Babies in day care have an increased risk of infection by rotavirus ,giardia lamblia and compylobactor
INFECTIOUS NON - INFLAMMATORY DIARRHEAS
BACTERIAL FOOD POISONING
Evidence of a common source outbreaks occur frequently. First Staphylococcus aureus enterotoxin produced in food left at room temperature (eg a picnic). The incubation period is 1-6 hours. Disease products within 12 hours, and consist of diarrhea, vomiting and stomach cramps usually without fever. Second Bacillus cereus . (A). emetic form : this is a food poisoning associated with S. aureus contaminated fried rice. (B). Diarrhea as: incubation period of 8-16 hours, diarrhea, cramping, no vomiting. 3rd Clostridium perfringens : spores resistant to heat sufficient in meat, poultry and legumes, incubation 8-14 hours, 24 hours of diarrhea and cramping abdominal disease, without vomiting or fever.
CHOLERA
Etiology
Vibrio cholerae serogroups OI (EI biotypes classical and Tor and O139 ).
Epidemiology
Occur in the delta of the Ganges in the Indian subcontinent and South east Asia and sometimes in coastal areas of Texas and Louisiana: the spread of faecal contamination of water and food sources. Infection requires a large consumption of inoculation. toxin to cause disease symptoms. clinical symptoms.
Clinical Manifestations
Incubation period of 24-48 hours following a painless diarrhea and vomiting, which can cause serious and rapid dehydration and death within hours. Rice water turbid liquid stool gray with patches of mucus.
Diagnosis .. stool culture on selective medium (e.g. TCBS agar).
TREATMENT
Rapid replacement of fluid, electrolytes and base with high sodium levels to correct the loss of Na in the stool or Ringer's lactate in patients with> 10% weight loss.Antibiotics can be used together, doxycycline, ciprofloxacin single dose of 1 g / d or erythromycin three divided doses for 3 days.
VIBRIO PARAHAEMOLTICUS AND NON - OI ,CHOLERA
These infections are associated with the consumption or contaminated by sea water, badly seafood.After an incubation period of four hours to four days, darrhea aqueous, abdominal cramps, nausea, vomiting and sometimes fever and chills develop.The disease lasts 3-7 days and requires supportive care. Patients with comorbid illness (eg liver disease), sometimes extra-intestinal infections requiring antibiotics
NORWALK VIRUS AND RELATED HUMAN CALCIVIRUSES
These viruses are common causes of traveler's diarrhea and viral gastroenteritis in patients of all ages and epidemics worldwide, with U.S. higher prevalence in colder climates. Shellfish concentrate the virus by filtration and are at particular risk. Very small Inocults required for infection. Thus, although the fecal-oral route is the main form of transmisson, aerosol, fomites of contact, and person to person contact can cause an infection.
Clinical Manifestations
After incubation period of 24 hours (range 12-72 hours). The patients experience sudden onset of nausea, vomiting, diarrhea or abdominal cramps with constitutional symptoms. the stool is soft, watery, without blood or mucus leukocytes. disease lasts 12 60 hours.
Treatment
Only the necessary support measures.
ROTA VIRUS
Rotavirus is the leading cause of severe diarrhea in infants and young children, and is one of several viruses that cause infections, often called stomach flu, but not from the flu. It is a kind of double-stranded RNA virus in the family Reoviridae. At the age of five years, nearly all children worldwide have been infected with rotavirus at least once. But each infection, immunity develops, subsequent infections are less serious, and adults are rarely affected. There are five species of this virus, called A, B, C, D and E. A rotavirus, the most common causes of more than 90% of infections in humans.
Rotavirus is transmitted by fecal-oral contact with contaminated hands, surfaces and objects, and possibly by the respiratory route. The faeces of an infected person can contain more than 10 billion of infectious particles per gram, only 10-100 of them are required to transmit the infection to another person.
Clinical Manifestations
Rotavirus gastroenteritis is a mild to severe illness characterized by vomiting, watery diarrhea and mild fever. When a child is infected with the virus has an incubation period of about two days before the onset of symptoms. Symptoms often start with vomiting, followed by four to eight days of severe diarrhea. Dehydration is more common than rotavirus infection in most of those caused by pathogenic bacteria, and is the most common cause of deaths related to rotavirus infection.
Diagnosis
Enzymes immunoassays (EIAs ) or viral RNA detection ,like PCR can identify this virus in sample of stool .
Treatments
Only necessary treatment is required .Antimotility agents should be avoided .
Prevention
For prevention ,vaccine was withdrawn shortly after approval by the U.S . Drug and Food intake because it was causally linked to intussusception .
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