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In the past year, Australia has experienced a surge in gastro cases due to an illness called cryptosporidium.听Children are the most at risk from the highly contaigious听water-borne parasite, with public pools and waterparks a hotbed for the bug.听听

As a mother, I know the dread of hearing a gastro bug is going around the daycare, school or netball team. Diarrhoea and vomiting can stun a healthy child for days and wreak havoc on a family for weeks.

As a paediatrician, with extensive research experience in acute gastroenteritis (gastro), I also understand the effects on the community, our hospitals and our most vulnerable patients.

is not the only cause of gastro, but its spread provides a timely reminder to think about what we can do to manage and prevent this nasty illness.

Gastro is characterised by the rapid onset of diarrhoea, or vomiting, or both, which lasts . These symptoms may be accompanied by tummy pain, nausea, appetite loss and fever.

Hundreds of strains of different pathogens may infect the gut to cause gastro. Worldwide, viral pathogens (such as rotavirus or norovirus) are the , but bacterial pathogens (such as Salmonella or E. coli) and parasites (such as Giardia and cryptosporidium) also cause gastro. Traveller鈥檚 diarrhoea may involve pathogens rarely seen in Australia, such as typhoid and cholera.

Gastro is usually transmitted from , including through contact with saliva, vomit or faeces. It may also be acquired by ingesting or food (food poisoning), swimming in contaminated water (in pools, dams, estuaries or water parks), or contact .

Cryptosporidium is a relatively common cause of gastro, called It especially affects young children, but the elderly and people with suppressed immune systems are also vulnerable.

Cryptosporidium is spread by excreted in the faeces of humans and animals.

People often become infected through ingestion of听听or contact with contaminated water, including in swimming pools.

When the parasite escapes the gut, it may survive in pool or spa water, even if it鈥檚 chlorinated,听听So outbreaks often occur in spring or summer months when children are more likely to be swimming.

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We saw this over the summer in Australia, when outbreaks of cryptosporidiosis led to and general alerts in , and

The infection can also be spread from person to person.

Cryptosporidium causes typical of gastro, notably watery diarrhoea and tummy pain. Fever and vomiting are less common. Symptoms usually begin a few days after infection but may come and go over a few weeks.

Children may be infectious for two weeks. People with may carry and shed cryptosporidium (and therefore infect others) for longer.

Data from the听听confirms an upward trend in cryptosporidiosis cases across Australia this year. Some 11,860 cases have been recorded so far in 2024, compared with 3,716 during all of 2023.

From听, cases were more than ten times higher than the five-year average for that period. Cases have been particularly high听.

We don鈥檛 know the reason for this cryptosporidiosis epidemic, but it听听changing weather patterns and听, perhaps reflecting climate change.

Rates may be higher in Queensland because more kids swim year-round in a warmer climate.

The mainstay of managing gastro at home, including cryptosporidiosis, is to prevent and treat dehydration. This can best be achieved by offering frequent drinks of a commercial听听which is formulated to promote absorption of water and electrolytes by the gut and replace fluids lost through diarrhoea and vomiting.

If your child鈥檚 symptoms are severe or ongoing and you鈥檙e worried, contact a doctor, as it鈥檚 possible they may need hospital treatment.

Keep any child with diarrhoea or vomiting away from other children or vulnerable adults and home from daycare, pre-school or school until 24 hours after their symptoms have resolved. Parents, child-care workers and teachers are also at risk of infection and should isolate if symptomatic.

If your child has had cryptosporidiosis, they should not听听for at least two weeks after the diarrhoea has stopped. Likewise, don鈥檛 share towels, linen or utensils with them during this period.

To prevent gastro generally, the approach is similar regardless of the pathogen. Some worthwhile precautions include:

• don鈥檛 drink untreated water from tanks, bores or wells

• don鈥檛 eat or drink unpasteurised milk or dairy products

• wash all fruit and vegetables before eating raw

• wash your hands with soap for at least 20 seconds, particularly after changing nappies, using the bathroom, gardening, before preparing food or drinks, or after contact with animals

• follow听听and avoid swimming at beaches and in other waterways after听, as run-off and sewage overflow may result in contamination.

• make sure your child is vaccinated against听.

Despite听听in diagnosis (improved identification of gut pathogens), prevention (notably听), and treatment (particularly use of oral rehydration therapy), gastro remains a major cause of illness and death in young children, particularly in developing countries.

According to the World Health Organization, each year there are nearly听听of diarrhoeal disease in children globally.

It鈥檚 worth taking extra care when travelling, especially to low- and middle-income countries where food and water may be less safe. Take advice from your doctor regarding appropriate vaccination for specific destinations, such as for听听or听.

The article was originally published in The Conversation as听听written by Professor of Paediatrics and Child Health Elizabeth Jane Elliot, University of Sydney.