EPIDEMIC GASTROENTERITIS is a frequent problem in the pediatric office and outpatient department. It is known to the public by numerous synonyms ("intestinal flu," "gi. grippe," "the winter vomiting disease," "epidemic vomiting," "acute nonspecific gastroenteritis," "the stomach virus," or, simply, "the bug"). Despite the scant references to this disorder as an entity in pediatric literature, it seems now to be the most frequent gastrointestinal infection, past 1 year of age, in this country. Sporadic occurrence is year-round but the season of greatest frequency is November through April. During this season, epidemic gastroenteritis generally ranks next to viral respiratory infection, otitis media, and streptococcal disease among pediatric infections.

The seasonal incidence, the sudden endemics, the short incubation period of less than a week, and the occasional respiratory symptoms have suggested that viral agents of the respiratory group are responsible for the disease, but attempts to isolate a specific agent have been fruitless. When enteroviruses have been implicated, especially ECHO type 18, the epidemics have been minor and have occurred during the summer months. Recurrent attacks in the same child, during a given winter on in subsequent years, indicate that the etiology is multiple or that solid immunity seldom develops from a single attack.

SYMPTOMS AND CLINICAL COURSE

The cardinal symptoms are nausea, vomiting, diarrhea, fever, abdominal pain, and anorexia. Less often, aching, dizziness and malaise are noted. The onset is typically with explosive vomiting, occurring at intervals of 10 to 30 minutes oven the first 4 to 8 hours, then spontaneously diminishing in frequency.

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