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Viral gastroenteritis is inflammation of the stomach and intestines caused by a virus. The infection can lead to diarrhea and vomiting. It is sometimes called the "stomach flu."

Rotavirus infection; Norwalk virus; Gastroenteritis - viral; Stomach flu

Viral gastroenteritis is a leading cause of severe diarrhea in both adults and children. Many types of viruses can cause gastroenteritis. The most common ones are:

• Astrovirus
• Enteric adenovirus
• Norovirus (also called Norwalk-like virus). It is common among school-age children.
• Rotavirus, the leading cause of severe gastroenteritis in children. It can also infect adults exposed to children with the virus. Outbreaks may also occur in nursing homes.

These viruses are often found in contaminated food or drinking water. Symptoms of viral gastroenteritis usually appear within 4 - 48 hours after exposure to the contaminated food or water.

Those with the highest risk for severe gastroenteritis include the young, the elderly, and people who have suppressed immune systems.

• Abdominal cramping
• Abdominal pain
• Diarrhea
• Nausea
• Vomiting

Additional symptoms may include:

• Chills
• Clammy skin
• Excessive sweating
• Fever
• Joint stiffness
• Leakage (incontinence) of stool
• Muscle pain
• Poor feeding
• Vomiting blood (very rare)
• Weight loss

Your health care provider will look for signs that your body does not have enough water (dehydration). These include:

• Dry or sticky mouth
• Lethargic or comatose (severe dehydration)
• Low blood pressure
• Low or no urine output; concentrated urine appears dark yellow
• Markedly sunken soft spots (fontanelles) on the top of an infant's head
• No tears
• Sunken eyes

Tests that examine stool samples may be used to identify the specific virus. This is usually not needed for virus gastroenteritis. A stool culture may be done to identify a bacterial cause for diarrhea.

Most infections will go away on their own. Children may become severely ill from dehydration caused by diarrhea.

Rotavirus causes severe gastroenteritis in infants and young children. Severe dehydration and death can occur in this age group.

Call your health care provider if diarrhea persists for more than several days or if dehydration occurs. You should also contact your doctor if you or your child have these symptoms:

• Blood in the stool
• Confusion
• Dizziness
• Dry mouth
• Felling faint
• Nausea
• No tears when crying
• No urine for 8 hours or more
• Sunken appearance to the eyes
• Sunken soft spot on an infant's head (fontanelle)

Most infectious organisms are transmitted by unwashed hands. The best way to prevent viral gastroenteritis is to handle food properly and wash hands thoroughly after using the toilet.

There are two rotavirus vaccines for use in children. Vaccination against rotavirus is recommended by the American Academy of Pediatrics. RotaTeq is one of the vaccines. A serious intestinal problem called intussusception has been reported in a small number of infants who received the RotaTeq vaccine. Immediately call your doctor if your child received this vaccine and has stomach pain, vomiting, diarrhea, blood in the stool, or a change in bowel movements.

Prevention of Rotavirus Disease: Guidelines for Use of Rotavirus Vaccine. Pediatrics. 2007; 119(1):171-82.

Dennehy PH. Acute diarrheal disease in children: epidemiology, prevention, and treatment. Infect Dis Clin North Am. 2005; 19(3): 585-602.

Zulfiqar AB. Acute Gastroenteritis in Children. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007. Chap: 337.