In a summer of social distancing and sanitising, Adelaide mother Stephanie Gheller never expected to end up bedridden with a tummy bug just two days before Christmas.
Her 16-month-old son Ezra had come home with the viral present no parent wants, as a result of a gastroenteritis outbreak at his childcare centre.
“We called Ezra patient zero,” she said.
The family made a quick but short-lived recovery, having the misfortune of being struck down not once, but twice in three weeks.
“It really did wipe us out. My husband’s parents had to come and pick Ezra up because we were just incapable of even getting out of bed to look after him,” Ms Gheller said.
“I was very surprised, particularly given how mindful everyone is of hand hygiene and social distancing now.”
The COVID-19 pandemic has been punctuated by constant reminders about hand-washing, mask-wearing, social distancing and infection control.
Despite all the vigilance about hygiene, childcare centres in most states have still been plagued by gastro outbreaks.
There were 446 outbreaks in childcare centres in south-east Queensland between October and December last year, compared to 113 over the same period in 2019.
The number of outbreaks in New South Wales childcare centres peaked at 221 last December, before falling to 76 last month.
There were 68 gastro outbreaks at ACT centres between October and December last year, although there was a significant drop in January.
South Australia had 60 outbreaks last month, compared to seven at the same time last year.
Notifications have also been above average in Western Australia, while there were 27 outbreaks in Victoria last month alone.
Bugs can be found ‘everywhere’ so risk still persists
The country’s relative success in suppressing coronavirus has left many hygiene-conscious parents wondering why there has been a resurgence of gastro.
Professor Raina MacIntyre from the University of New South Wales’ Kirby Institute said rates of respiratory viruses like COVID-19 and influenza dropped dramatically with measures like masks and social distancing.
But viruses that often spread through close contact with infected people, such as rhinovirus and norovirus, have not.
“It’s a different mode of spread to respiratory transmission,” she said.
“Gastro is spread through contact, the fecal-oral route where something is contaminated, you touch it and then it infects you.”
Highly-infectious bugs are particularly hard to manage at daycare centres because children find it difficult to keep their distance and do not always wash their hands thoroughly.
“Certain viruses like norovirus, which are commonly the cause of gastro in childcare centres, can be really widespread,” Professor MacIntyre said.
“You can find it on the walls, on the tap, on the sink, everywhere, so unless you’re thoroughly cleaning and disinfecting everything around you, that risk will still persist.”
Dr Bruce Bolam from Victoria’s Department of Health and Human Services said the risk of gastro cases inevitably increased as children returned to daycare and school after months apart.
“We’ve really improved a lot, but there’s a long way to go for us in terms of our hand hygiene and general hygiene to prevent gastro,” he said.
“It doesn’t take much. While people are more aware, it doesn’t necessarily mean they’re practising it all the time or universally.”
Viral gastroenteritis is highly infectious and can spread rapidly in childcare centres, with symptoms including nausea, vomiting, diarrhoea, fever, abdominal pain, headache and muscle aches.
The illness can take up to three days to develop and usually lasts between one and two days, sometimes longer.
Children are usually infected when they put their unwashed hands in their mouth or touch food and drinks, but it can also be spread through coughing and sneezing.
Children with gastro should stay home for at least 48 hours after their symptoms have cleared.
Doctors say thorough hand-washing with soap and water for at least 20 seconds before eating, using the toilet, changing nappies or helping some who is sick is the best defence against the spread of gastroenteritis.
“Alcohol-based sanitisers are not effective against many of the bugs that cause gastro in childcare,” Dr Bolam said.
“Hand-washing is the bulwark. We must not treat things like masks and hand sanitisers as if they magically mean we won’t spread a bug.”