Q: My younger child had rotavirus and EPEC. Now my older child has a fever and diarrhea. Do they need antibiotics too?

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Question:

My 6-year-old was recently hospitalized for four days with a fever, vomiting, diarrhea, and dehydration. Tests showed both Rotavirus and EPEC E. coli, and they were treated with IV fluids and antibiotics. Now that they're home, my 11-year-old has developed symptoms. Yesterday, they had a 39°C (102.2°F) fever. Today, they have mild diarrhea, nausea, and a fever around 38°C (100.4°F). We saw a doctor yesterday when it was just a fever, who thought it was a cold (a flu test was negative). The symptoms seem milder than my younger child's, but should we go back to the doctor for antibiotics now, or wait and see? I'm not sure what the best course of action is.

Answer:

It must be very worrying for you to see your older child develop symptoms after your younger one was hospitalized.

【Summary of the Current Situation】

• Younger child: Rotavirus + EPEC E. coli → Hospitalization completed

• Older child (11 yrs): Fever of 39°C yesterday → Diarrhea & nausea added today, fever persists around 38°C

• Yesterday's visit: Flu negative, diagnosed with a cold

【Key Point for Decision-Making】

EPEC E. coli is treated with antibiotics, but antibiotics are not effective against Rotavirus (because it is a virus).

If your older child was exposed to the same pathogens as the younger one, it's possible they have a Rotavirus infection alone, or their milder symptoms could indicate a better immune response.

【Return to the Doctor Today if ANY of the Following Occur】

• No urination for more than 8 hours.

• Lips or tongue are dry, or they cry without tears.

• They are constantly lying down and slow to respond.

• Diarrhea suddenly increases to more than once per hour, or you see blood in the stool.

• Vomiting is so persistent they cannot even keep water down.

• Fever rises above 40°C (104°F) or does not come down at all after taking fever reducers.

【If None of the Above are Present → You Can Observe at Home for 24 Hours】

1. Prioritize Hydration: Offer small, frequent sips of water, oral rehydration solutions, or thin rice porridge (e.g., a few sips every 10-15 minutes).

2. Fever Reducers: If they seem uncomfortable, use acetaminophen or ibuprofen according to their weight.

3. Diet: Do not force them to eat. If they are hungry, offer bland foods like congee/porridge, bananas, or toast.

4. Isolation: Use separate towels and dishes from the younger sibling. Ensure thorough handwashing after using the bathroom.

5. Stool Diary: Keep a record of the frequency and consistency of their bowel movements (e.g., watery, bloody).

【Regarding Antibiotics】

• If antibiotics were not prescribed at yesterday's visit, it's likely the doctor considered a viral infection to be the more probable cause.

• If symptoms worsen within 24 hours (see the red flag signs above) or if the diarrhea continues for more than 3 days → return to the same doctor. Inform them that "the younger sibling was confirmed to have EPEC, and the older one has similar symptoms" and request a re-evaluation.

• A stool culture can be performed, and antibiotics may be added if necessary based on the results.

It's also a good idea to call the clinic you visited yesterday, explain the situation, and ask when you should come back in. Sharing the changes in symptoms will help the doctor make a more accurate assessment.

For today, focus on hydration and observation. If you see any of the red flag signs mentioned above, please let us know immediately so we can adjust the plan.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us