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Preventing gastroenteritis

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As the rotavirus is the single leading cause of fatal diarrhoea in children, a vaccine called Rotashield was developed to combat this virus.

It’s since been withdrawn from use in countries that used the vaccine, as there is an increased risk of intussusception – an intestinal obstruction in which the bowel folds into itself, forming a tube within a tube.

Two new vaccines (Rotarix and RotaTeq) have subsequently been developed and tested extensively. With excellent safety records, the rotavirus vaccine is available at all South Africa EPI clinics and is given at six and 14 weeks.

Since the introduction of the rotavirus vaccine, there’s been a tremendous drop in the numbers of cases of rotavirus diarrhoea in South Africa. This vaccine is the best way to prevent severe diarrhoea associated with this virus.

It isn’t possible to physically isolate yourself sufficiently to prevent any contact with the micro-organisms that cause gastroenteritis. However, if you have a healthy immune system, you may develop immunity to many of them after a first exposure without even getting serious symptoms.

While some microorganisms will cause gastroenteritis during a first infection, subsequent infections will not cause symptoms.

Infection through contact with infected people can be prevented to some extent by avoiding contact with their bodily fluids.

Other preventive measures include:

  • Frequently cleaning and disinfecting high-risk surfaces such as food-preparation areas and toddlers’ toys.
  • Encouraging those with symptoms of gastroenteritis to practise good hygiene (e.g. hand washing after using the toilet).
  • Washing your hands after going to the bathroom, changing nappies, working with soil, cleaning the cat’s litter tray, and playing with pets.
  • Washing your hands before preparing food, between handling raw and ready-to-eat foods, and before eating.

Risks of environmental contamination due to poor living conditions or bad sanitation can be reduced by:

  • Breast-feeding babies. This negates the risks of contaminated water and unsterile bottles and teats.
  • Practising good food-storage techniques. Raw foods such as meat, poultry, fish and eggs must be eaten within a limited time period if it isn’t possible to store these foods at a cool temperature (cool temperatures prevent bacterial growth). These foods should be stored separately so as not to contaminate other foodstuffs.
  • Thoroughly cooking all food to kill any bacteria, and allowing microwaved food to stand for the specified period after cooking.
  • Peeling fruit and vegetables, and thoroughly washing those that can’t be peeled when there is a risk of contamination from human or animal manure.
  • Reheating previously cooked food to at least 75° Celsius.
  • Boiling drinking water for a few minutes if water supplies aren’t reliably filtered and chlorinated.
  • Keeping insects and animals away from food-preparation areas.

It’s important to note that, in many impoverished areas, the only way to really help reduce the incidence of gastroenteritis and other diseases of poverty is to implement overall improvements in the standard of living, sanitation and other environmental factors.

Reviewed by Kim Hofmann, registered dietitian, BSc Medical (Honours) Nutrition and Dietetics, BSc (Honours) Psychology. December 2017.

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