Stomach Flu vs. Foodborne Illness in Kids: How to Tell the Difference

As a parent, when your child is suffering from an upset stomach and diarrhea or vomiting, it can be tricky to identify the source of the symptoms. Some of the most common causes of these symptoms are the stomach flu or a foodborne illness—but how can a parent or caregiver tell one from the other?

Fortunately, as pediatric gastroenterologist Sonia Michail, MD, FAAP, CPE, AGAF, explains, there are a few key ways to differentiate the stomach flu from a foodborne illness. Dr. Michail answers some of the most common questions she hears from parents at Children’s Hospital Los Angeles when it comes to identifying and treating these gastrointestinal conditions.

Stomach flu: Signs and symptoms

A child with an upset stomach and diarrhea may have a viral gastroenteritis, a viral infection commonly referred to as the "stomach flu"–especially if the symptoms come on suddenly and are accompanied by other signs of a viral (contagious) infection.

Common signs of a viral gastroenteritis in a child start 1-3 days after exposure to the virus and may include:

• Watery diarrhea (without blood)

• Vomiting, which may start before the diarrhea

• Stomach cramps or abdominal pain

• Nausea

• Fever

• Loss of appetite

• Fatigue or low energy

• Headache or muscle aches (in some cases)

The illness is most likely a viral infection if:

• Other family members, classmates, or daycare contacts have similar symptoms that started around the same time

• The illness spreads from person to person over several days and there isn't an obvious common food exposure

Foodborne illness: Signs and symptoms

In the case of foodborne illness, also called food poisoning, symptoms often start soon after eating a particular food. Depending on the specific germ or toxin that has been ingested, symptoms can begin anywhere from 30 minutes to several days after the meal. It is more likely that other people become sick after eating the same food.

Common signs of foodborne illness in a child can include:

• Vomiting, often starting within a few hours of eating

• Diarrhea, which can be watery or, less commonly, bloody

• Stomach cramps

• Nausea

• Fever

• Loss of appetite

The illness is most likely foodborne illness if:

• Symptoms are clearly linked to a recent meal

• Others who ate the same food as the child are also sick

How it spreads: Stomach flu vs. Foodborne illness

What we refer to as the "stomach flu" is usually caused by viruses that spread either through direct contact with the viruses on surfaces or when tiny amounts of viruses from an infected person's stool or vomit end up in another person's mouth. This can happen through close contact with an infected person, touching contaminated surfaces (doorknobs, toys, bathroom fixtures) and then touching your mouth before washing your hands, eating food or drinking water contaminated by an infected person, or exposure to vomit droplets.

Foodborne illnesses are caused by eating or drinking something contaminated with harmful microorganisms or the toxins they produce. Unlike the stomach flu, foodborne illnesses do not spread easily from person to person. The infection usually comes directly from contaminated food or water.

Common examples of contaminated food include:

• Raw or undercooked meat, poultry, or eggs

• Raw or undercooked seafood or shellfish

• Unpasteurized milk or juice

• Contaminated fresh fruits and vegetables

Preventing illness: Food safety and personal hygiene

Following food safety and hygiene best practices can help to reduce the risk of contracting both foodborne illness and gastroenteritis.

Food safety tips:

• Wash fresh produce with clean water

• Avoid cross-contamination, such as using the same cutting board for raw chicken and salad without washing it

• Ensure foods reach safe internal temperatures while cooking

• Store foods properly to prevent invisible bacteria from growing

• Avoid contaminated water

Personal hygiene tips:

• Wash hands before, during, and after food preparation, as well as in public places such as schools, airports, and malls

Caring for a stomach bug

Most children with uncomplicated viral gastroenteritis or mild foodborne illness recover within a few days with supportive care provided at home. The key is looking out for more serious warning signs that medical evaluation is required.

The most important priorities for both stomach flu and foodborne illnesses are:

• Preventing dehydration

• Monitoring for signs that medical care is needed

• Helping prevent the illness from spreading

When treating a stomach bug, keep kids hydrated! Dehydration is the biggest concern, especially in infants and young children. Offer small, frequent sips of fluid rather than large amounts all at once. Use oral rehydration solutions (ORS) such as Pedialyte. Help prevent the spread of the virus by washing hands thoroughly with soap and water, and avoid sharing cups or utensils.

Also, avoid anti-diarrhea agents or medications unless advised by your provider.

When to seek medical attention for gastrointestinal symptoms

See a healthcare provider or take your child to the ER if they have any of the following symptoms for more than a few days without improvement:

• Signs of dehydration (dry mouth, passing little urine, no tears when crying, or unusual sleepiness)

• Bloody diarrhea

• Severe abdominal pain

• High or persistent fever

• Vomiting that prevents them from keeping down fluids

For infants, children with weakened immune systems, or children with significant underlying medical conditions, it's a good idea to contact a healthcare provider sooner than a few days after the onset of these symptoms, as they can develop complications quicker. Staying aware and proactive of changes in your child’s condition is key to supporting their recovery.

(Newswise/MSM)