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Letter for Parents Regarding Viral Gastroenteritis

(U.S. Air Force graphic by Alexx Pons)

(U.S. Air Force graphic by Alexx Pons)


Letter for Parents Regarding Viral Gastroenteritis

10 January 2019


Dear Parent, Guardian, or Staff,


Grand Forks Air Force Base has become aware of children experiencing vomiting and/or diarrhea.  From the information we have at this point, it appears that the illness might be caused by a virus. Fortunately, people infected with viral gastroenteritis usually recover quickly with rest and hydration.


What is Viral Gastroenteritis? Viral gastroenteritis is an illness caused by a virus usually spread by person-to-person contact but can also be spread through aerosolized vomitus, food, water, or contact with things that infected persons have touched (e.g., door knobs, computer mouse, light switches, toilet flush handles, remote control). Illness usually occurs one or two days after being exposed. Infected persons are contagious while they have symptoms and usually for a couple of days after symptoms have resolved.


Symptoms: Symptoms of viral gastroenteritis usually begin 12 to 48 hours following exposure, and last for 3 to 5 days. The most common symptoms are vomiting, diarrhea, nausea, and stomach cramps. Other symptoms can include a low-grade fever, chills, headache, muscle aches, or fatigue. People with viral gastroenteritis can vomit or have diarrhea many times a day, which can lead to dehydration. Symptoms of dehydration include decreased urination, dry mouth and throat, and feeling dizzy when standing up. Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy.


How is viral gastroenteritis treated? Treatments for viral gastroenteritis is supportive. It cannot be treated with antibiotics, because it is not a bacterial infection. Drink plenty of fluids to replace fluid lost from vomiting and diarrhea, and to prevent dehydration.


It is extremely difficult to avoid getting viral gastroenteritis when someone in your house has it. It is spread so easily and is so contagious that it almost always affects nearly everyone living under the same roof. The following will help your child recover and prevent others from getting sick:


·      Keep your child home for at least 48 hours after the vomiting and diarrhea have stopped.

·      Your child should not prepare food or help out in the kitchen for at least 48 hours

after their symptoms have stopped.

·      Ensure your child stays hydrated by sipping fluids frequently as tolerated.

·      All members of your household should wash their hands frequently and correctly. There is a right and a wrong way to wash hands, and if not done correctly, the virus will still remain on your hands and then transfer to any object, surface, or person you touch afterwards.

o   Rub all surfaces of hands with soap, rub lathered hands together vigorously for at least 30 seconds including under the nails, and then thoroughly rinse the hands under a stream of water.

o   Wash hands after using the bathroom, cleaning, changing diapers, or before eating or preparing food. Do not use hand sanitizer solely, as it is not 100% effective at eliminating all contagious viruses.

·      If possible ill household members should use only one bathroom. Non-sick household members should use a different bathroom.

·      Avoid sharing anything the sick child has come in contact with while sick. This includes toys, towels, food, utensils, cups, bars of soap, remote control, cell phone, computer/ keyboard, etc.  This also includes bathing with other siblings.

·  Work with your school or local health department to coordinate laboratory testing.

· Contact a healthcare provider if your child is dehydrated or if you have any concerns.

Clean and disinfect frequently.  Viruses can remain alive and infectious on surfaces for 2 weeks. This means the illness can be transmitted to anyone in the household for 2 weeks after the first ill child has recovered. The following practices will help prevent you and your family from getting viral gastroenteritis:

·      Handle anything contaminated with vomit or diarrhea cautiously:

o   Wear protective gear (gloves, masks, etc.).  Viral gastroenteritis can be aerosolized

– wear a mask.

o   Wash your hands with soap and water after any cleaning of vomit or diarrhea. Do not use alcohol-based disinfectants, some viruses are less susceptible to them.

·      Prior to disinfecting, remove as much vomit or diarrhea as possible using disposable paper towels or other absorbent material. (Disinfection is not effective on visibly soiled surfaces.) Immediately discard used cleaning materials in a plastic bag and seal it. Minimize airborne particles while cleaning.

·      Disinfect: All surfaces must be disinfected. Disinfection kills germs on surfaces or objects after cleaning. Cleaning surfaces with soap and water alone or using a non-bleach product can spread virus particles. Viral gastroenteritis can be resistant to many common disinfectants including lower bleach concentrations that normally kill other bacteria and viruses. As such, it requires higher bleach concentrations with an extended contact time

(10-20 minutes). Even with higher bleach concentrations and prolonged contact time, Gastroenteritis causing viruses might not be fully killed. The physical mechanics of cleaning (the abrasion and friction of wiping a surface) will remove viruses that bleach does not kill. For this reason, it is critical to clean and disinfect often:

o   Disinfect after every episode of vomiting or diarrhea.

         Infectious material has been shown to travel more than 10 feet after a vomiting episode, therefore, the immediate area that should be cleaned and disinfected should be all objects and surfaces within a minimum of 10 feet in all directions of the vomiting or diarrhea episode.

o   Disinfect the living area twice a day.

o   Disinfect frequently touched items 3 times a day including:

         Toys                                                                   •     Toilet flush handles

         Light switches                                                    •     Phones

         Hand dryer buttons                                            •     Countertops

         Sinks and faucet knobs                                     •     Chair handles and backs

         Door knobs                                                        •     Hand railings

         Toilet stall hand rail                                            •     Kitchen equipment

         Toilet stall inner and outer door handles           •     CAC/credit cards

         Frequently used items (keyboards, mouse, pens, changing table, refrigerator handles, remote control, cell phone, etc.)


o   Disinfect surfaces starting from areas with a lower likelihood of contamination (e.g. counter tops) to areas with highly contaminated surfaces (e.g., toilets, bathroom fixtures). Change mop heads/cleaning cloths when new cleaning solutions are prepared or after cleaning large spills of vomit or diarrhea.

o   Leave the surface wet with bleach for 10-20 minutes, or follow the directions on the commercial cleaner to allow sufficient time for the disinfectant to work.

    • Make up fresh bleach dilutions daily because the active ingredient (sodium hypochlorite) degrades quickly, thus reducing the bleach concentration and its effectiveness.


  • Carpets and upholstery: Remove as much vomit or diarrhea as possible prior to disinfecting. (Disinfection is not effective on visibly soiled surfaces.) Minimize airborne particles (do not shake). Steam clean at 2158° F for 5 minutes or 212°F for 1 minute. Do Not Vacuum as vacuuming can aerosolize the virus.

  •  Laundry and other cloth items (e.g., plush toys, bedding, clothing): Viral gastroenteritis can spread in the laundry. Do not mix contaminated laundry with everyday laundry in one load;


    • It is better to discard soiled cloth items than to risk exposure during laundering.

    • Remove as much vomit or diarrhea as possible prior to laundering. Minimize airborne particles (do not shake).

    • Wash items in a pre-wash cycle with bleach using the hottest temperature setting. (Viruses can survive in temperatures up to 145º F.) Do not agitate, as agitation will aerosolize the virus. Then wash items in a regular cycle with bleach and detergent using the hottest temperature and maximum cycle length. Dry items on the hottest setting at a temperature greater than 170º F. Do not air-dry.

    • If the item will not tolerate the hottest wash cycle, bleach, or the hottest or dryer cycle, consider discarding it.

    • Color-safe-bleaches, which typically contain hydrogen peroxide, will not kill all viruses.

    • Disinfect all surfaces the contaminated laundry contacted including hamper, laundry basket, folding surfaces, laundry room floor, laundry room door handle and light switches, etc.

  • Dishes and utensils: hand-washing dishes does not remove all infectious viruses because the water does not get hot enough. If a dishwasher is available, it should be used on the hottest and

longest setting.

  • Objects Not Easily Cleaned: Items that are difficult to clean like puzzle pieces, chalk, crayons, and clay should be discarded.