Medicine
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Tristan, aged 22, has come to the emergency department with a daylong history of profuse watery diarrhoea and vomiting. You think he may have gastroenteritis. Name two bacteria that may cause acute diarrhoea. (2)Name a viral cause of gastroenteritis. (1)Name three symptomatic treatments you can give. (3)Tristan was recently treated with ciprofloxacin for a sexually transmitted infection. What may Tristan be at risk of? (1)What medications can be used to treat your answer above? (2)What infection-control measures should be used when treating acute diarrhoea? (2)
Bacteria Causing Gastrointestinal Infections
K. Balamurugan, U. Prithika in Pocket Guide to Bacterial Infections, 2019
Listeria monocytogenes are gram-negative bacilli, usually causing invasive illness in neonates, patients who are immunocompromised, older, and pregnant. Febrile gastroenteritis is another manifestation of L. monocytogenes, which is almost always (99%) foodborne. They are responsible for less than 1% of reported cases of foodborne illness (MacDonell and Colwell 1985). The diarrheal illness is often sporadic, but a few outbreaks have been reported. The incubation period for gastroenteritis is less (usually 24 hours) ranging from 1 to 10 days, when compared to invasive illness which is usually 11 days (i.e., 90% occurs within 28 days). Listeria is seen contaminated in a wide range of foods including rice, vegetables, chocolate milks, cheese, smoked trout, corned beef, ham, and delicatessen meat. The infective dose is about 10,000 organisms per gram of food.
Microbiology of the Autopsy
Julian L Burton, Guy Rutty in The Hospital Autopsy, 2010
If gastrointestinal infection is considered to be a major cause or contributing factor of death, then attempts must be made to identify the infecting micro-organisms. Although Salmonella species are often thought to be the most common cause of food poisoning, Campylobacter jejuni is by far the most common food-borne infection. In 2005, over 46 000 cases of Campylobacter infection were notified to the Communicable Disease Surveillance Centre in England and Wales, compared with fewer than 12 000 cases of salmonellosis (Health Protection Agency, 2008b). Most deaths due to gastroenteritis are due to fluid loss, which affects the young and very old. However, if there is an associated septicaemia, particularly with Salmonella, then there is an associated mortality. In children, viruses such as rotavirus are the leading cause of gastroenteritis, though rarely fatal. However, a report from Toronto described 21 fatal cases in healthy children over a 5-year period, all dying from severe dehydration with marked hypernatraemia (Carlson et al., 1978).
Decreased performance of live attenuated, oral rotavirus vaccines in low-income settings: causes and contributing factors
Published in Expert Review of Vaccines, 2018
Daniel E. Velasquez, Umesh Parashar, Baoming Jiang
Rotavirus is the most important cause of severe gastroenteritis in children worldwide [1]. The main symptoms of rotavirus gastroenteritis are low-grade fever, vomiting, and acute watery diarrhea. Vaccines represent the optimal practice for preventing the severe consequences of rotavirus infection, especially in impoverished regions where resources and access to medical care are usually limited. Two live attenuated oral rotavirus vaccines were licensed in 2006. Rotarix (RV1, GSK Biologics) is a two-dose monovalent (G1P[8]) human rotavirus vaccine. RotaTeq (RV5, Merck & Co.) is a three-dose pentavalent vaccine consisting of a mixture of bovine-human mono-reassortants carrying the genes encoding the human G1, G2, G3, G4, and P[8] in the genetic background of a bovine rotavirus WC3 (G6P[5]) [2]. In 2009, the WHO recommended implementation of rotavirus vaccines worldwide. Rotavirus vaccine is recommended to be administered in infancy concurrently with polio, diphtheria-tetanus-pertussis, and pneumococcal (PCV) vaccines as early as 6 weeks of age [3,4]. Currently, rotavirus vaccines are introduced into national immunization programs of 85 countries and in a phase introduction of 7, including 41 GAVI-eligible countries with financial support for vaccine procurement [5]. Implementation of rotavirus vaccines into national vaccination programs has led to substantial declines in the burden of severe gastroenteritis in several countries [5–7].
Prevalence and relative risk of Rotavirus Gastroenteritis in children under five years in Nigeria: a systematic review and meta-analysis
Published in Pathogens and Global Health, 2023
Daniel Digwo, Paul Chidebelu, Kenneth Ugwu, Adedapo Adediji, Kata Farkas, Vincent Chigor
The weight of evidence presented in this systematic review and meta-analysis showed that rotavirus is responsible for a considerable proportion of acute gastroenteritis among children in Nigeria. This reinforces the need for the implementation of rotavirus vaccine in the national immunization program to reduce this huge burden in children. Furthermore, these findings reveal the need for more prospective and case-control research to access the rotavirus disease burden. Most studies reviewed here were carried out in healthcare and clinical settings, however very limited information is available on viral diseases in community settings. More importantly, future studies should adopt more sensitive acute gastroenteritis diagnostic techniques for accurate and valid estimation of viral burden among the study population.
Rotavirus vaccines performance: dynamic interdependence of host, pathogen and environment
Published in Expert Review of Vaccines, 2021
Debasish Saha, Martin O.C. Ota, Priya Pereira, Philippe Buchy, Selim Badur
There is no specific treatment for rotaviral diarrhea, but as with other forms of gastroenteritis, treatment is based on addressing dehydration through fluid replacement, either orally, through oral rehydration solutions (ORS), or intravenously, depending on the severity of dehydration [17,18]. Like for all cases of gastroenteritis, zinc supplementation is recommended to reduce the duration and severity of diarrhea [19] and breastfeeding encompasses an important aspect of rehydration therapy as well as nutrition for children under 2 years of age [20]. Prevention of infection remains the cornerstone of effective management of rotaviral disease. The provision of clean water, maintaining hygienic practices like handwashing, and promoting exclusive breastfeeding for 6 months is beneficial to reduce the risk of rotavirus infections. Lastly, rotavirus vaccines are considered to have an acceptable safety profile and are effective in preventing rotavirus gastroenteritis in children [17,21,22]. The World Health Organization (WHO) emphasizes on the use of rotavirus vaccination but together with the scaling-up of both prevention (promotion of early and exclusive breastfeeding, handwashing with soap, improved water, and sanitation) and treatment packages (including low-osmolarity ORS and zinc) [17].