VIRAL GASTROENTERITIS

Viral gastroenteritis is an intestinal infection marked by watery diarrhea, abdominal

cramps, nausea or vomiting, and sometimes fever.

The most common way to develop viral gastroenteritis — often called stomach flu —
is through contact with an infected person or by ingesting contaminated food or water.
If you're otherwise healthy, you'll likely recover without complications. But for
infants, older adults and people with compromised immune systems, viral
gastroenteritis can be deadly.

There's no effective treatment for viral gastroenteritis, so prevention is key. In

addition to avoiding food and water that may be contaminated, thorough and frequent
hand-washings are your best defense.

Risk factors

Gastroenteritis occurs all over the world, affecting people of every age, race and
background.

People who may be more susceptible to gastroenteritis include:

Young children. Children in child care centers or elementary schools may be

especially vulnerable because it takes time for a child's immune system to mature.

Older adults. Adult immune systems tend to become less efficient later in life. Older
adults in nursing homes, in particular, are vulnerable because their immune systems
weaken and they live in close contact with others who may pass along germs.

Schoolchildren, churchgoers or dormitory residents. Anywhere that groups of people

come together in close quarters can be an environment for an intestinal infection to
get passed.

Anyone with a weakened immune system. If your resistance to infection is low — for
instance, if your immune system is compromised by HIV/AIDS, chemotherapy or
another medical condition — you may be especially at risk.

Each gastrointestinal virus has a season when it's most active. If you live in the
Northern Hemisphere, for instance, you're more likely to have rotavirus or norovirus
infections between October and April.

Complications
The main complication of viral gastroenteritis is dehydration — a severe loss of water
and essential salts and minerals. If you're healthy and drink enough to replace fluids
you lose from vomiting and diarrhea, dehydration shouldn't be a problem.

Infants, older adults and people with suppressed immune systems may become
severely dehydrated when they lose more fluids than they can replace. Hospitalization
might be needed so that lost fluids can be replaced intravenously. Dehydration can be
fatal, but rarely.

Prevention

The best way to prevent the spread of intestinal infections is to follow these
precautions:

 Get your child vaccinated. A vaccine against gastroenteritis caused by the

rotavirus is available in some countries, including the United States. Given to
children in the first year of life, the vaccine appears to be effective in preventing
severe symptoms of this illness.
 Wash your hands thoroughly. And make sure your children do, too. If your
children are older, teach them to wash their hands, especially after using the
toilet. It's best to use warm water and soap and to rub hands vigorously for at
least 20 seconds, remembering to wash around cuticles, beneath fingernails and
in the creases of the hands. Then rinse thoroughly. Carry sanitizing wipes and
hand sanitizer for times when soap and water aren't available.
 Use separate personal items around your home. Avoid sharing eating utensils,
drinking glasses and plates. Use separate towels in the bathroom.
 Keep your distance. Avoid close contact with anyone who has the virus, if
possible.
 Disinfect hard surfaces. If someone in your home has viral gastroenteritis,
disinfect hard surfaces, such as counters, faucets and doorknobs, with a mixture
of 2 cups (0.47 liters) of bleach to 1 gallon (3.8 liters) of water.
 Check out your child care center. Make sure the center has separate rooms for
changing diapers and preparing or serving food. The room with the diaper-
changing table should have a sink as well as a sanitary way to dispose of
diapers.
Take precautions when traveling

When you're traveling in other countries, you can become sick from contaminated
food or water. You may be able to reduce your risk by following these tips:

 Drink only well-sealed bottled or carbonated water.

 Avoid ice cubes, because they may be made from contaminated water.
 Use bottled water to brush your teeth.
  Avoid raw food — including peeled fruits, raw vegetables and salads — that
has been touched by human hands.
 Avoid undercooked meat and fish.

GESTATIONAL DIABETES

Gestational diabetes is diabetes diagnosed for the first time during pregnancy
(gestation). Like other types of diabetes, gestational diabetes affects how your cells
use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your
pregnancy and your baby's health.

While any pregnancy complication is concerning, there's good news. Expectant

mothers can help control gestational diabetes by eating healthy foods, exercising and,
if necessary, taking medication. Controlling blood sugar can keep you and your baby
healthy and prevent a difficult delivery.

In women with gestational diabetes, blood sugar usually returns to normal soon after
delivery. But if you've had gestational diabetes, you have a higher risk of getting type
2 diabetes. You'll need to be tested for changes in blood sugar more often.

Risk factors

Some women have a greater risk of gestational diabetes. Risk factors for gestational
diabetes include the following:

 Overweight and obesity.

 A lack of physical activity.
 Previous gestational diabetes or prediabetes.
 Polycystic ovary syndrome.
 Diabetes in an immediate family member.
 Previously delivering a baby weighing more than 9 pounds (4.1 kilograms).
 Race — Women who are Black, Hispanic, American Indian and Asian
American have a higher risk of developing gestational diabetes.
Complications

Gestational diabetes that's not carefully managed can lead to high blood sugar levels.
High blood sugar can cause problems for you and your baby, including an increased
likelihood of needing a C-section to deliver.

Complications that may affect your baby

If you have gestational diabetes, your baby may be at increased risk of:
 Excessive birth weight. Higher than normal blood sugar in mothers can cause
their babies to grow too large. Very large babies — those who weigh 9 pounds
or more — are more likely to become wedged in the birth canal, have birth
injuries or need a C-section birth.
 Early (preterm) birth. High blood sugar may increase women's risk of early
labor and delivery before the due date. Or early delivery may be recommended
because the baby is large.
 Serious breathing difficulties. Babies born early to mothers with gestational
diabetes may experience respiratory distress syndrome — a condition that
makes breathing difficult.
 Low blood sugar (hypoglycemia). Sometimes babies of mothers with
gestational diabetes have low blood sugar (hypoglycemia) shortly after birth.
Severe episodes of hypoglycemia may cause seizures in the baby. Prompt
feedings and sometimes an intravenous glucose solution can return the baby's
blood sugar level to normal.
 Obesity and type 2 diabetes later in life. Babies of mothers who have
gestational diabetes have a higher risk of developing obesity and type 2 diabetes
later in life.
 Stillbirth. Untreated gestational diabetes can result in a baby's death either
before or shortly after birth.
 Prevention
 There are no guarantees when it comes to preventing gestational diabetes —
but the more healthy habits you can adopt before pregnancy, the better. If you've
had gestational diabetes, these healthy choices may also reduce your risk of
having it again in future pregnancies or developing type 2 diabetes in the future.
 Eat healthy foods. Choose foods high in fiber and low in fat and calories.
Focus on fruits, vegetables and whole grains. Strive for variety to help you
achieve your goals without compromising taste or nutrition. Watch portion
sizes.
 Keep active. Exercising before and during pregnancy can help protect you
from developing gestational diabetes. Aim for 30 minutes of moderate activity
on most days of the week. Take a brisk daily walk. Ride your bike. Swim laps.
Short bursts of activity — such as parking further away from the store when you
run errands or taking a short walk break — all add up too.
 Start pregnancy at a healthy weight. If you're planning to get pregnant, losing
extra weight beforehand may help you have a healthier pregnancy. Focus on
making lasting changes to your eating habits that can help you through
pregnancy, such as eating more vegetables and fruits.
 Don't gain more weight than recommended. Gaining some weight during
pregnancy is normal and healthy. But gaining too much weight too quickly can
up your risk of gestational diabetes. Ask your doctor what a reasonable amount
of weight gain is for you.

Asthma
Asthma is a condition in which your airways narrow and swell and may produce extra
mucus. This can make breathing difficult and trigger coughing, a whistling sound
(wheezing) when you breathe out and shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a major problem
that interferes with daily activities and may lead to a life-threatening asthma attack.

Asthma can't be cured, but its symptoms can be controlled. Because asthma often
changes over time, it's important that you work with your doctor to track your signs
and symptoms and adjust your treatment as needed

Risk factors

A number of factors are thought to increase your chances of developing asthma. They
include:

 Having a blood relative with asthma, such as a parent or sibling

 Having another allergic condition, such as atopic dermatitis — which causes red,
itchy skin — or hay fever — which causes a runny nose, congestion and itchy
eyes
 Being overweight
 Being a smoker
 Exposure to secondhand smoke
 Exposure to exhaust fumes or other types of pollution
 Exposure to occupational triggers, such as chemicals used in farming,
hairdressing and manufacturing

Complications

 Asthma complications include:

 Signs and symptoms that interfere with sleep, work and other activities
 Sick days from work or school during asthma flare-ups
 A permanent narrowing of the tubes that carry air to and from your lungs
(bronchial tubes), which affects how well you can breathe
 Emergency room visits and hospitalizations for severe asthma attacks
 Side effects from long-term use of some medications used to stabilize severe
asthma

Proper treatment makes a big difference in preventing both short-term and long-term
complications caused by asthma