Tag Archives: Coronavirus

Straight, No Chaser: About That Vomiting and Diarrhea…

December 1, 2016Gastrointestinal, Infectious Disease, Health PreventionInfluenza, 844-SMA-TALK, Behind the Curtain, Coronavirus, Diarrhea, Gastroenteritis, health, Intestine, Norovirus, Oral rehydration therapy, Rotavirus, Sterling Medical Advice, SterlingMedicalAdvice.com, Stomach, Straight No Chaser, VomitingJeffrey Sterling, MD

You’ve all been there and done that. It’s always a bad day when you get the so-called stomach flu… First of all ‘the flu’ is a respiratory disease (affects the lungs, not the stomach and intestines), and the influenza viruses don’t cause that syndrome of vomiting and watery diarrhea. So, what you’re actually getting is gastroenteritis (gastro = stomach, entero = intestines, and itis = inflammation), an inflammation of the stomach and intestines.
Gastroenteritis means inflammation of the stomach and small and large intestines. Most cases of gastroenteritis are infections caused by a variety of viruses that results in vomiting or diarrhea (other symptoms may include belly cramping, fever and headache from all that retching). There are other (bacterial) causes of vomiting and diarrhea, but the overwhelming number of cases is due to viruses. Your physician will know when the other considerations come into play. Here’s a few points you really want to know.
1. Is it serious?

In most cases of viral gastroenteritis, the symptoms and condition are rate limited and will come and go without much further ado. Your symptoms will last up to 10 days in most cases.
The concern isn’t nearly as much with the vomiting and diarrhea as it is with the dehydration that can result from all those fluid losses. Dehydration can cause all manner of electrolyte abnormalities, leading to serious acute illness and even death. In fact, diarrhea and dehydration have long been the number one cause of death worldwide outside of the United States.

2. Is it contagious?

Absolutely. This is one of the main reasons you’re always being told to wash your hands, especially after using the bathroom. Fecal-oral (yes, anus to mouth) transmission of viruses makes gastroenteritis and many other illnesses contagious. Hand shaking and other forms of contact (including eating food poorly handled or undercooked) extend the risk of transmission.

3. How can I avoid gastroenteritis?
There are good options available to you.

Avoid food and water that you believe to be contaminated, perhaps because others have had problems with it.
Frequent hand washing is very important.
Similarly, take steps to wash and disinfect possibly contaminated clothing and surfaces, preventing this before it gets started.
A vaccine is available for two of the more common causes of gastroenteritis. Discuss whether it’s appropriate for your child with his/her pediatrician (it needs to be given during your child’s first year of life).

4. How will it be treated?

Fluids, fluids and more fluids will be given, and unless you can’t keep anything down at all, the fluids should be given by mouth. It’s interesting to note that the U.S. overuses intravenous (IV) fluids much more in these instances than the rest of the world. Learn about oral rehydration therapy (ORT). It’s how the rest of the world (very successfully) treats most cases of vomiting and diarrhea, and it’s roughly approximated by all those popular rehydration brands. The key is to take in enough fluids to stay ahead of the fluid losses. ORT is available over the counter, and remember that you don’t have to guzzle it. As little as a teaspoon at a time still can keep you hydrated.

It’s important to discuss some other treatment considerations.

Antibiotics don’t work against these viruses, so in this example, they won’t be helpful.
In select instances, your physician may provide symptomatic treatment for vomiting and diarrhea, but in the absence of this, they should be avoided. There are significant consequences to taking these medications, and a physician should be involved in taking that risk.

In summary, you don’t always have to run to the ER when you get the runs. Stay hydrated, my friends.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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Straight, No Chaser In The News: The Emerging Threat of MERS

May 13, 2014General Health and WellnessStraight No Chaser, SterlingMedicalAdvice.com, 844-SMA-TALK, Coronavirus, MERS, Middel East Respiratory Syndrome, Sterling Medical AdviceJeffrey Sterling, MD

When something new occurs in medicine and healthcare, it immediately becomes newsworthy. Today we focus on a relatively new viral disease called MERS. The Middle East Respiratory Syndrome (MERS) is a viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a virus called MERS-CoV. Most people confirmed to have MERS-CoV infection had developed a severe acute respiratory illness, including fever, cough and shortness of breath. At this point, more than 30% of those contracting MERS have died.

So far, all the cases have been linked to countries in the Arabian Peninsula, including Saudi Arabia, United Arab Emirates, Qatar, Oman, Jordan, Kuwait, Yemen, and Lebanon. Travel-associated cases have occurred in France, Greece, Italy, Jordan, Malaysia, Tunisia, Turkey, United Kingdom and the United States.
This virus has spread from ill people to others through close contact, such as caring for or living with an infected person. However, there is no evidence of sustained spreading throughout communities.

On May 2, 2014, the first U.S. case of MERS was confirmed in a traveler from Saudi Arabia to the U.S. The traveler is considered to be fully recovered and has been released from the hospital. Public health officials have contacted healthcare workers, family members, and travelers who had close contact with the patient. At this time, none of these contacts has had evidence of being infected with MERS-CoV.

On May 11, 2014, a second U.S. imported case of MERS was confirmed in a traveler who also came to the U.S. from Saudi Arabia. This patient is currently hospitalized and doing well. People who had close contact with this patient are being contacted. The two U.S. cases are not linked.

It is important to note these two cases of MERS imported to the U.S. represent a very low risk to the general public in this country.

Here is additional information provided by the Center for Disease Control and Prevention (CDC).

Q: What is MERS?
A: Middle East Respiratory Syndrome (MERS) is a viral respiratory illness first reported in 2012 in Saudi Arabia. MERS is caused by a virus called “Middle East Respiratory Syndrome Coronavirus” (MERS-CoV).
Q: Is MERS-CoV the same as the SARS virus?
A: No. MERS-CoV is not the same virus that caused severe acute respiratory syndrome (SARS) in 2003. However, like the SARS virus, MERS-CoV is most similar to viruses found in bats. CDC is still learning about MERS.
Q: What are the symptoms of MERS?
A: Most people who got infected with MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. 30% of them died. Some people were reported as having a mild respiratory illness.
Q: Does MERS-CoV spread from person to person?
A: MERS-CoV has been shown to spread between people who are in close contact. Transmission from infected patients to healthcare personnel has also been observed. Clusters of cases in several countries are being investigated.
Q: What is the source of MERS-CoV?
A: We don’t know for certain where the virus came from. However, it likely came from an animal source. In addition to humans, MERS-CoV has been found in camels in Qatar, Egypt and Saudi Arabia, and a bat in Saudi Arabia. Camels in a few other countries have also tested positive for antibodies to MERS-CoV, indicating they were previously infected with MERS-CoV or a closely related virus. However, we don’t know whether camels are the source of the virus.
Q: Am I at risk for MERS-CoV infection in the United States?
A: The U.S. cases of MERS represent a very low risk to the general public in this country. You are not considered to be at risk for MERS-CoV infection if you have not had close contact, such as caring for or living with someone who is being evaluated for MERS-CoV infection.
Q: Can I still travel to countries in the Arabian Peninsula or neighboring countries where MERS cases have occurred?
A: Yes. CDC does not recommend that anyone change travel plans because of MERS. The current CDC travel notice is an Alert (Level 2), which provides special precautions for travelers. Because spread of MERS has occurred in healthcare settings, the alert advises travelers going to countries in or near the Arabian Peninsula to provide health care services to practice CDC’s recommendations for infection control of confirmed or suspected cases and to monitor their health closely. Travelers who are going to the area for other reasons are advised to follow standard precautions, such as hand washing and avoiding contact with people who are ill.
Q: What if I recently traveled to countries in the Arabian Peninsula or neighboring countries and got sick?
A: If you develop a fever and symptoms of respiratory illness, such as cough or shortness of breath, within 14 days after traveling from countries in the Arabian Peninsula or neighboring countries, you should see your healthcare provider and mention your recent travel.
Q: How can I help protect myself?
A: CDC advises that people follow these tips to help prevent respiratory illnesses:

Wash your hands often with soap and water for 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer.
Cover your nose and mouth with a tissue when you cough or sneeze then throw the tissue in the trash.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Avoid close contact, such as kissing, sharing cups, or sharing eating utensils, with sick people.
Clean and disinfect frequently touched surfaces, such as toys and doorknobs.

Q: Is there a vaccine?
A: No, but CDC is discussing with partners the possibility of developing one.
Q: What are the treatments?
A: There are no specific treatments recommended for illnesses caused by MERS-CoV. Medical care is supportive and to help relieve symptoms.
Q: Is there a lab test?
A: Yes. Lab tests (polymerase chain reaction or PCR) for MERS-CoV are available at state health departments, CDC, and some international labs. Otherwise, MERS-CoV tests are not routinely available. There are a limited number of commercial tests available.

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Straight, No Chaser: About That Vomiting and Diarrhea…

August 21, 2013Health Prevention, Medical TreatmentRotavirus, Coronavirus, Diarrhea, Gastroenteritis, health, Influenza, Intestine, Norovirus, Oral rehydration therapy, Stomach, United States, VomitingJeffrey Sterling, MD

In most cases of viral gastroenteritis, the symptoms and condition are rate limited and will come and go without much further ado. Your symptoms will last up to 10 days in most cases.
The concern isn’t nearly as much with the vomiting and diarrhea as it is with the dehydration that can result from all those fluid losses. Dehydration can cause all manner of electrolyte abnormalities, leading to serious acute illness and even death. In fact, diarrhea and dehydration have long been the number one cause of death worldwide outside of the United States.

2. Is it contagious?

Absolutely. This is one of the main reasons you’re always being told to wash your hands, especially after using the bathroom. Fecal-oral (yes, anus to mouth) transmission of viruses makes gastroenteritis and many other illnesses contagious. Hand shaking and other forms of contact (including eating food poorly handled or undercooked) extend the risk of transmission.

3. How can I avoid gastroenteritis?
There are good options available to you.

Avoid food and water that you believe to be contaminated, perhaps because others have had problems with it.
Frequent hand washing is very important.
Similarly, take steps to wash and disinfect possibly contaminated clothing and surfaces, preventing this before it gets started.
A vaccine is available for two of the more common causes of gastroenteritis. Discuss whether it’s appropriate for your child with his/her pediatrician (it needs to be given during your child’s first year of life).

4. How will it be treated?

Fluids, fluids and more fluids will be given, and unless you can’t keep anything down at all, the fluids should be given by mouth. It’s interesting to note that the U.S. overuses intravenous (IV) fluids much more in these instances than the rest of the world. Learn about oral rehydration therapy (ORT). It’s how the rest of the world (very successfully) treats most cases of vomiting and diarrhea, and it’s roughly approximated by all those popular rehydration brands. The key is to take in enough fluids to stay ahead of the fluid losses. ORT is available over the counter, and remember that you don’t have to guzzle it. As little as a teaspoon at a time still can keep you hydrated.

It’s important to discuss some other treatment considerations.

Antibiotics don’t work against these viruses, so in this example, they won’t be helpful.
In select instances, your physician may provide symptomatic treatment for vomiting and diarrhea, but in the absence of this, they should be avoided. There are significant consequences to taking these medications, and a physician should be involved in taking that risk.