“Mommy, I think I’m going to throw up.”
Those may be the eight most dreaded words a child can utter, especially in the midst of a stomach bug outbreak like the one that has gripped the Richmond area for the past two weeks.
I heard them early this afternoon, my poor little girl standing in the bathroom with fat tears rolling down her flushed cheeks.
I think I mentioned once before that I’m a little manic when my babies get sick. Our pediatrician laughs and says I’ve gotten “much better” than I was when my oldest was a toddler, but I know I still freak out more than your average mom.
I particularly loathe stomach viruses because they force me to isolate the sick child in hopes of preventing the rest of the household from falling victim to a daylong pukefest. I like to cuddle my kids when they’re sick, and the stomach yuck prevents me from doing that, which ticks me off.
My oldest is currently quarantined to her bedroom and bathroom, with a movie playing for distraction and the younger children barred from going upstairs.
I’m pushing fluids on the little ones just in case, but hoping that my manic freak out superpowers have armed me with enough information to keep the germs from spreading: we got three tummy bugs last winter, and by the time the last vomit was cleaned, I was determined to never have to go through such a horrendous season again.
I spent a chunk of my spring researching the bejeebers out of what causes them and how to prevent them and everything else to do with them. And why should you have to wade through the Internet hunting that information when I’ve already done it?
So, fellow mommy: have a seat. No, right there on the steps is good. I’d offer you a cup of coffee or a glass of wine, but I don’t want to risk you taking germs home to your babies. So excuse my hostessing today, and let’s talk about how to keep the stomach bug from ripping through your house faster than Carrie Bradshaw at a Manolo sample sale.
What is it?
To understand how to defeat the enemy, fellow mommy, you must first know what you’re fighting. My mom always called it the “stomach flu,” but it’s not related to the flu at all — influenza is a respiratory virus that can put people in the hospital, but it does not make you vomit. A more appropriate general term for what you’re facing is gastroenteritis.
The overwhelming majority of U.S. cases of gastroenteritis are caused by the norovirus, named for a town in Ohio where the first recorded outbreak of the virus occurred in a school in the 1950s. More than 20 million cases of norovirus are reported in the U.S. each year, according to the Centers for Disease Control, and the good news is that the infection, while it may make you feel like death on toast for a couple of days, is rarely serious.
There’s an important "but" here, though, fellow mommy — little ones and the elderly need to be more closely monitored for dehydration, and sometimes a particularly nasty bout can be complicated for otherwise healthy kids.
My oldest got a really awful case when she was 5 that lasted for a solid week and didn’t even respond to the Zofran our pediatrician prescribed (don’t call and ask for meds for a run-of-the-mill bug, though. According to the American Academy of Pediatrics, it’s generally best to let it run its course, but if you see puking for more than 6 hours in a little one under 2 or more than 12 hours in an older child, call your doctor or just go to the ER). My daughter lost more than 10 percent of her body weight and looked like she belonged on a Save the Children ad by that Friday, and scared the bejeebers out of me.
The pediatrician told me later that my little monkey should have probably been hospitalized, but our wires got crossed. I still thank God occasionally that the miscommunication didn’t have dire consequences.
How do we get it?
This is the gross part, fellow mommy. If you’re squeamish, it may make you feel a little nauseous if you think about it too hard, so we’ll just say it fast, like ripping off a band aid: you ingest infected fecal matter.
Yep. Yuck. What commonly happens is that you eat something a sick person has touched, or you touch a contaminated surface and then put your fingers in your mouth (this is an easy way for the virus to spread at school and in daycares, because we all know how much little ones like to put their blasted hands in their mouths). You can also get it from eating oysters, so make sure they've been steamed well if you like them.
The thing about the norovirus is that it’s super contagious, so it takes as little as 10 particles (and they’re itsy-bitsy) to make you sick. It also lives for a long time in the environment, which is unique. Even HIV dies after being exposed to the air for a while. But not these little buggers — they can live on fabric or hard surfaces for up to three weeks. This is why it spreads like wildfire on cruise ships and college campuses.
How do you kill it?
This is the all-important question for mommies trying to contain an outbreak. And the short answer is, ditch the Lysol.
I love it, too — but it doesn’t work on these germs. According to the Virginia Department of Health (and everyone else who knows their belly bugs) there are only two ways to kill norovirus: with heat and bleach. (Update, January 2014: Lysol III says on the back of the can that it will kill norovirus after five minutes. But you must read the label and make sure you bought the right kind. And if you’re as overzealous as I am, you’ll use the lysol and bleach, too.)
Get an empty spray bottle and mix up a 10:1 bleach solution (I do 5:1, but I’m, you know, a little paranoid) and spray down sinks, toilets, floors, and everything else you can think of — but not the sofa unless it’s white, and we know it’s not white because you have kids. So don’t get overzealous and wreck your upholstery. I may or may not be advising this from experience.
Carefully transfer any laundry that may have come into contact with puke or poop to the washer, trying not to shake it too much (I don’t know exactly why, but the CDC advised it, so I figure we might as well just do it to be safe) and wash it in the hottest water you can on the longest cycle your machine has. (Tangent: you know when is the very worst possible time there is for the pump motor on your washer to break? When everyone in your house has fallen one by one to the stomach bug over a week and the machine is full of vomit water and germy laundry. Ask me how much I cursed Whirlpool that day). Dry it on the highest heat the fabric will take.
How long is it contagious?
The good news (there’s good news? I thought we were talking about the stomach bug) is that norovirus, unlike strep and influenza, is generally not contagious until the infected person begins showing symptoms. So you don’t have to call everyone from playgroup three days ago if your child comes down with it tonight.
The bad news (you knew it was coming, right?) is that your body sheds the virus for two weeks after your symptoms stop, and you’re actively contagious for three days after your last upchuck. What does that mean? Well, since isolating a kid for more than the 24-48 hours that they’re actually sick is impractical, it means I make them wash the heck out of their hands when I finally allow them to come downstairs. If they go in the bathroom, mommy follows, supervises the handwashing (because, you know, most children are really thorough when they wash their hands, aren’t they? Why are you laughing?) and gives them a paper towel for drying.
How can I avoid it?
On a day-to-day basis, wash your hands really well after using the restroom and before every meal. Teach your children to do the same, and start in on them at a young age about keeping their hands out of their mouths.
Once it’s in your house, step up the handwashing.
“Wash your hands until they bleed. I’m serious,” one mommy friend who has successfully managed to contain the bug to just one of her four children on more than one occasion, said. “Wash them every time you walk past a sink, and every time you touch anything your sick kid has touched. Sing the whole ABC song every time, and rinse them with the hottest water you can stand. Just keep some Cetaphil cream on hand for the cracking that will come if you do it right.”
Forget the hand sanitizer — while it works great for other germs, this one has no lipid envelope, so alcohol-based cleaners are rendered ineffective against it.
Also, breastfeed your babies: several studies show that a protein in breastmilk binds the virus and keeps it from the receptors in your baby’s intestines, which then keeps baby from getting sick. One of many advantages, and a very welcome one when there’s a germ in the same house as a baby.
How will I know if we’re in the clear?
Again, good news and bad news.
The good news is that most of the time, someone else who’s going to get sick will do it with in 10-48 hours.
The bad news is that the stubbornness of these germs is ridiculous, and they can live in your house for weeks.
So, fellow mommy, at the three day mark, you have my permission to be cautiously optimistic. But keep your bleach solution handy and clean every bathroom and the kitchen with it at least once a day for two weeks to improve your odds.
Can you get it more than once?
Unfortunately, yes, but you shouldn’t be able to get the same strain of it more than once in the same season.
Human immunity to norovirus is a scantily understood medical area. There are some recent studies that suggest that blood type and genes play a role in succeptibility in the first place: on a genetic level, folks who lack a functioning FUT2 gene can't absorb the virus in their intestinal tract and won't get sick; and people with type O blood are more likely to get sick, while people with B and AB tend to be at least partially immune.
In my own very unscientific real-life-mom experience, the blood type thing holds water. I’m O+ and I get sick with a vengeance with this stuff. I had it in December when my little boy brought it home and I threw up every 20 minutes for six solid hours and felt like I was going to be seeing the pearly gates any moment for about five of them.
My hubby, on the other hand, is one of the “B” types and he very rarely gets it. Twice in 17 years, and both times he threw up once and was fine in a couple of hours. I hate him just a little bit when this happens. However, I’m thankful for it when he cleans up the children’s vomit because he’s “Superman” and he won’t get sick.
Once you’ve had it, your system has immunity to that same exact strain of the virus for 4-24 months (I said scantily understood, didn’t I?).
Again, very unscientific, but I know that the three bouts of it we had last year all behaved quite differently — from a raging, uber-contagious superbug that even took down hubs (and my visiting in-laws, who stayed at a hotel and weren’t even in our house that much) to a weird little hiccup that made everyone who got it (not hubby, of course) puke one time, feel puny for about three hours, and then bounce right back.
This minute, I am praying that the strain my oldest has is the same one my little boy and I had in December, so maybe we won’t get sick again. Between that, the still-nursing baby, and my "Superman," I at least like our odds a little better this time.
I’ve bleached the whole house and scrubbed everything I can with hot water, but I’m still hoping.
Preparedness is the best line of defense
After last winter, I made a “stomach bug kit” for each bathroom upstairs. Here’s what to put in each one:
Several plastic grocery sacks: put all of the sick person trash in these and take them outside ASAP once you've used them.
A box of disposable gloves: wear them every time you touch anything that even might be contaminated, and toss them in a trash sack when you’re done.
A roll of paper towels: regular hand towels leave the premises while the stomach bug is around. Use the paper towels to dry hands and wipe down surfaces, then put them in your handy plastic grocery bag for disposal.
A spray bottle of bleach solution: get a heavy duty, chemical-resistant plastic bottle from the cleaning aisle (the ones I found at the Midlothian Wal Mart have the dilution scale handily printed on the side). I read something that said the solution can lose its potency after a few months, so I mix fresh each time because bleach is cheap, but I’m also not sure what the difference is between being diluted in a spray bottle or on the laundry room shelf in the Clorox bottle, so you make your own call.
There you have it, fellow mommy — the culmination of years of mommy experience and hours of obsessive reporter research. I sincerely hope it helped. Good luck keeping this nasty bug at bay.
I hear retching from the upper reaches of the house again, so I’m off to the trenches to don my gloves and try to help my baby. This mommy-on-the-front-lines thing isn’t always fun, but at least it’s never boring.
If you enjoyed this article, please click the "Like" button at the top of the page. You can also subscribe at the bottom of this page, and follow me on twitter @LynDeeWalker. I make no assumptions about having all the answers, but I do have smart friends and a love for sharing and hearing ideas on raising smart, happy kids. For information on my Headlines in High Heels mystery series, (Front Page Fatality, and Buried Leads, Henery Press, 2013) visit me online at www.lyndeewalker.com.