Stomach & Intestinal Infections

About Rotavirus

Almost all kids have had a rotavirus infection by the time they’re 5 years old. Rotavirus is one of the most common causes of diarrhea, and severe infection (rotavirus gastroenteritis) is the leading cause of severe, dehydrating diarrhea in infants and young children.

In the U.S., rotavirus infections are responsible for about 3 million cases of diarrhea and 55,000 hospitalizations for diarrhea and dehydration in children younger than 5 years old each year.

Although these infections cause relatively few U.S. deaths, diarrhea caused by rotavirus causes more than half a million deaths worldwide every year. This is especially true in developing countries, where nutrition and health care are not optimal.

Signs and Symptoms

Kids with a rotavirus infection have fever, nausea, and vomiting, often followed by abdominal cramps and frequent, watery diarrhea. Kids may also have a cough and runny nose. As with all viruses, though, some rotavirus infections cause few or no symptoms, especially in adults.

Sometimes the diarrhea that accompanies a rotavirus infection is so severe that it can quickly lead to dehydration. Signs of dehydration include thirst, irritability, restlessness, lethargy, sunken eyes, a dry mouth and tongue, dry skin, fewer trips to the bathroom to pee, and (in infants) a dry diaper for several hours.

Contagiousness

In the United States, rotavirus infection outbreaks are common during the winter and spring months. It is particularly a problem in childcare centers and children’s hospitals because rotavirus infection is very contagious.

The virus passes in the stool of infected people before and after they have symptoms of the illness. Kids can become infected if they put their fingers in their mouths after touching something that has been contaminated. Usually this happens when kids don’t wash their hands often enough, especially before eating and after using the toilet.

People who care for kids, including health care and childcare workers, also can spread the virus, especially if they don’t wash their hands after changing diapers.

Prevention

The American Academy of Pediatrics (AAP) now recommends a rotavirus vaccine be included in the lineup of routine immunizations given to all infants.

The RotaTeq vaccine has been found to prevent approximately 75% of cases of rotavirus infection and 98% of severe cases. Another vaccine, Rotarix, also is available and is effective in preventing rotavirus infection. Your doctor will have the most current information about these vaccines.

A previous rotavirus vaccine was taken off the market in 1999 because it was linked to an increased risk for intussusception, a type of bowel obstruction, in young infants. Neither RotaTeq nor Rotarix have been found to have this increased risk.

Washing hands well and often is the best way to limit the spread of rotavirus infection. Kids who are infected should stay home from childcare groups until their diarrhea has ended. In hospitals, rotavirus outbreaks are controlled by isolating infected patients and following strict hand-washing procedures.

Professional Treatment

An infant or toddler who becomes moderately or severely dehydrated may need to be treated in a hospital with intravenous (IV) fluids to bring the body’s fluid and salt levels back to normal. Most older kids can be treated at home.

Your doctor may need to test your child’s blood, urine, or stool to confirm that the diarrhea is being caused by rotavirus and not by bacteria. Because antibiotics do not work against illnesses caused by viruses, the doctor will not prescribe antibiotics to treat a rotavirus infection.

Home Treatment

To prevent dehydration, follow your doctor’s guidance about what your child should eat and drink. Your doctor may suggest that you give your child special drinks that replace body fluids, especially if the diarrhea has been going on for longer than 2 or 3 days.

In general, kids with mild diarrhea who are not dehydrated should continue to eat normally but should drink more fluids. (Fruit juices and soft drinks can make diarrhea worse and should be avoided.) Those who have mild to moderate dehydration should get small, frequent amounts of an oral rehydration solution, then should go back to eating normally when they’re better. Children who are breastfed should be breastfed throughout.

A child who is vomiting will need to eat smaller amounts of food more often. Follow your doctor’s advice and don’t give your child store-bought medicines for vomiting or diarrhea unless your doctor recommends them.

When to Call the Doctor

Call the doctor for advice if your child has signs of a rotavirus infection, including watery diarrhea, fever, nausea, and vomiting. Call immediately if your child has signs of dehydration.

Salmonellosis is a foodborne illness caused by infection with Salmonella bacteria. Most infections are spread to people through consumption of contaminated food (usually meat, poultry, eggs, or milk).

Salmonella infections affect the intestines and cause vomiting, fever, and cramping, which usually clear up without medical treatment.

You can help prevent Salmonella infections by not serving any raw meat or eggs, and by not keeping reptiles as pets, particularly if you have very young children.

Hand washing is a powerful way to guard against Salmonella infections. So teach kids to wash their hands, particularly after trips to the bathroom and before handling food in any way.

Salmonella Basics

Not everyone who ingests Salmonella bacteria will become ill. Children, especially infants, are most likely to get sick from it. About 50,000 cases of salmonellosis are reported in the United States each year and about a third of those are in kids 4 years old or younger.

There are many different types of Salmonella bacteria. The type responsible for most infections in humans is carried by chickens, cows, pigs, and reptiles (such as turtles, lizards, and iguanas). Another, rarer form — called Salmonella Typhi (S.Typhi) — causes typhoid fever. People usually get typhoid fever by drinking beverages or eating food that has been handled by someone who has typhoid fever or is a carrier of the illness. Most cases are in developing countries where clean water and other sanitation measures are hard to come by.

Signs and Symptoms

A Salmonella infection generally causes nausea, vomiting, abdominal cramps, diarrhea (sometimes bloody), fever, and headache. Because many different kinds of illnesses can cause these symptoms, most doctors will take a stool sample to make an accurate diagnosis.

Symptoms of most infections start within 3 days of contamination and usually go away without medical treatment.

At first, typhoid fever caused by Salmonella bacteria looks similar to infections by non-typhoid Salmonella. But in the second week, the liver and spleen can become enlarged, and a distinctive “rose spotted” skin rash may appear. From there, the infection can cause other health problems, like meningitis and pneumonia.

People at risk for more serious complications from a Salmonella infection include those who:

• have problems with their immune systems (such as people with HIV)
• take cancer-fighting drugs
• have sickle cell disease or an absent or nonfunctioning spleen
• take chronic stomach acid suppression medication

In these higher-risk groups, most doctors will treat an infection with antibiotics to prevent it from spreading to other parts of the body.

Prevention

Here are some ways to help prevent Salmonella bacteria from making your family sick:

• Cook food thoroughly. Salmonella bacteria are most commonly found in animal products and can be killed by the heat of cooking. Don’t serve raw or undercooked eggs, poultry, or meat. Microwaving is not a reliable way to kill the bacteria. If you’re pregnant, be especially careful to avoid undercooked foods.
• Take care with eggs. Because Salmonella bacteria can contaminate even intact and disinfected grade A eggs, cook them well and avoid serving poached or sunny-side up eggs (with runny yolks).
• Clean cooking surfaces regularly. Salmonellosis also can spread through cross-contamination, so when you’re preparing meals, keep uncooked meats away from cooked and ready-to-eat foods. Thoroughly wash your hands, cutting boards, counters, and knives after handling uncooked foods.
• Avoid foods that might contain raw-food products. Caesar salad dressing, the Italian dessert tiramisu, homemade ice cream, chocolate mousse, eggnog, cookie dough, and frostings can contain raw eggs. Unpasteurized milk and juices also can be contaminated with Salmonella.
• Wash hands often. Fecal matter (poop) is often the source of Salmonella contamination, so hand washing is extremely important, especially after using the toilet and before preparing food.
• Take care with pets. Avoid contact with the feces of family pets — especially reptiles. Wash your hands thoroughly after handling an animal and make sure that no reptiles are permitted to come into contact with a baby. Even healthy reptiles (especially turtles and iguanas) are not safe pets for small children and should not be in the same house as an infant.
• Don’t cook food for others if you are sick, especially if you have vomiting or diarrhea.
• Keep food chilled. Don’t leave cooked food out for more than 2 hours after serving (1 hour on a hot day) and store it promptly. Also, keep your refrigerator set to under 40°F (4.4°C).

Treatment

If your child has salmonellosis and a healthy immune system, your doctor may let the infection pass without giving any medicines. But any time a child develops a fever, headache, or bloody diarrhea, call the doctor to rule out any other problems.

If your child is infected and has a fever, you may want to give acetaminophen to reduce his or her temperature and relieve cramping. As with any infection that causes diarrhea, it’s important to give your child plenty of liquids to avoid dehydration.

About Shigella

Shigella are bacteria that can infect the digestive tract and cause a wide range of symptoms, from diarrhea, cramping, vomiting, and nausea, to more serious complications and illnesses. Infections, called shigellosis, sometimes go away on their own; while other times, antibiotics can shorten the course of the illness.

Shigellosis, which is most common during the summer months, usually affects kids 2 to 4 years old and rarely infects infants younger than 6 months old.

These infections are very contagious and can be prevented with good hand washing practices.

Signs and Symptoms

Shigella bacteria produce toxins that can attack the lining of the large intestine, causing swelling, ulcers on the intestinal wall, and bloody diarrhea.

The severity of the diarrhea sets shigellosis apart from regular diarrhea. In kids with shigellosis, the first bowel movement is often large and watery. Later bowel movements may be smaller, but the diarrhea may have blood and mucus in it.

Other symptoms of shigellosis include:

• abdominal cramps
• high fever
• loss of appetite
• nausea and vomiting
• painful bowel movements

In very severe cases of shigellosis, a person may have convulsions (seizures), a stiff neck, a headache, extreme tiredness, and confusion. Shigellosis can also lead to dehydration and in rare cases, other complications, like arthritis, skin rashes, and kidney failure.

Some children with severe cases of shigellosis may need to be hospitalized.

Contagiousness

Shigellosis is very contagious. Someone may become infected by coming into in contact with something contaminated by stool from an infected person. This includes toys, surfaces in restrooms, and even food prepared by someone who is infected. For instance, kids who touch a contaminated surface such as a toilet or toy and then put their fingers in their mouths can become infected. Shigella can even be carried and spread by flies that have touched contaminated stool.

Because it doesn’t take many Shigella bacteria to cause an infection, the illness spreads easily in families and childcare centers. The bacteria also may spread in water supplies in areas with poor sanitation. Shigella can be passed in the person’s stool for about 4 weeks even after the obvious symptoms of illness have resolved (although antibiotic treatment can reduce the excretion of Shigella bacteria in the stool).

Prevention

The best way to prevent the spread of Shigella is by frequent and careful hand washing with soap, especially after they use the toilet and before they eat. This is especially important in childcare settings.

If you’re caring for a child who has diarrhea, wash your hands before touching other people and before handling food. (Anyone with a diarrhea should not prepare food for others.) Be sure to frequently clean and disinfect any toilet used by someone with shigellosis.

Diapers of a child with shigellosis should be disposed of in a sealed garbage can, and the diaper area should be wiped with disinfectant after use. Young children (especially those still in diapers) with shigellosis or with diarrhea of any cause should be kept away from other kids.

Proper handling, storage, and preparation of food can also help prevent Shigella infections. Cold foods should be kept cold and hot foods should be kept hot to prevent bacterial growth.

Diagnosis and Treatment

To confirm the diagnosis of shigellosis, your doctor may take a stool sample to be tested for Shigella bacteria. Blood tests and other tests can also rule out other possible causes of the symptoms, especially if your child has a large amount of blood in the stool.

Some cases of shigellosis require no treatment, but antibiotics often will be given to shorten the illness and to prevent the spread of bacteria to others.

If the doctor prescribes antibiotics, give them as prescribed. Avoid giving your child nonprescription medicines for vomiting or diarrhea unless the doctor recommends them, as they can prolong the illness. Acetaminophen (such as Tylenol) can be given to reduce fever and make your child more comfortable.

To prevent dehydration, follow your doctor’s guidance about what your child should eat and drink. Your doctor may recommend a special drink called an oral rehydration solution, or ORS (such as Pedialyte), to replace body fluids quickly, especially if the diarrhea has lasted 2 or 3 days or more.

Children who become moderately or severely dehydrated or those with other more serious illnesses may need to be hospitalized to be monitored and receive treatment such as intravenous (IV) fluid therapy or antibiotics.

When to Call the Doctor

Call the doctor if your child has signs of a Shigella infection, including diarrhea with blood or mucus, accompanied by abdominal pain, nausea and vomiting, or high fever.

Kids with diarrhea can quickly become dehydrated, which can lead to serious complications. Signs of dehydration include:

• thirst
• irritability
• restlessness
• lethargy
• dry mouth, tongue, and lips
• sunken eyes
• a dry diaper for several hours in infants or fewer trips to the bathroom to urinate in older children

If you see any of these signs, call the doctor right away.

Tapeworms are flat worms that live in a person’s digestive tract. Though upsetting to think about, they usually don’t cause any serious problems.

Tapeworm infections aren’t common in the United States and, when they do happen, they’re usually easy to treat.

Tapeworm Basics

Tapeworms are parasites. As you probably remember from biology class, parasites are organisms that live in, or on, other organisms (called “hosts”). Parasites take their nutrients from the host, sometimes depriving the host of nutrition.

Tapeworms get into the body when someone eats or drinks something that’s infected with a worm or its eggs. Once inside the body, the tapeworm head attaches to the inner wall of the intestines. The tapeworm feeds off the food that the host is digesting. It uses this nutrition to grow.

Tapeworms are made up of segments, and they get longer by growing new segments. Each segment can reproduce by making thousands of eggs. Since tapeworms can have more than three thousand segments, that’s a lot of opportunity to spread. They can grow to more than 82 feet (25 meters) and live as long as 30 years.

New segments grow at the head of the tapeworm, pushing older segments to the end of the line, where they break off. These segments, along with the eggs they contain, pass out of the digestive tract in the host’s feces (poop). If the infected feces aren’t disposed of in a sanitary way — like down a flush toilet — they can get into the soil or water.

Tapeworm segments can live for months in the environment, waiting for a host to come along. Animals like cows or pigs that eat grass or nose around in the soil can pick up tapeworm segments or eggs. When the tapeworm reaches the animal’s intestine, the attach-and-grow cycle begins again.

Causes

Most of the time, people get tapeworm infections from eating food that’s contaminated and not prepared properly:

• Tapeworms can spread when someone eats or drinks food or water that’s contaminated with infected feces. This is one reason why tapeworm infections are rare in places that have good sanitation. Flush toilets, sewer systems, and water treatment plants help keep feces out of the water and food supply.
• People can pass tapeworm eggs on to others when they don’t wash their hands after using the bathroom. Tapeworm eggs in feces can easily spread into food or onto surfaces like doorknobs. If you ever need another reason to get your kids to wash their hands, this might do it!
• Kids can get tapeworms from eating meat or fish that hasn’t been cooked enough to kill the tapeworm or its eggs.

Symptoms

Most kids who have a tapeworm infection don’t feel anything. It can take months or years to notice any symptoms. Some of the things a child might complain of are:

• mild nausea
• diarrhea
• abdominal pain
• weight loss

Kids with a tapeworm infection may feel a piece of the worm coming out through the anus. If your child has an infection, you may see a tapeworm segment in his or her feces.

There are different types of tapeworms. One (fish tapeworm) can cause anemia because it absorbs vitamin B12, which helps make red blood cells. This can lead kids to feel tired or short of breath. More severe cases of vitamin B12 deficiency can lead to feelings of numbness and other signs of damage to the nervous system. Curing the tapeworm infection usually makes vitamin B12 levels get back to normal.

The eggs of another type of tapeworm (pork tapeworm) can hatch into larvae in the intestine. These larvae go through the intestinal wall and enter the bloodstream. From there they can travel to different parts of the body (such as muscles, eyes, or the brain), where they form cysts. This disease is known as cysticercosis (sis-tuh-sir-KO-sus). It is rare in the United States, but common in many developing countries.

With cysticercosis, kids might develop:

• lumps under the skin
• seizures, if the cysts are in the brain
• vision problems, if the cysts are in the eyes
• an abnormal heartbeat, if cysts are in the heart
• weakness or trouble walking, if cysts are in the spine

Eating contaminated pork can lead to a tapeworm infection in the intestines, but it won’t turn into cysticercosis. To develop cysticercosis, someone would have to swallow the eggs of the pork tapeworm, and these eggs aren’t found in the meat itself. They are found in feces and around the anus.

Cysticercosis occurs as a result of eating food that has been contaminated with feces. It can be any kind of food — all it takes is for that food to come into contact with feces.

When to Call a Doctor

Call a doctor if you see worms in your child’s feces or if he or she has abdominal pain or other symptoms that might suggest a tapeworm infection. You’ll also want to call a doctor if your child shows signs of infection after traveling to a part of the world that doesn’t have good sanitation.

Call a doctor right away if your child has masses or lumps under the skin and develops a fever, headache, or any of the other symptoms of cysticercosis. If your child has seizures or trouble moving, walking, or talking, go to the emergency room right away.

Diagnosis and Treatment

To diagnose a tapeworm infection, doctors usually examine a stool sample for tapeworm segments. Doctors may need to get a couple of samples because tapeworms don’t always show up in every sample.

Doctors can easily cure a tapeworm infection with prescription anti-parasite drugs. Often, just one dose is enough.

Tapeworm infection isn’t usually serious and most kids have no complications. But in a few rare cases, large tapeworms can block up a child’s intestines, appendix, bile duct, or pancreatic duct. This can lead to things like appendicitis or inflamed gall bladder — not pleasant, but they can be treated.

Cysticercosis is a much more serious condition. If a doctor thinks a person has cysticercosis, he or she might recommend a CT scan (also called CAT scan) or magnetic resonance imaging (MRI) of the brain to check for cysts. Doctors also may prescribe anti-inflammatory drugs, like steroids, for cysticercosis infections. If a child has seizures, doctors may prescribe anti-epilepsy medications.

If a child gets hydrocephalus because of cysticercosis, doctors might put in a shunt to drain excess fluid. Surgeons will remove cysts if they pose a threat to the eyes, liver, lungs, heart, or other organs.

Prevention

You can protect your family from tapeworm infections by always following these tips:

• Wash your hands thoroughly and often with soap and hot water, especially after using the bathroom and before touching food. Teach your kids to do the same.
• Thoroughly cook meat until juices run clear and the centers are no longer pink.
• Cook fish until it is solid in color (no longer clear) and flakes when separated with a fork.
• Freeze meat for 24 hours before cooking to kill tapeworm eggs.

Here are some things you should do if you’re in a place where tapeworm infections are common:

• Wash and cook all fruits and vegetables with safe water.
• Avoid raw or undercooked meat and fish, raw fruits and vegetables that you aren’t able to peel yourself, and any food from street vendors.
• Drink only water boiled for a least a minute, bottled water (carbonated is more reliable than regular), or other beverages in bottles and cans. Wipe the top of cans and bottles before you drink from them or use a straw. Avoid fountain drinks and ice cubes.

Most tapeworm infections are harmless. But it’s always a good idea to take your child to a doctor to get checked out if he or she has symptoms.

Typhoid fever is a serious and sometimes life-threatening infection that mostly affects people in developing countries, where clean water and other sanitation measures are hard to come by. The disease usually causes symptoms that include a high fever, a stomachache, and achiness. It can be cured with antibiotics.

If you live in the U.S. the chances of someone in your family getting typhoid fever are slim. But if you’re planning to travel to a foreign country, especially one in the tropics, it’s a good idea to know about typhoid fever. Before you travel, get vaccinated against the disease and learn about safety precautions regarding food and water.

About Typhoid Fever

Typhoid fever is caused by bacteria called Salmonella Typhi (S. Typhi), which are related to the bacteria salmonella that cause food poisoning. S. Typhi typically live in humans and are shed through a person’s feces (poop) or urine (pee).

Once the bacteria get into the body, they quickly multiply and spread into the bloodstream. The body responds with a high fever and other symptoms, usually a week or two after exposure to the bacteria (but sometimes later). Symptoms can be mild to severe and usually disappear 2 to 5 days after antibiotic treatment begins.

Without treatment, typhoid fever may last a month or more and become very serious, even life-threatening.

After recovering from typhoid fever, some people still can become carriers of the bacteria. This means that they’ll have no symptoms, but do have the bacteria in their bodies and can pass it on to other people.

How People Get It

People usually get typhoid fever by drinking beverages or eating food that has been handled by someone who has typhoid fever or is a carrier of the illness. Those infected also can pass the disease onto others directly (for example, by touching them with unwashed hands). People also get the illness by drinking water that is contaminated by sewage that contains the S. Typhi bacteria.

For these reasons, the disease is common in areas with poor sanitation and inadequate water treatment. It is also common in tropical and subtropical areas around the world, including Africa, Asia, and Latin America.

Signs & Symptoms

The symptoms of typhoid fever may range from mild to severe, depending on factors such as the age, health, and vaccination history of the infected person and the geographic location where the infection originated.

Typhoid fever can come on suddenly or very gradually over a few weeks. Early signs and symptoms of the illness include:

• fever that can reach as high as 104°F (40°C)
• feeling achy, tired, or weak
• constipation
• diarrhea
• headache
• stomach pain and loss of appetite
• sore throat

When typhoid fever isn’t treated, symptoms become worse week by week. Besides a fever, someone may lose weight; develop a swollen or bloated belly; or develop a red, spotted rash on the lower chest or upper belly. The rash usually clears up in 2 to 5 days.

In most cases, the symptoms of typhoid fever start to go away in the third and fourth weeks, as long as the disease doesn’t cause any other health problems. After the illness has appeared to go away, it can come back.

Complications

Serious health problems (complications) as a result of typhoid fever are rare in children. When kids do develop complications, they tend to be gastrointestinal problems, specifically an intestinal perforation (a hole in the intestines). This life-threatening condition requires immediate medical attention.

Less common complications include problems with the lungs or heart, infections in the bones or joints, urinary tract infections, or mental health problems.

When to Call a Doctor

Call a doctor if you think your child has been exposed to typhoid fever or develops any symptoms of typhoid fever, even mild ones, especially after visiting an area where the infection is common.

To make a diagnosis, the doctor will evaluate the symptoms and ask you about your child’s medical history and recent travels. The doctor probably will take a sample of stool (poop), urine (pee), or blood to test it for the disease.

Treatment

Typhoid fever is treated with antibiotics that kill S. Typhi bacteria. If the doctor prescribes antibiotics, be sure your child completes the course of treatment. Do not end the treatment early even if your child begins to feel better.

Most kids start feeling better within 2 to 3 days of beginning treatment. In addition to giving antibiotics, offer your child plenty of fluids to prevent dehydration. Kids who are severely dehydrated from a loss of fluids due to diarrhea might be given IV (intravenous) fluids in a hospital or other medical care facility.

Acetaminophen can help reduce fever and make your child feel more comfortable. Call a doctor immediately if your child’s symptoms persist, if symptoms go away and then reappear, or if your child develops any new symptoms.

Stopping the Spread

If your child is recovering from typhoid fever or is a healthy carrier of the disease, washing hands frequently is the best way to prevent the spread of the disease. Use warm water and scrub hands with soap for at least 20 seconds. Also clean the things your child touches (such as toilets, door handles, and telephones) every day. People with typhoid fever should avoid handling or preparing food and should keep their personal items away from other people’s belongings.

Kids with typhoid fever should remain out of school until the disease has run its course and a doctor has cleared them of having the S. Typhi bacteria. The same goes for teens who work in the food service industry, who may not legally be allowed to return to work until a doctor has proven them to be free of the bacteria.

Preventing Infection

There are two typhoid vaccines available in the U.S. One is a series of capsules and the other an injection. In certain cases, a booster is sometimes needed.

The typhoid vaccine is not a routine childhood vaccination, so if your child will be traveling to an area where typhoid fever is common, you’ll need to ask your doctor for the vaccine. Kids should be vaccinated at least 1 to 2 weeks before traveling. This gives the vaccine time to take effect.

Even if your child has been vaccinated, keep in mind that vaccines are not completely effective and lose effectiveness over time, so make sure you and your child take the following precautions in high-risk areas:

• Sanitize water. Boil or disinfect any water that will be used for drinking, washing or preparing food, making ice, or brushing teeth. Better yet, try to drink only bottled water (carbonated is safer than regular) or other drinks that come in cans or bottles, but wipe the outside of the can or bottle before drinking from it. Tell kids to avoid tap water, fountain drinks, and ice cubes, and remind them to not swallow any water in the shower or bath.
• Cook all food. Fully cook all food, and avoid food from street vendors and food stored or served at room temperature. Instead, serve packaged foods or meals that are freshly cooked and served steaming hot.
• Avoid raw food. Avoid raw, unpeeled fruits and vegetables that may have been washed with contaminated water, especially lettuce and fruits like berries that can’t be peeled. Bananas, avocados, and oranges make better choices, but be sure you peel them yourself. For safety’s sake, you may want your kids to avoid raw foods entirely.
• Wash hands frequently. Wash with soap and clean, warm water, especially after kids use the bathroom or before they eat or prepare food. If no soap and water are available, use an alcohol-based hand sanitizer.

Yersiniosis is a relatively uncommon infection contracted through the consumption of undercooked meat products (especially pork), unpasteurized milk, or contaminated water.

Usually, someone with an infection caused by Yersinia bacteria recovers within a few days without medical treatment (in some cases, doctors prescribe antibiotics).

About Yersiniosis

Of the three main types of yersiniosis that affect people, Yersinia enterocolitica (bacteria that thrive in cooler temperatures) are responsible for most infections in the United States. The infection seems to be more common in cooler climates.

The bacteria can infect the digestive tracts of humans, cats, dogs, pigs, cattle, and goats. People can contract it by eating or handling contaminated foods (such as raw or undercooked meat) or by drinking untreated water or unpasteurized milk that contain the bacteria.

An infant can be infected if a parent or caretaker handles contaminated food without cleaning up adequately before handling the baby’s toys, bottles, or pacifiers.

Signs and Symptoms

Symptoms of yersiniosis appear 4–7 days after exposure and can last up to 3 weeks. They include fever, stomach pain, nausea, vomiting, and bloody diarrhea. Sometimes, older kids also get pain in the lower right side of the abdomen, which can mimic appendicitis. Some people also have a sore throat along with other symptoms.

If your child has these symptoms, call your doctor. For infants, it’s particularly important to call the doctor as soon as symptoms appear to prevent the infection from leading to other health problems.

In rare cases, the infection can cause a skin rash called erythema nodosum, or joint pain that appears a month after the initial symptoms. The rash usually appears on the legs and trunk. The joint pain is usually in the larger joints and is thought to be due to an immune system response. These symptoms usually go away with time but can last several months.

The diagnosis of Yersinia can be confirmed with a stool culture. If the Yersinia infection leads to an infection of the blood, known as bacteremia, it can be confirmed with a blood culture.

Treatment

Diarrhea caused by yersiniosis generally goes away on its own, though in some cases antibiotics are prescribed. In infants, however — particularly those who are 3 months old or younger — it can develop into bacteremia. Infants who contract yersiniosis are usually treated in a hospital.

Depending on the severity of the diarrhea, your doctor may suggest modifying your child’s diet for 1 or 2 days and encouraging your child to drink more fluids (which may include drinks with electrolytes to replace body fluids quickly).

If your child has frequent bouts of diarrhea, watch for signs of dehydration, including:

• severe thirst
• dry mouth or tongue
• sunken eyes
• dry skin
• not peeing as often as usual
• in infants, a dry diaper for several hours
• no tears when crying
• looking lethargic

Prevention

To reduce the risk of yersiniosis, take these precautions:

• Don’t serve or eat raw or undercooked meat.
• Drink and serve only pasteurized milk and milk products.
• Wash hands with soap and water particularly before eating and preparing food; before touching infants or their toys, bottles, or pacifiers; and after contact with animals or handling raw meat.
• Use separate cutting boards for meat and other foods.
• Clean all cutting boards, countertops, and utensils with soap and hot water after preparing raw meat.
• Always cook meat thoroughly before you eat it, especially pork products.
• Dispose of animal feces and sanitize anything they have touched.
• Avoid drinking directly from natural water sources such as ponds and mountain streams, particularly if the water is near farmland where cattle, pigs, or goats are raised.
• As you care for a family member who has diarrhea, remember to wash your hands thoroughly before touching other people and before handling food.
• If your pet dog or cat has diarrhea, wash your hands frequently as you care for it, and check with your veterinarian about treatment and/or contagiousness.

When to Call the Doctor

Call your doctor if your child:

• has diarrhea streaked with blood
• is vomiting
• has abdominal pain
• has a fever

With some rest, kids with yersiniosis usually make a full recovery quickly.