What you probably have
Most sudden vomiting and diarrhea comes from norovirus, the so-called stomach flu, which is unrelated to influenza. It begins twelve to forty-eight hours after exposure and lasts one to three days. True food poisoning has a wider range of timing. Toxins in food left out too long can strike within thirty minutes to a few hours, while salmonella may take six hours to six days and some strains of E. coli take three or four days. The last thing you ate is therefore often innocent.
Getting through it
Take small sips every few minutes instead of full glasses, which tend to come straight back. Oral rehydration solution is best, broth and diluted juice are fine, and alcohol and caffeine make things worse. Once vomiting eases, eat small amounts of whatever appeals, since there is no need to live on toast and rice. Do not take an anti-diarrheal medicine if you have a fever or blood in the stool, because it can trap the infection.
When to get help
- See a doctor for bloody diarrhea, or diarrhea that lasts more than three days.
- See a doctor for a fever above 102 degrees.
- See a doctor when vomiting prevents you from keeping liquids down.
- See a doctor for signs of dehydration, which include very little urine, a dry mouth and dizziness on standing.
People who are pregnant, over 65 or immunocompromised should call sooner, as should the parents of small children. Call 911 for confusion, fainting, or blurred vision and muscle weakness after eating, which can indicate botulism.
Not giving it to everyone
Norovirus spreads easily, and alcohol hand sanitizer does not reliably kill it. Wash your hands with soap and water for twenty seconds, and clean the bathroom with a bleach solution. You remain contagious after you feel better, so do not cook for other people for at least two days after symptoms stop.
Prevention in the kitchen
Keep the refrigerator at 40 degrees or below, and never leave perishable food out for more than two hours, or one hour in heat above 90 degrees. Use a thermometer: poultry and leftovers reach 165 degrees, ground meat 160, fish 145, and whole cuts of beef and pork 145 followed by a three-minute rest. Eat leftovers within three to four days. If you suspect a restaurant, tell the county health department, which is how outbreaks are found.
Tip Keep a few packets of oral rehydration powder in the first aid kit. Nobody wants to drive to the pharmacy in the middle of needing it.
