Encephalitis is a rare condition. It occurs more often in the first year of life and decreases with age. The very young and older adults are more likely to have a severe case.
Encephalitis is most often caused by a viral infection. Many types of viruses may cause it. Exposure to viruses can occur through:
· Breathing in respiratory droplets from an infected person
· Contaminated food or drink
· Mosquito, tick, and other insect bites
· Skin contact
Different viruses occur in different locations. Many cases occur during a certain season.
Encephalitis caused by the herpes simplex virus is the leading cause of more severe cases in all ages, including newborns.
Routine vaccination has greatly reduced encephalitis due to some viruses, including:
The outcome varies. Some cases are mild and short, and the person fully recovers. Other cases are severe, and permanent problems or death is possible.
The acute phase normally lasts for 1 to 2 weeks. Fever and symptoms gradually or suddenly disappear. Some people may take several months to fully recover.
Children and adults should avoid contact with anyone who has encephalitis.
Controlling mosquitoes (a mosquito bite can transmit some viruses) may reduce the chance of some infections that can lead to encephalitis.
· Apply an insect repellant containing the chemical, DEET when you go outside (but do not use DEET products on infants younger than 2 months).
· Remove any sources of standing water (such as old tires, cans, gutters, and wading pools).
· Wear long-sleeved shirts and pants when outside, especially at dusk.
Children and adults should get routine vaccinations for viruses that can cause encephalitis. People should receive specific vaccines if they are traveling to places such as parts of Asia, where Japanese encephalitis is found.
Vaccinate animals to prevent encephalitis caused by the rabies virus.
Death is possible in people with a severe pulmonary embolism.
Blood thinners may be prescribed to help prevent DVT in people at high risk, or those who are undergoing high-risk surgery.
If you had a DVT, your provider will prescribe pressure stockings. Wear them as instructed. They will improve blood flow in your legs and reduce your risk of blood clots.
Moving your legs often during long plane trips, car trips, and other situations in which you are sitting or lying down for long periods can also help prevent DVT. People at very high risk for blood clots may need shots of a blood thinner called heparin when they take a flight that lasts longer than 4 hours.
Do not smoke. If you smoke, quit. Women who are taking estrogen must stop smoking. Smoking increases your risk of developing blood clots.
Note: Serum is the part of blood that doesn't contain cells.
Sodium, potassium, and chloride levels can also be measured as part of a basic metabolic panel. A more complete test, called comprehensive metabolic panel, can test for these several more electrolytes.
The electrolytes - urine test measures electrolytes in urine. It test the levels of calcium, chloride, potassium, sodium, and other electrolytes.
Morning sickness often begins 4 to 6 weeks after conception and may continue until the 4th month of pregnancy. Some women have morning sickness during their entire pregnancy. This happens most often for women who are carrying more than 1 baby.
It is called morning sickness because the symptoms are more likely to occur early in the day, but they can occur at any time. For some women, morning sickness lasts all day.
The exact cause of morning sickness is not known.
· Most experts think changes in the woman's hormone levels during pregnancy cause it.
· Other factors that can make the nausea worse include a pregnant woman's enhanced sense of smell and gastric reflux.
Morning sickness that is not severe does not hurt your baby in any way. In fact:
· It may even be a sign that all is well with you and your baby.
· Morning sickness may be associated with a lower risk of miscarriage.
· Your symptoms probably show that the placenta is making all the right hormones for your growing baby.
When nausea and vomiting are severe, a condition known as hyperemesis gravidarum may be diagnosed.
· Eat a lot of protein and carbohydrates. Try peanut butter on apple slices or celery; nuts; cheese and crackers; and low-fat dairy products like milk, cottage cheese, and yogurt.
· Bland foods, such as gelatin, frozen desserts, broth, ginger ale, and saltine crackers, also soothe the stomach.
· Avoid eating foods that are high in fat and salt.
· Try to eat before you get hungry and before nausea occurs.
· Eat a few soda crackers or dry toast when you get up at night to go to the bathroom or before you get out of bed in the morning.
· Avoid large meals. Instead, have a snack as often as every 1 to 2 hours during the day. DO NOT let yourself get too hungry or too full.
· Drink plenty of liquids.
· Try to drink between meals rather than with meals so that your stomach does not get too full.
· Seltzer, ginger ale, or other sparkling waters may help control symptoms.
Foods that contain ginger may also help. Some of these are ginger tea and ginger candy, along with ginger ale. Check to see that they have ginger in them rather than just ginger flavoring.
· Take them at night, since the iron they contain may irritate your stomach. At night, you might be able to sleep through this. Also take them with a little food, not on an empty stomach.
· You may have to try several different brands of prenatal vitamins before finding one you can tolerate.
· You can also try cutting your prenatal vitamins in half. Take half in the morning and the other half at night.
Some other tips are:
· Keep your morning activities slow and calm.
· Avoid poorly ventilated spaces that trap food odors or other smells.
· DO NOT smoke cigarettes or be in areas where people are smoking.
· Get extra sleep and try to lessen stress as much as possible.
Try acupressure wristbands that apply pressure to specific points on your wrist. Often these are used to ease motion sickness. You can find them at drug stores, health food stores, travel stores, and online.
Try acupuncture. Some acupuncturists are trained to work with pregnant women. Talk to your health care provider beforehand.
Vitamin B6 (100 mg or less daily) has been shown to ease symptoms of morning sickness. Many health care providers recommend trying it first before trying other medicines.
There are no drugs currently approved by the Food and Drug Administration to treat morning sickness. Your provider may not advise medicines to prevent nausea unless your vomiting is severe and will not stop.
· The drug doxylamine (brand name Unisom) may be taken along with vitamin B6 to treat nausea and vomiting. Ask your provider before taking it.
· In severe cases, you may be admitted to the hospital, where you will receive fluids through an IV (into your vein).
· Your provider might prescribe other medicines if your morning sickness is severe.
· Your morning sickness does not improve after trying home remedies.
· You are vomiting blood or something that looks like coffee grounds.
· You lose more than 2 pounds (1 kilogram) in a week.
· You have severe vomiting that will not stop. This can cause dehydration (not having enough fluid in your body) and malnutrition (not having enough nutrients in your body).
Morning sickness often begins 4 to 6 weeks after conception and may continue until the 4th month of pregnancy. Some women have morning sickness during their entire pregnancy. This happens most often for women who are carrying more than 1 baby.
It is called morning sickness because the symptoms are more likely to occur early in the day, but they can occur at any time. For some women, morning sickness lasts all day.
The exact cause of morning sickness is not known.
· Most experts think changes in the woman's hormone levels during pregnancy cause it.
· Other factors that can make the nausea worse include a pregnant woman's enhanced sense of smell and gastric reflux.
Morning sickness that is not severe does not hurt your baby in any way. In fact:
· It may even be a sign that all is well with you and your baby.
· Morning sickness may be associated with a lower risk of miscarriage.
· Your symptoms probably show that the placenta is making all the right hormones for your growing baby.
When nausea and vomiting are severe, a condition known as hyperemesis gravidarum may be diagnosed.
· Eat a lot of protein and carbohydrates. Try peanut butter on apple slices or celery; nuts; cheese and crackers; and low-fat dairy products like milk, cottage cheese, and yogurt.
· Bland foods, such as gelatin, frozen desserts, broth, ginger ale, and saltine crackers, also soothe the stomach.
· Avoid eating foods that are high in fat and salt.
· Try to eat before you get hungry and before nausea occurs.
· Eat a few soda crackers or dry toast when you get up at night to go to the bathroom or before you get out of bed in the morning.
· Avoid large meals. Instead, have a snack as often as every 1 to 2 hours during the day. DO NOT let yourself get too hungry or too full.
· Drink plenty of liquids.
· Try to drink between meals rather than with meals so that your stomach does not get too full.
· Seltzer, ginger ale, or other sparkling waters may help control symptoms.
Foods that contain ginger may also help. Some of these are ginger tea and ginger candy, along with ginger ale. Check to see that they have ginger in them rather than just ginger flavoring.
· Take them at night, since the iron they contain may irritate your stomach. At night, you might be able to sleep through this. Also take them with a little food, not on an empty stomach.
· You may have to try several different brands of prenatal vitamins before finding one you can tolerate.
· You can also try cutting your prenatal vitamins in half. Take half in the morning and the other half at night.
Some other tips are:
· Keep your morning activities slow and calm.
· Avoid poorly ventilated spaces that trap food odors or other smells.
· DO NOT smoke cigarettes or be in areas where people are smoking.
· Get extra sleep and try to lessen stress as much as possible.
Try acupressure wristbands that apply pressure to specific points on your wrist. Often these are used to ease motion sickness. You can find them at drug stores, health food stores, travel stores, and online.
Try acupuncture. Some acupuncturists are trained to work with pregnant women. Talk to your health care provider beforehand.
Vitamin B6 (100 mg or less daily) has been shown to ease symptoms of morning sickness. Many health care providers recommend trying it first before trying other medicines.
There are no drugs currently approved by the Food and Drug Administration to treat morning sickness. Your provider may not advise medicines to prevent nausea unless your vomiting is severe and will not stop.
· The drug doxylamine (brand name Unisom) may be taken along with vitamin B6 to treat nausea and vomiting. Ask your provider before taking it.
· In severe cases, you may be admitted to the hospital, where you will receive fluids through an IV (into your vein).
· Your provider might prescribe other medicines if your morning sickness is severe.
· Your morning sickness does not improve after trying home remedies.
· You are vomiting blood or something that looks like coffee grounds.
· You lose more than 2 pounds (1 kilogram) in a week.
· You have severe vomiting that will not stop. This can cause dehydration (not having enough fluid in your body) and malnutrition (not having enough nutrients in your body).
Dehydration means your body does not have as much water and fluids as it should.
Dehydration can be mild, moderate, or severe based on how much of the body's fluid is lost or not replenished. When it is severe, dehydration is a life-threatening emergency.
Dehydration in sick children is often a combination of refusing to eat or drink anything and losing fluid from vomiting, diarrhea, or fever.
Infants and children are more likely to become dehydrated than adults because they weigh less and their bodies turn over water and electrolytes more quickly. The elderly and people with illnesses are also at higher risk.
You may also have vomiting, diarrhea, or the feeling that you "can't keep anything down." All of these can be causing the dehydration.
A decrease in skin turgor is indicated when the skin (on the back of the hand for an adult or on the abdomen for a child) is pulled up for a few seconds and does not return to its original state. A decrease in skin turgor is a late sign of dehydration.
Poor skin turgor -- the skin may not be as elastic as normal and sag back into position slowly when the health care provider pinches it up into a fold (normally, skin springs right back into place)
Drinking fluids is usually enough for mild dehydration. It is better to drink small amounts of fluid often (using a teaspoon or syringe for an infant or child), instead of trying to force large amounts of fluid at one time. Drinking too much fluid at once can bring on more vomiting.
Electrolyte solutions or freezer pops are very effective. These are available at pharmacies. Sports drinks contain a lot of sugar and can cause or worsen diarrhea. In infants and children, avoid using water as the primary replacement fluid.
Intravenous fluids and a hospital stay may be needed for moderate to severe dehydration. The health care provider will try to identify and then treat the cause of the dehydration.
Most cases of stomach viruses (also called viral gastroenteritis) tend to get better on their own after a few days. See also: Diarrhea
Even when you are healthy, drink plenty of fluids every day. Drink more when the weather is hot or you are exercising.
Carefully monitor someone who is ill, especially an infant, child, or older adult. If you believe that the person is getting dehydrated, call your health care provider before the person becomes dehydrated. Begin fluid replacement as soon as vomiting and diarrhea start -- DO NOT wait for signs of dehydration.
Always encourage a person who is sick to drink fluids. Remember that fluid needs are greater with a fever, vomiting, or diarrhea. The easiest signs to monitor are urine output (there should be frequent wet diapers or trips to the bathroom), saliva in the mouth, and tears when crying.
Viral gastroenteritis is present when a virus causes an infection of the stomach and intestine. The infection can lead to diarrhea and vomiting. It is sometimes called the "stomach flu."
Gastroenteritis can affect one person or a group of people who all ate the same food or drank the same water. The germs may get into your system in many ways:
· Directly from food or water
· By way of objects such as plates and eating utensils
· Passed from person to person by way of close contact
Many types of viruses can cause gastroenteritis. The most common viruses are:
· Norovirus (Norwalk-like virus) is common among school-age children. It may also cause outbreaks in hospitals and on cruise ships.
· Rotavirus is the leading cause in children. It can also infect adults who are exposed to children with the virus, and people living in nursing homes.
· Astrovirus.
· Enteric adenovirus.
People with the highest risk for a severe infection include young children, older adults, and people who have a suppressed immune system.
The health care provider will look for signs of dehydration, including:
· Dry or sticky mouth
· Lethargy or coma (severe dehydration)
· Low blood pressure
· Low or no urine output, concentrated urine that looks dark yellow
· Sunken soft spots (fontanelles) on the top of an infant's head
· No tears
· Sunken eyes
Tests of stool samples may be used to identify the virus that is causing the sickness. Most of the time, this test is not needed. A stool culture may be done to find out if the problem is being caused by bacteria.
The goal of treatment is to make sure the body has enough water and fluids. Fluids and electrolytes (salt and minerals) that are lost through diarrhea or vomiting must be replaced by drinking extra fluids. Even if you are able to eat, you should still drink extra fluids between meals.
· Older children and adults can drink sports beverages such as Gatorade, but these should not be used for younger children. Instead, use the electrolyte and fluid replacement solutions or freezer pops available in food and drug stores.
· Do NOT use fruit juice (including apple juice), sodas or cola (flat or bubbly), Jell-O, or broth. These liquids do not replace lost minerals and can make diarrhea worse.
· Drink small amounts of fluid (2 to 4 oz. or 60 to 120 mL) every 30 to 60 minutes. Do not try to force down large amounts of fluid at one time, which can cause vomiting. Use a teaspoon (5 milliliters) or syringe for an infant or small child.
· Babies can continue to drink breast milk or formula along with extra fluids. You do NOT need to switch to a soy formula.
Try eating small amounts of food frequently. Foods to try include:
· Cereals, bread, potatoes, lean meats
· Plain yogurt, bananas, fresh apples
· Vegetables
If you have diarrhea and are unable to drink or keep down fluids because of nausea or vomiting, you may need fluids through a vein (IV). Infants and young children are more likely to need IV fluids.
Parents should closely monitor the number of wet diapers an infant or young child has. Fewer wet diapers is a sign that the infant needs more fluids.
People taking water pills (diuretics) who develop diarrhea may be told by their provider to stop taking them until symptoms improve. However, DO NOT stop taking any prescription medicine without first talking to your provider.
Antibiotics do not work for viruses.
You can buy medicines at the drugstore that can help stop or slow diarrhea.
· Do not use these medicines without talking to your provider if you have bloody diarrhea, a fever, or if the diarrhea is severe.
Call your provider if diarrhea lasts for more than several days or if dehydration occurs. You should also contact your provider if you or your child has these symptoms:
Most viruses and bacteria are passed from person to person by unwashed hands. The best way to prevent stomach flu is to handle food properly and wash your hands thoroughly after using the toilet.
A vaccine to prevent rotavirus infection is recommended for infants starting at age 2 months.
People get traveler's diarrhea by eating food and drinking water that contain germs. People can get this illness in areas of the world where the drinking water is not clean.
People who live these areas often drink tap water that contains these germs, but they do not get diarrhea. This is because their bodies are used to the germs. In the same way, cooks and food handlers may have the germs that cause traveler's diarrhea on their hands, but they may not get sick themselves. When people travel to a new place, they are more likely to become sick, because they lack protective antibodies (infection-fighting agents in the blood) that attack these germs.
How can I tell if I have traveler's diarrhea?
You may have traveler's diarrhea if you have at least 3 loose stools in 24 hours. You may also have one or more of the following symptoms:
Even if you don't treat traveler's diarrhea, it will usually go away in 4 to 5 days. You should drink plenty of clear liquids to replace lost fluids due to the diarrhea. Taking medicine to treat traveler's diarrhea may make you feel better more quickly. It often is treated with antibiotics (medicines that kill bacteria). To get antibiotics, you need a prescription from your doctor.
You also can take a medicine called loperamide (brand name: Imodium). However, if you have bloody diarrhea, you should not take this medicine without also taking an antibiotic.
Children, pregnant women, older adults and other people who get dehydrated easily should drink rehydration solutions. Rehydration solutions help replace the fluid you lose while you are sick. You can buy packets of rehydration salts (to be mixed with safe water) at camping/outdoor stores or drug stores.
When should I contact my doctor?
If your child has a fever higher than 102°F, is dehydrated, has blood in the stool or vomits several times, he or she should see a doctor right away.
If treating your traveler's diarrhea isn't helping you to feel better, talk to your doctor.
How can I avoid traveler's diarrhea?
When you will be traveling to an area where the water may not be clean, see your doctor 4 to 6 weeks before your trip. Your doctor may want to give you some medicines, such as antibiotics or shots, to protect you from illness while you are away. During your trip, be careful about the following things:
Do not drink tap water and do not use it to brush your teeth.
Do not drink bottled water if the seal on the bottle has been broken.
Do not use ice unless you're sure it's made from purified water.
Do not drink milk or eat dairy products that have not been pasteurized (heated to a temperature that kills all germs).
Do not eat raw fruits or vegetables unless they can be peeled and you are the one who peels them.
Do not eat cut-up fruit salad.
Do not eat lettuce or other leafy raw vegetables (such as spinach).
Do not eat raw or rare (slightly cooked) meat or fish.
Do not eat food from people who sell it on the street.
Boiling water will kill the germs that cause diarrhea, making the water safe to drink. Boil water vigorously for 1 minute and allow it to cool to room temperature (do not add ice). When traveling in high altitudes (6,562 feet or higher), boil water for 3 minutes.
What is safe to eat or drink?
When you are in a place where you could get traveler's diarrhea, it is probably safe to eat or drink the following:
Soft drinks that are carbonated (such as cola).
Hot drinks, such as tea or coffee.
Carbonated or noncarbonated bottled water, as long as you are the one who breaks the seal on the bottle.
Raw fruits or vegetables that can be peeled, as long as you are the one who peels them.
Food that is served hot.
Meat that is well cooked.
Questions to Ask Your Doctor
Is there medicine I can take to prevent traveler’s diarrhea?
Is traveler’s diarrhea common in the country I’m traveling to?
If I get traveler’s diarrhea, who should I contact and when?
Bacterial gastroenteritis can affect one person or a group of people who all ate the same food. It more commonly occurs after eating at picnics, school cafeterias, large social functions, or restaurants.
The germs may get into your food (called contamination) in different ways:
Meat or poultry may come into contact with bacteria from the intestines of an animal being processed
Water that is used during growing or shipping may contain animal or human waste
Improper food handling or preparation in grocery stores, restaurants, or homes
Food poisoning often occurs from eating or drinking:
Any food prepared by someone who did not wash their hands properly
Any food prepared using unclean cooking utensils, cutting boards, or other tools
Dairy products or food containing mayonnaise (such as coleslaw or potato salad) that have been out of the refrigerator too long
Frozen or refrigerated foods that are not stored at the proper temperature or are not reheated properly
Raw fruits or vegetables that have not been washed well
Raw vegetable or fruit juices and dairy products (look for the word "pasteurized" to make sure the food is safe to eat or drink)
Undercooked meats or eggs
Water from a well or stream, or city or town water that has not been treated
Many different types of bacteria can cause bacterial gastroenteritis, including:
Figure: Your small intestine is the longest part of your digestive system - about twenty feet long! It connects your stomach to your large intestine (or colon) and folds many times to fit inside your abdomen. Your small intestine does most of the digesting of the foods you eat. It has three areas called the duodenum, the ileum, and the jejunum.
Your health care provider will examine you for signs of food poisoning, such as pain in the stomach and signs your body does not have as much water and fluids as it should. This is called dehydration.
Laboratory tests may be done on the food or a stool sample to determine what germ is causing your symptoms. However, these tests do not always show the cause of the diarrhea.
Tests may also be done to look for white blood cells in the stool, a sign of infection.
You will usually recover from the most common types of bacterial gastroenteritis in a couple of days. The goal is to make you feel better and avoid dehydration.
Drinking enough fluids and learning what to eat will help keep you or your child comfortable. You may need to:
If you have diarrhea and are unable to drink or keep down fluids because of nausea or vomiting, you may need fluids through a vein (IV). This is especially true for young children.
If you take diuretics ("water pills"), talk to your health care provider. You may need to stop taking the diuretic while you have diarrhea. Never stop or change medications without first talking to your health care provider.
Antibiotics are usually not prescribed for most common types of bacterial gastroenteritis, unless the diarrhea is very severe.
You can buy medicines at the drugstore that can help stop or slow diarrhea.
Do not use these medicines without talking to your health care provider if you have bloody diarrhea, a fever, or the diarrhea is severe.
Gastroenteritis is an infection that causes vomiting and diarrhea.
Gastroenteritis can be due to an infection with a virus, bacteria, or parasites. Also called the "stomach flu," it is contagious and spreads easily in childcare and schools. It often also causes fever.
Stool samples might be tested for bacteria or parasites if there is blood in the stool. Antibiotics are usually not needed except for certain types of infections in young infants and in people with immune problems.
Gastroenteritis usually is not serious and generally lasts a few days. The greatest risk from gastroenteritis is dehydration, so it's most important to stay hydrated with plenty of fluids. Young kids are at the highest risk for dehydration.
Bacterial gastroenteritis can affect one person or a group of people who all ate the same food. It more commonly occurs after eating at picnics, school cafeterias, large social functions, or restaurants.
The germs may get into your food (called contamination) in different ways:
Meat or poultry may come into contact with bacteria from the intestines of an animal being processed
Water that is used during growing or shipping may contain animal or human waste
Improper food handling or preparation in grocery stores, restaurants, or homes
Food poisoning often occurs from eating or drinking:
Any food prepared by someone who did not wash their hands properly
Any food prepared using unclean cooking utensils, cutting boards, or other tools
Dairy products or food containing mayonnaise (such as coleslaw or potato salad) that have been out of the refrigerator too long
Frozen or refrigerated foods that are not stored at the proper temperature or are not reheated properly
Raw fruits or vegetables that have not been washed well
Raw vegetable or fruit juices and dairy products (look for the word "pasteurized" to make sure the food is safe to eat or drink)
Undercooked meats or eggs
Water from a well or stream, or city or town water that has not been treated
Many different types of bacteria can cause bacterial gastroenteritis, including:
Figure: Your small intestine is the longest part of your digestive system - about twenty feet long! It connects your stomach to your large intestine (or colon) and folds many times to fit inside your abdomen. Your small intestine does most of the digesting of the foods you eat. It has three areas called the duodenum, the ileum, and the jejunum.
Your health care provider will examine you for signs of food poisoning, such as pain in the stomach and signs your body does not have as much water and fluids as it should. This is called dehydration.
Laboratory tests may be done on the food or a stool sample to determine what germ is causing your symptoms. However, these tests do not always show the cause of the diarrhea.
Tests may also be done to look for white blood cells in the stool, a sign of infection.
You will usually recover from the most common types of bacterial gastroenteritis in a couple of days. The goal is to make you feel better and avoid dehydration.
Drinking enough fluids and learning what to eat will help keep you or your child comfortable. You may need to:
If you have diarrhea and are unable to drink or keep down fluids because of nausea or vomiting, you may need fluids through a vein (IV). This is especially true for young children.
If you take diuretics ("water pills"), talk to your health care provider. You may need to stop taking the diuretic while you have diarrhea. Never stop or change medications without first talking to your health care provider.
Antibiotics are usually not prescribed for most common types of bacterial gastroenteritis, unless the diarrhea is very severe.
You can buy medicines at the drugstore that can help stop or slow diarrhea.
Do not use these medicines without talking to your health care provider if you have bloody diarrhea, a fever, or the diarrhea is severe.
