The Essential Guide to Surviving a Stomach Flu Outbreak in Childcare Centres

March 26, 2019

Stomach flu is the common term for gastroenteritis, an inflammation of the stomach and intestines.

According to the Ministry of Health, stomach flu is the top three most common illnesses in children.

Bacteria, parasites or viruses such as rotavirus, sapovirus, astrovirus and norovirus are causes of gastroenteritis, with norovirus being the most common cause of acute stomach flu. Norovirus is mainly caused by contaminated food while rotavirus is mainly spread through the oral-faecal route.

There is no vaccine for norovirus, but there is one for rotavirus that is offered as an optional vaccine that has to be taken before a baby turns four months old. The rotavirus vaccine prevents diarrhoea and vomiting caused by rotavirus and children who have been vaccinated contract a milder form of the stomach flu.


Symptoms of gastroenteritis include diarrhoea, vomiting and stomach pain. Fever may be a symptom for some people.

Stomach flu is highly contagious and can be spread through the following:

  • Sharing utensils with an infected person
  • Nursing an infected person
  • Ingesting contaminated food or water
  • Touching contaminated surfaces or objects and placing fingers in the mouth


There is currently no specific treatment for gastroenteritis and most people typically recover without complications within a week. Young children, the elderly and those with compromised immune systems are at higher risk of contracting stomach flu.

Unlike chickenpox, immunity is not developed after contracting stomach flu. Norovirus is more prevalent during the winter months in countries with four seasons, but can occur at any time in Singapore.

Why stomach flu is a common infectious disease prevalent in childcare centres in Singapore

Stomach flu is highly infectious and in situations where groups share a common space, transmission from person to person gets harder to prevent. Viruses that spread stomach flu can easily get onto surfaces and objects, especially in the playing and sleeping areas.

In addition, young children tend to put their fingers into their mouth very often to soothe their aching gums when teething or as a form of comfort and exploration. Most viruses that cause stomach flu are RNA viruses that are mutation-prone and resistant to many common alcohol-based disinfectants. Soap and water wash the viruses away but it takes hot water and bleach to kill them.

Therefore, apart from daily cleaning and housekeeping, childcare centres in Singapore do a deep cleaning of their centres once a week.

Read also: What Childcare Subsidies Do You Qualify for?

Tips on how to cope when your child contracts stomach flu

If your child has contracted stomach flu from his childcare centre, they will need to remain at home until they have fully recovered.

To ensure that the contagious virus is contained, take note of the following precautions.

1. Maintain a strict level of hygiene and cleanliness

Wash your hands thoroughly using proper handwashing techniques with soap and warm water, more so after using the toilet and changing diapers, as well as before and after preparing meals.

Keeping the toilet seat down when flushing will prevent the spread of infectious microbes into the air.

2. Handle and prepare food safely

Fresh fruits and vegetables must be washed and scrubbed thoroughly before serving. Adhere to proper storage methods for food products as improper refrigeration may cause food to turn bad. Throw out any food that has come into contact or been prepared by an infected person. Kitchen utensils, equipment, counters and surfaces should be sanitised before food preparation as the norovirus can survive in room temperature for days.

3. Clean and disinfect surfaces and contaminated items thoroughly

Use a bleach-based household cleaner to disinfect surfaces and floors. If possible, let the bleach remain for 10 minutes before cleaning off. Wear rubber or disposable gloves before handling soiled items and wash your hands afterwards.

As infected people tend to vomit without warning and have diarrhoea, vomit and faeces should be promptly cleaned up with paper towels and disinfected with a bleach-based household cleaner.

4. Use hot soapy water to wash laundry

Soiled clothing and laundry must be washed with hot soapy water at the maximum available cycle length and the highest heat setting to kill off germs.

5. Keep your child and yourself hydrated to minimise symptoms

To avoid the symptoms from worsening, ensure that the infected child is sufficiently hydrated by providing enough fluids. Diarrhoea and vomiting result in the loss of essential salts and electrolytes. Your child may enjoy sucking on frozen electrolyte popsicles that are easily available from pharmacies.

6. Isolate the sick child from other family members

Avoid sharing food and drinks, and use separate cutlery for each family member to avoid getting infected. If possible, isolate the sick child from other healthy members in the household until the stomach flu has resolved.

Read also: Essential Ways To Help Your Child Adjust To Childcare in Singapore

Although highly contagious, stomach flu typically resolves within a week. As such, following the above tips will greatly reduce the chances that another member of the household gets infected, prolonging the situation. Seek further medical attention if there are signs of dehydration, greenish vomit, bloody stools or vomit, persistent abdominal pain or if the child is lethargic or irritable.

Written by Jamie Koh