What advice should I provide to patients regarding hydration and dietary modifications during a Cryptosporidium infection?

Hydration advice during Cryptosporidium infection:

• Encourage patients to drink plenty of fluids to prevent dehydration.
• Use oral rehydration solution (ORS) as the preferred supplemental fluid, especially if dehydration is present; prepare ORS according to package instructions and give 50 ml/kg over 4 hours in small, frequent amounts.
• Continue breastfeeding or usual milk feeds during rehydration and after.
• Avoid fruit juices and carbonated drinks until diarrhoea has resolved.
• After rehydration, encourage resumption of usual fluids and diet, including solid foods.
• If the patient is at increased risk of dehydration (e.g., young infants, frequent stools or vomiting), consider giving 5 ml/kg ORS after each large watery stool.

Dietary advice during Cryptosporidium infection:

• Continue usual feeds, including breast or other milk feeds, during illness.
• Do not give solid foods during initial rehydration phase but reintroduce usual solid foods promptly after rehydration.
• Avoid fruit juices and carbonated drinks until diarrhoea has stopped.

Additional advice:

• Advise patients that diarrhoea typically lasts 5–7 days and vomiting 1–2 days, but symptoms can persist up to 2 weeks.
• Advise seeking medical advice if symptoms persist beyond these durations or if signs of dehydration develop.

This advice aligns with management of gastroenteritis caused by Cryptosporidium, focusing on maintaining hydration and nutrition while avoiding fluids that may worsen diarrhoea.

NICE CG84