Although there has been a decline in gastroenteritis cases during the past week ending 25 February with about 85 cases reported, the Medical Officer of Health Dr. Kiran Kumar again urged people to practice good hygiene to help stem the outbreak.

“Usually, we see between 15 and 25 cases of gastroenteritis per week at the Health Services Authority facilities, however,  in the week ending 5 February, we had 64 cases and for the following two  weeks 132 and 133,” Dr. Kumar noted.

Since 5 February, 42 children and 5 adults were hospitalised and all recovered.

“During the same period (5 – 25 February), we tested 22 stool samples of which 11 were positive for Norovirus and 8 were positive for Rotavirus, thus indicating that we are experiencing a viral gastroenteritis outbreak,” Dr. Kumar confirmed.

To stem the outbreak of any diarrhoeal disease, the public is urged to practice good hygiene and follow these guidelines:

• Avoid contact with those who are ill.
• Keep sick children out of schools/nurseries; stay away from work until 48 hours after the symptoms have stopped.
• Wash your hands often, especially if you care for a sick person: Scrub your hands for at least 20 seconds with soap and water or use alcohol- based hand cleaner especially after using the toilet. You can also use antiseptics such as Dettol or Savlon.
• Control flies by ensuring sanitary premises, including proper collection and disposal of garbage.
• Drinking water must be safe; use desalinated, bottled or boiled water.
• Disinfect cisterns by adding 2½ ounces of bleach for each 1,000 gallons of water in the cistern.
• Soiled disposable diapers should be placed in a garbage bag and securely tied. The bag should then be placed into a securely covered container for collection.
• Toilets should be disinfected after use by sick persons, so that others will not contract the illness.
• Do not share towels, cups, or food with sick persons.

For more information, call the Public Health Department on 244-2632 or 244-2621, or Faith Hospital on 948-2243. For assistance with cisterns or sanitary advice, call the Department of Environmental Health on 949-6696 in Grand Cayman or 948-2321 on the Brac.
Tips for good hand washing

• Wash your hands often, and always after using the bathroom and playing with pets and before eating or preparing food.  Clean the whole hand, under your nails, between your fingers, and up the wrists:
• Wash for at least 15 seconds.  Don’t just wipe.  Scrub well.
• Rinse, letting the water run down your fingers, not up your wrists.
• Dry your hands well.  Use a paper towel to turn off the faucet and open the door.

Cleaning the toilet

• Always wear rubber gloves to clean and disinfect the toilet and keep them for this use only.  Wash your hands thoroughly after removing the gloves.
• Toddlers’ potties and toilets, including the flush handle, toilet seats, toilet door handles and wash basin taps should be cleaned frequently, at least once per day, or more often when a person has diarrhea and when the toilet is in frequent use.
• A diluted bleach solution is recommended – (e.g. 1 part bleach diluted in 10 parts water) or according to the manufacturer’s instructions.

Handling food and drink

• Always wash your hands before handling food.  Handle the food as little as possible.  Serve food fresh and if any is left over, store it correctly in a refrigerator.  Try not to ask people to visit you for a meal or drink whilst there is anybody with gastroenteritis in the house.
• If your work involves looking after children, sick or elderly people, or involves handling food, you must STAY OFF WORK while you are ill.

Exclusion of staff

• All staff should be excluded from work until 48 hours after the symptoms have stopped.
• Children should stay away from school/nursery until 48 hours after the symptoms have stopped.

Gastroenteritis Fact Sheet

What is gastroenteritis?

• Gastroenteritis is commonly called the “stomach flu”.  It is an inflammation of the gastrointestinal tract, which includes your stomach and intestines.
• Gastroenteritis can be caused by several different types of viruses, including Noroviruses, rotaviruses and adenoviruses.  Viral gastroenteritis is common in the winter.  Reported outbreaks occur in institutions such as nursing/residential homes, schools and nurseries.
• Gastroenteritis can also be caused by many different bacteria, e.g. Salmonella, Campylobacter, Cryptosporidiosis. The bacteria that cause gastroenteritis can be acquired from contaminated food or drink, or from the environment.

What are the symptoms of gastroenteritis?

• Nausea and vomiting
• Watery diarrhea
• Fever and chills
• Abdominal pain
• Blood in the stool (in severe cases)

How does gastroenteritis spread?

• Viral particles can spread from person to person by the droplets produced by violent vomiting and disperses viruses into the air.
• The bacteria and viruses can also be spread from person to person by close contact with someone who is ill with the infection, especially if hygiene is poor.
• People with gastroenteritis have harmful germs in their stool.  When they don’t wash their hands well after using the bathroom, they can spread the germs to objects.  If you touch the same objects, you can pick up the germs on your hands and transfer them to your mouth.
• Gastroenteritis can be spread through consumption of food or water contaminated by stool or vomit of an infected person.

What is the duration of the illness?

• Viral gastroenteritis is usually a short illness lasting usually 1-2 days
• Bacterial gastroenteritis can last for much longer, depending on the organism responsible for the illness.

What is the incubation period?

• The incubation period for viral gastroenteritis is between 24-48 hours.  A person is infectious during the acute stage of the illness and for up to 48 hours after the diarrhea and/or vomiting has stopped.  Therefore affected persons should stay away from school/work until 48hours after the vomiting and/or diarrhea has stopped.
• The incubation period for bacterial gastroenteritis can vary from a few hours to several days.  Bacteria behave in different ways, however affected person should observe the general exclusion advice as above.  If certain bacteria are identified as the cause of the illness, additional precautions may be advised.

How is gastroenteritis treated?

• Gastroenteritis often goes away without treatment.  In some cases, symptoms are gone in day or two.  In others, symptoms linger for weeks.
• Get plenty of rest
• Drink lots of liquids to replace water lost through diarrhea and vomiting.  Plain water, clear soups, and electrolyte solutions are best.  (You can find electrolyte solutions in most drug stores).  Avoid carbonated drinks, alcohol, coffee, tea, colas, milk, fruit juice and sports drinks.  These can make symptoms worse.  If nausea and vomiting make it hard for you to drink, try sucking on ice chips.
• Until the diarrhea clears up, avoid eating fruit and all dairy products except yogurt.  They can make diarrhea worse.
  You may be admitted to the hospital if your symptoms are very severe.