Food poisoning - Cholera - v.cholerae - rota virus infections

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 .

 

Cyclosporiasis - Microsporidia

INFECTIOUS NON - INFLAMMATORY DIARRHEAS 

CYCLOSPORIASIS 

A parasitic disease caused by Cyclospora cayetensis transmitted through food or water contaminated by infected feces. Some cases are asymptomatic, while others can be very severe and untreated cases can suffer relapses.

cyclosporiasis reasons are contaminated water or produce, or exposure to the organism during travel to countries where it is endemic. Immunosuppression is a risk factor for chronic cyclosporiasis in endemic areas or very popular in these areas.

Cyclospora cayetanensis oocysts when you enter the small bowel mucosa and penetrates it incubates for about a week. After incubation, the person begins to experience severe diarrhea, edema, fever, abdominal pain and muscle aches. Oocysts may be present due to contaminated water or human feces as fertilizer. This infection primarily affects humans and other primates.

DIAGNOSIS AND TREATMENT 

The diagnosis can be difficult due to the lack of recognizable oocysts in the feces. The use of evidence such as DNA PCR and acid-fast stain can help in identification. The infection is often treated with CPT, as conventional anti-protozoa are not sufficient. To prevent transmission through food, cooking and trying to prevent water while outdoors. 

MICROSPORIDIOSIS 

Microsporidiosis is a disease caused by infection by microscopic organisms called microsporidia. Microsporidia are eukaryotic parasites that must live in host cells in which others can produce infectious spores. These spores cause microsporidiosis, a disease that is mostly seen in people infected with human immunodeficiency virus (HIV). Microspridiosis is an opportunistic infection that causes diarrhea and intestinal wasting in immunocompromised individuals (HIV, for example). It follows from the different species of microsporidia, a group of parasitic protozoa.

DIAGNOSIS 

There are several tests available for diagnosing microsporidian infection. Microscopic examination of stained specimens of body fluids, especially fecal samples, allowing a rapid diagnosis, although the exact nature of microsporidia can not be identified. Urine samples can also be used to detect spores when the kidneys and / or participation of the bladder. 

TREATMENT 

Treatment of microsporidiosis is usually made in therapy and supportive treatment. Depending on the species infected with microsporidia and different drugs are used. The drugs most commonly used for microsporidiosis are albendazole (Albenza) and fumagillin. Patients with diarrhea, management of intravenous fluids and electrolytes may be necessary to satiety. Diet, nutrition and farm management can help with chronic diarrhea. Moreover, to improve the immune system with antiretroviral therapy in patients with HIV infection can also lead to an improvement of symptoms.

Health information - Isosporiasis

NFECTIOUS NON - INFLAMMATORY DIARRHEAS

ISOSPORIASIS

Isosporiasis is a disease caused by protozoan Isospora Belli. Organism to infect the lining of the small intestine and can cause severe diarrhea and malabsorption (inability to absorb nutrients). Isospora beautiful spread in the faeces. Food or water contaminated by animal droppings can do this organism, it is also possible that oral-anal sex can spread the infection. Sometimes it occurs can be traced isosporiasis water contaminated by faeces. Isosporiasis is not common in the United States is more common in tropical areas of the world and in places where water contamination is a problem. isosporiasis United States is the first AIDS-defining illness in approximately 0.2% of AIDS.

CLINICAL MANIFESTATIONS

The infection causes severe diarrhea, not the blood and abdominal cramps that can last for weeks and the result of malabsorption and weight loss. In immunocompromised patients and in infants and children, diarrhea can be severe. Eosinophilia may be present (otherwise other protozoal infections).

DIAGNOSIS

Large oocyst detection in stool by modified acid-fast staining .


TREATMENT

Isosporiasis effective treatment is a combination of two drugs: trimethoprim and sulfamethoxazole (TMP-SMX, Bactrim, Septra). Treatment isosporiasis two double-strength tablets of TMP-SMX twice daily. The alternative is the double strength tablet three times daily. TMP-SMX therapy usually continues for 2-4 weeks. Patients who are intolerant to SMX, drug pyrimethamine (Daraprim), together with folinic acid can be implemented. This combination of drugs used per month.

To help control diarrhea, perhaps in combination with antibiotic treatment, a number of anti-diarrhea medication may be taken. And because the diarrhea is the direct result of intestinal inflammation caused by infection, certain drugs non-steroidal anti-inflammatory drugs (NSAIDs) help, such as ibuprofen. Another drug, has proven to significantly reduce diarrhea due to its anti-inflammatory drug, thalidomide (Thalomid). Women taking this drug should avoid becoming pregnant Thalidomide can cause severe birth defects.

PREVENTION

The most effective way to prevent isosporiasis is to eliminate its sources, mainly foods potentially contaminated human feces. This is particularly true for HIV positive people with weakened immune systems rave tion in the tropics and subtropics where water and food may be contaminated. Drink bottled water and ensure that food is cooked properly, can help reduce the risk of any rave isosporiasis tion in the tropics and subtropics.

Giardiasis

INFECTIOUS NON - INFLAMMATORY DIARRHEAS

GIARDIASIS
Giardiasis, a disease that affects the gastrointestinal tract, is caused by a microscopic parasite called Giardia lamblia. The parasite attaches to the mucosa of the small intestine in humans, which sabotages the body absorb fats and carbohydrates in food digestion. Giardia is a major cause of diarrhea in the United States, and is transmitted by contaminated water. It can survive the normal amount of chlorine used to purify the water supply of the Community, and can live more than two months in cold water. As little as 10 microscopic parasites in a glass of water can cause a severe case of giardiasis in a human being who drinks it.

Travellers are the largest group at risk of giardiasis infection, especially those traveling to developing countries. Giardiasis is common among hikers and campers, people who swim in public pools, children attending day care, and gay men. Others are high-risk close contacts of infected people and those with contact with infected animals.

INCUBATION PERIOD

Symptoms usually begin 1-2 weeks (an average of seven days) after a person is infected. In healthy people, symptoms can last from 2-6 weeks. Although symptoms may last longer, medications can help reduce the duration of symptoms.

TRANSMISSION

Giardiasis is caused by ingestion of infected cysts. There are several modes of communication including bilateral disease, water and sexually transmitted diseases. Bilateral transfer of the majority of infections with Giardia and is generally associated with poor hygiene and sanitation. transmission of water is common in the United States Giardia outbreaks, often associated with ingestion of unfiltered water (polluted). Sex of disease transmission occurs through fecal-oral contamination. Moreover, changing diapers, and hand washing is a low risk factors for transmission of infected children. Finally, Giardia outbreaks of epidemics has been developed for food contamination by infected food handlers.

CLINICAL MANIFESTATIONS

It is estimated that between 1% and 20% of the U.S. population has giardiasis, and this figure could be 20% or more in developing countries where giardiasis is a major cause of infantile diarrhea epidemic. But more than two-thirds of those infected may have no signs or symptoms of the disease, although the living parasite in their intestines. When the parasite causes symptoms, the illness usually begins with severe watery diarrhea without blood or mucus. Giardiasis affects the body's ability to absorb fat from the diet, so the diarrhea contains unabsorbed fats. This means that the diarrhea floats, is shiny and smells terrible.

DIAGNOSIS

It can diagnosed by parasite antigen detection in stool and /or multiple freshly collected samples of stool ,use to identify cyst by concentration methods ( oval with four nuclei ) or trophozoites ( pear shaped ,flattened parasites with two nuclei and four pairs of flagella ).

TREATMENT

Giardiasis is the most common treatment of metronidazole (Flagyl) is 5-10 days. Giardia does not suffocate with over 85% of the time, but often cause gastrointestinal side effects such as nausea, metallic taste and dizziness and headache. Although its efficacy, metronidazole is not FDA approved for the treatment of giardiasis United States. Only approved drug for the treatment of giardiasis in the United States and furazolidone (Furoxone) is 7-10 days. And broadly as effective as metronidazole. Tinidazole is available outside the U.S. is highly effective in treating Giardiasis (90%). It can also be administered as a single dose and is well tolerated. Quinacrina is a highly effective treatment for giardiasis, but is no longer available in U.S. paromomycin and albendazole are equally effective than other treatments.

Sometimes the treatment fail to eliminate Giardia. In this case, drugs may be altered or longer or higher dose may be used. Combination therapy may also be effective (e.g, quinacrina and metronidazole).