daughters, she has been particularly interested in the infections which affect children who attend daycare. She is a teacher, speaker, and author. The specialized documents and courses she conceives help those involved in early childhood outsmart germs. She writes for a magazine called La Culbute and the mamanpourlavie.com website.

Gastroenteritis: Yes, it's possible to not get it!

Tuesday, a first case of gastroenteritis is declared in your group, oh no! Often, children develop symptoms one after the other and everyone suffers from it. In daycares, gastroenteritis represents the second most important problem after respiratory infections.

What is gastroenteritis?

Gastroenteritis is a general term which is used for all infections which affect the digestive system with one or more of the following symptoms: nausea, vomiting, diarrhea, abdominal cramps, poor general state of health, and sometimes, a light to high fever. When the germ which caused the infection is known, the infection takes on
other names: salmonella, shigellosis, a Rotavirus infection, E. coli, etc.

What is the purpose of gastroenteritis?

In fact, as you already know, it only causes problems... Parents miss 1.6 work days annually due to gastroenteritis! The only small advantage is that we can develop, for a very small quantity of the germs which cause gastroenteritis, immunity memory after several infections (five or six) with the same germ as a source. Quite the price to pay don't you think?

How does it work?

One person is infected, the germ multiplies very rapidly and the first symptoms appear. Germs can be found in vomit, but are mostly present in feces in very, very important quantities! Because feces are very liquid, germs are easily spread everywhere without us knowing it (changing table, door handles, toys, floor, bedding, hands, etc.). Invisibility is the greatest advantage germs have, don't forget it! Certain germs can resist and remain contagious for a very long period of time (up to 2 weeks!). Other cases can be expected in a daycare environment. Gastroenteritis infections are mainly transmitted the fecal oral way. In simple terms, your mouth must come into contact with contaminated feces!!! Yuck! Of course, this simple fact is difficult for everyone who has had gastroenteritis to accept. It even prevents efficient prevention! Believe me, gastroenteritis cannot be transmitted through air or from smelling feces! Germs are unable to travel on their own. You must carry them to your lips and children's lips!

Solutions

Once the first case of gastroenteritis is declared in your group, you must sound off the alarm. You mustn't wait until half the group is sick to do so, it will then be too late. Prevent the scattering of germs at the source. This means excluding symptomatic children, having an irreproachable diaper changing technique with gloves, disinfecting the changing table and toilet seat (for older children) after each use, and washing your hands and children's hands frequently, especially after using the bathroom (feces) and prior to eating (mouth). Adults can also try to avoid bringing their hands to their face!

A diarrheal accident, a time bomb...

A diarrheal accident (feces which leak out of a diaper or underpants) or vomiting must not be taken lightly because it can be the source of an epidemic. When it happens, ask for help if possible and clean it up while wearing gloves.

Place all objects which came in contact with feces or vomit in a bag: one bag for garbage, one for clothing. Disinfect contaminated surfaces. If you must completely wash the child, try to splatter as little as possible and disinfect the bathtub or sink (do not use the kitchen sink!) afterwards. Do not forget to disinfect all objects you touched during the "cleanup" operation. Obviously, wash your hands and the child's hands.

Furthermore, when a child has diarrhea, he can become dehydrated very quickly! The liquid lost must be replaced, keep this in mind!

For proper disinfection: 1 part bleach for 9 parts water Contact period: 3-5 minutes and gastroenteritis germs are inactivated!

Attitudes which make the transmission of gastroenteritis infections easier:

Taking diarrhea lightly.
Believing that the child is teething or ate too many berries.
Believing that the diarrhea is caused by medication.
Forgetting to wash babies' hands after diaper changes.

Changing diapers right before lunch or snacks.

Note: We mustn't neglect the rare possibility that a child taking antibiotics has developed diarrhea caused by C. difficile!

You now have information you can provide parents of children who attend your daycare with! Even if gastroenteritis cases are common in daycares, they are still a nuisance which can be avoided with minimal effort and organization.

Bibliography

Après les rhumes, les gastro-entérites!, Marc Lebel, Bye-Bye les Microbes, Vol. 1, no 2, décembre 1998, p. 1-2, www.messf.gouv.qc.ca/publications/bye-bye-microbes

La gastro-entérite, un fléau entre nos mains. Renée Julien, vol. 5, no 4 - Décembre 2003, Bulletin Sans Pépins ASSTSAS, http://www.asstsas.qc.ca

Bisson, É.,Prévention et contrôle des infections dans les centres de la petite enfance - Guide d'intervention, 1998, Comité Provincial de prévention des infections en service de garde, Publications du Québec, 435 p.

Hospitalisations d'enfants de moins de cinq ans pour gastroentérite au Québec : analyse de la fraction attribuable au rotavirus et des complications associées, Paul Rivest, Institut national de santé publique du Québec, 2002, 40 pages.

This text appeared in the La Culbute magazine, 2006.

Nathalie Thibault

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