When the stomach turns .. tummy bugs or COVID-19?

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As South Africa nears the end of the second wave of Covid-19 and braces for a third, a stomach bug is circulating and spreading in schools and the community.  Dr Morgan Mkhatshwa, head of operations at Bonitas Medical Fund, discusses the signs and symptoms of a stomach bug and common gastrointestinal (GI) viral infections versus the GI symptoms from Covid-19. 

He says, ‘Although the period between November and May usually coincides with an increase in diarrhoea and pneumonia cases, according to the MMC: Community Services and Health, Zahid Badroodien, it is significantly reduced with a 29% decrease in cases and a 15% decrease in hospital admissions. The decline is partially attributed to the increased adherence to health protocols for Covid-19 like hand-washing, sanitisation and wearing masks.’

However, the recent tummy bug that is circulating, is proof that the virus is still around, Dr Mkhatshwa talks about common GI viral infections and GI symptoms associated with Covid-19.

What are the symptoms of a tummy bug? 

Stomach bugs (or stomach flu) are known as viral gastroenteritis and are characterised by the following symptoms:

  • Diarrhoea 
  • Abdominal cramps 
  • Nausea 
  • Vomiting 
  • Fever 
  • Thirst 
  • Joint aches 
  • Headache 
  • General malaise

How long does a stomach bug last?

People typically develop stomach bug symptoms within 24 to 72 hours of being exposed to the virus. While most cases resolve in three to four days, it’s not uncommon to feel unwell for up to a week.

How do I know if it’s food poisoning or a stomach virus?

The symptoms of food poisoning and a stomach virus are very similar. However, food poisoning symptoms develop in as little as a few hours. Most people suspect food poisoning when symptoms develop shortly after eating food which may seem questionable.

Covid and gastroenteritis

Research consistently shows that approximately 10% of adults with Covid-19 report GI symptoms such as nausea, vomiting or diarrhea. Typically, patients will also have the more common upper respiratory symptoms that accompany Covid-19, such as a dry cough or difficulty breathing. 

How do you tell the difference between Covid-19 symptoms and ‘stomach flu’?

So, how do you know which one you’re dealing with if you’re experiencing, for instance, a fever, vomiting, and diarrhoea? ‘Unfortunately, it is not always easy,’ says Dr Mkhatshwa, ‘if you have respiratory symptoms, (particularly chest pain) and loss of smell or taste, it is pretty clear cut. However, GI symptoms can occur on their own with Covid-19.  A stomach bug also typically lasts only 72 hours while GI related symptoms with the coronavirus can last much longer.’

What should you do if you suspect the GI symptoms are in fact, Covid-19 related? 

Consult your doctor – via phone or virtually – to discuss your symptoms and if he/she feels you are displaying signs of the coronavirus infection, they will refer you for a Covid-19 test.  

How long are you contagious with a stomach bug?

Stomach viruses are highly contagious and can spread quickly. People infected with a stomach virus are contagious from the moment they begin feeling ill and also for the first few days (up to 72 hours) after they recover.

A stomach virus can spread in several different ways:

  • Eating food or drinking liquids that have been contaminated with the virus
  • Having direct or indirect mouth contact with an infected person or surface with the virus on it
  • Unhygienic behaviour, such as not washing hands after toilet use, not washing fruits and vegetables before consumption
  • The virus also inhabits the vomit and stools of people who have the infection

How do you treat or get rid of a stomach bug?

Supportive therapy that includes increased hydration, rest, electrolyte replenishment and medication for fever is usually all that is needed for viral illnesses.  This is because viruses do not respond to antibiotics and simply need to run their course. If the infection is caused by bacteria, like Salmonella, an antibiotic may be prescribed.

Viral gastroenteritis will typically resolve within a few days or less without medication. However, hydration is vital to a speedy recovery and prevention of complications.

Here are a few steps you can take at home to aid recovery from a stomach virus or food poisoning:

  • Try not to eat any solid foods until you feel better
  • Suck on ice chips or take small sips of water to prevent dehydration
  • Avoid juices or other beverages with a lot of sugar or sweeteners that can make diarrhea worse
  • Ease yourself back into eating. Start with bland, easy-to-digest foods, such as toast and rice. Stop eating if a feeling of nausea returns
  • Avoid dairy, caffeine, fatty foods and sugar until you feel better
  • You should be cautious of taking over-the-counter medications, unless advised by a healthcare provider, as some can worsen the infection

When to treat it seriously and consult a medical doctor?

Seek medical attention if you have any of the following symptoms:

  • A bloody stool or vomit
  • Are unable to keep liquid down for 12-24 hours
  • Feel dizzy or  light-headed
  • Have a fever above 40°C
  • Are experiencing severe, unrelenting abdominal pain.

Fortunately, thanks to the Covid-19 protocols which include wearing masks, social distancing and the washing and sanitising of hands the incidence of stomach bugs has been reduced. However, it is a virus and you may still be susceptible but remember it will run its course and you will recover. During the time you are experiencing symptoms rest, stay hydrated and stay away from others while you are still contagious.

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