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Gastroenteritis Definition. Gastroenteritis is a catchall term for infection or irritation of the digestive tract, particularly the stomach and intestine. Although animals such as pigs can be infected by norovirus, it’s not the same strains that infect humans, and that’s also one of the reasons it’s not possible. Table 6.2 Epidemiologic Steps of an Outbreak Investigation. Prepare for field work; Establish the existence of an outbreak; Verify the diagnosis; Construct.
Gastric flu definition of Gastric flu by Medical dictionary Definition. Gastroenteritis is a catchall term for infection or irritation of the digestive tract, particularly the stomach and intestine. It is frequently referred to as the stomach or intestinal flu, although the influenza virus is not associated with this illness. Major symptoms include nausea and vomiting, diarrhea, and abdominal cramps.
These symptoms are sometimes also accompanied by fever and overall weakness. Gastroenteritis typically lasts about three days.
State of Rhode Island: Department of Health. Anyone who may have had any physical contact with the cat who tested positive for rabies in the East Bay Village area. Cruise Critic is reporting that the Holland America Line (HAL) Ryndam cruise ship is a code red situation with a gastrointestinal virus sickening passengers sailing.
Adults usually recover without problem, but children, the elderly, and anyone with an underlying disease are more vulnerable to complications such as dehydration. Description. Gastroenteritis is an uncomfortable and inconvenient ailment, but it is rarely life- threatening in the United States and other developed nations. However, an estimated 2. United States annually. Of these children, 3.
In developing nations, diarrheal illnesses are a major source of mortality. In 1. 99. 0, approximately three million deaths occurred worldwide as a result of diarrheal illness. The most common cause of gastroenteritis is viral infection. Viruses such as rotavirus, adenovirus, astrovirus, and calicivirus and small round- structured viruses (SRSVs) are found all over the world.
Exposure typically occurs through the fecal- oral route, such as by consuming foods contaminated by fecal material related to poor sanitation. However, the infective dose can be very low (approximately 1. Typically, children are more vulnerable to rotaviruses, the most significant cause of acute watery diarrhea. Annually, worldwide, rotaviruses are estimated to cause 8.
For this reason, much research has gone into developing a vaccine to protect children from this virus. Adults can be infected with rotaviruses, but these infections typically have minimal or no symptoms. Children are also susceptible to adenoviruses and astroviruses, which are minor causes of childhood gastroenteritis. Adults experience illness from astroviruses as well, but the major causes of adult viral gastroenteritis are the caliciviruses and SRSVs. These viruses also cause illness in children. The SRSVs are a type of calicivirus and include the Norwalk, Southhampton, and Lonsdale viruses.
These viruses are the most likely to produce vomiting as a major symptom. Bacterial gastroenteritis is frequently a result of poor sanitation, the lack of safe drinking water, or contaminated food- conditions common in developing nations. Natural or man- made disasters can make underlying problems in sanitation and food safety worse. In developed nations, the modern food production system potentially exposes millions of people to disease- causing bacteria through its intensive production and distribution methods.
Common types of bacterial gastroenteritis can be linked to Salmonella and Campylobacter bacteria; however, Escherichia coli 0. Listeria monocytogenes are creating increased concern in developed nations. Cholera and Shigella remain two diseases of great concern in developing countries, and research to develop long- term vaccines against them is underway. Causes and symptoms.
Gastroenteritis arises from ingestion of viruses, certain bacteria, or parasites. Food that has spoiled may also cause illness. Certain medications and excessive alcohol can irritate the digestive tract to the point of inducing gastroenteritis. Regardless of the cause, the symptoms of gastroenteritis include diarrhea, nausea and vomiting, and abdominal pain and cramps.
Sufferers may also experience bloating, low fever, and overall tiredness. Typically, the symptoms last only two to three days, but some viruses may last up to a week. A usual bout of gastroenteritis shouldn't require a visit to the doctor. However, medical treatment is essential if symptoms worsen or if there are complications. Infants, young children, the elderly, and persons with underlying disease require special attention in this regard. The greatest danger presented by gastroenteritis is dehydration.
The loss of fluids through diarrhea and vomiting can upset the body's electrolyte balance, leading to potentially life- threatening problems such as heart beat abnormalities (arrhythmia). The risk of dehydration increases as symptoms are prolonged.
Dehydration should be suspected if a dry mouth, increased or excessive thirst, or scanty urination is experienced. If symptoms do not resolve within a week, an infection or disorder more serious than gastroenteritis may be involved. Symptoms of great concern include a high fever (1. F [3. 8. 9 °C] or above), blood or mucus in the diarrhea, blood in the vomit, and severe abdominal pain or swelling.
These symptoms require prompt medical attention. Diagnosis. The symptoms of gastroenteritis are usually enough to identify the illness. Unless there is an outbreak affecting several people or complications are encountered in a particular case, identifying the specific cause of the illness is not a priority. However, if identification of the infectious agent is required, a stool sample will be collected and analyzed for the presence of viruses, disease- causing (pathogenic) bacteria, or parasites. Treatment. Gastroenteritis is a self- limiting illness which will resolve by itself. However, for comfort and convenience, a person may use over- the- counter medications such as Pepto Bismol to relieve the symptoms.
These medications work by altering the ability of the intestine to move or secrete spontaneously, absorbing toxins and water, or altering intestinal microflora. Some over- the- counter medicines use more than one element to treat symptoms. If over- the- counter medications are ineffective and medical treatment is sought, a doctor may prescribe a more powerful anti- diarrheal drug, such as motofen or lomotil.
Should pathogenic bacteria or parasites be identified in the patient's stool sample, medications such as antibiotics will be prescribed. It is important to stay hydrated and nourished during a bout of gastroenteritis. If dehydration is absent, the drinking of generous amounts of nonalcoholic fluids, such as water or juice, is adequate. Caffeine, since it increases urine output, should be avoided. The traditional BRAT diet- bananas, rice, applesauce, and toast- is tolerated by the tender gastrointestinal system, but it is not particularly nutritious. Many, but not all, medical researchers recommend a diet that includes complex carbohydrates (e. Milk and other dairy products shouldn't create problems if they are part of the normal diet.
Fatty foods or foods with a lot of sugar should be avoided. These recommendations are based on clinical experience and controlled trials, but are not universally accepted.
Minimal to moderate dehydration is treated with oral rehydrating solutions that contain glucose and electrolytes. These solutions are commercially available under names such as Naturalyte, Pedialyte, Infalyte, and Rehydralyte.
Oral rehydrating solutions are formulated based on physiological properties. Fluids that are not based on these properties- such as cola, apple juice, broth, and sports beverages- are not recommended to treat dehydration. If vomiting interferes with oral rehydration, small frequent fluid intake may be better tolerated. Should oral rehydration fail or severe dehydration occur, medical treatment in the form of intravenous (IV) therapy is required.
IV therapy can be followed with oral rehydration as the patient's condition improves. Once normal hydration is achieved, the patient can return to a regular diet. Alternative treatment.
Symptoms of uncomplicated gastroenteritis can be relieved with adjustments in diet, herbal remedies, and homeopathy. An infusion of meadowsweet (Filipendula ulmaria) may be effective in reducing nausea and stomach acidity.
Once the worst symptoms are relieved, slippery elm (Ulmus fulva) can help calm the digestive tract. Of the homeopathic remedies available, Arsenicum album, ipecac, or Nux vomica are three said to relieve the symptoms of gastroenteritis. Probiotics, bacteria that are beneficial to a person's health, are recommended during the recovery phase of gastroenteritis. Specifically, live cultures of Lactobacillus acidophilus are said to be effective in soothing the digestive tract and returning the intestinal flora to normal.
L. acidophilus is found in live- culture yogurt, as well as in capsule or powder form at health food stores. The use of probiotics is found in folk remedies and has some support in the medical literature.
Castor oil packs to the abdomen can reduce inflammation and also reduce spasms or discomfort. Prognosis. Gastroenteritis is usually resolved within two to three days and there are no long- term effects. If dehydration occurs, recovery is extended by a few days. Prevention. There are few steps that can be taken to avoid gastroenteritis. Ensuring that food is well- cooked and unspoiled can prevent bacterial gastroenteritis, but may not be effective against viral gastroenteritis. Resources. Periodicals. Hart, C. Anthony, and Nigel A.
Cunliffe. "Viral Gastroenteritis." Current Opinion in Infectious Diseases 1. Moss, Peter J., and Michael W. Mc. Kendrick. "Bacterial Gastroenteritis." Current Opinion in Infectious Diseases 1. Key terms. Dehydration — A condition in which the body lacks the normal level of fluids, potentially impairing normal body functions.
Electrolyte — An ion, or weakly charged element, that conducts reactions and signals in the body. Examples of electrolytes are sodium and potassium ions.
Glucose — A sugar that serves as the body's primary source of fuel. Influenza — A virus that affects the respiratory system, causing fever, congestion, muscle aches, and headaches. Microflora — The bacterial population in the intestine. Probiotics — Bacteria that are beneficial to a person's health, either through protecting the body against pathogenic bacteria or assisting in recovery from an illness.
Bitesize Bio. While reading my back. В issues of Applied and Environmental Microbiology (AEM), I came across an interesting paper that detailed an in- depth study on the effectiveness of hand cleaners to remove Norwalk virus (NV) from intentionally contaminated hands. Yes that’s right – intentionally contaminated, and how.
The study volunteers. В allowed a. В 2. Norwalk virus to be pipetted onto their fingers. В and then examined how well the different hand sanitizers and liquid soap. В removed the virus. В Nice. Because of the uniqueness of the study and because hand santizers are everywhere now, even at the bank to.
В disinfect hands after touching the “community pen”, I thought it would be interesting to review this paper and. В summarize the results.
The paper is called Effectiveness of Liquid Soap and Hand Sanitizer against Norwalk Virus on Contaminated Hands by Pengbo Liu, Yvonne Yuen, Hui- Mien Hsiao, Lee- Ann Jaykus, and Christine Moe. All authors were from the Rollins School of Public Health at Emory University in Atlanta. В except for. В Lee- Ann Jaykus who is from the Dept.
Food Science at North Carolina State University in Raleigh, NC. The paper was published January 2.
No. 2, p. 3. 94- 3. Introduction: Norwalk virus infects 2. While the virus can contaminate inanimate surfaces, hand to hand transmission is thought to be the primary vehicle for spread of infection. Hand sanitizers make. В no virucidal claims against noroviruses because proving it is difficult. The virus can’t be cultured. В so experiments need to be performed with clinical samples.
В And that is what this research team did. В The authors infected the fingers (called “finger pads”) of volunteers with human Norowalk virus and then used RT- q. PCR to evaluate the effectiveness of liquid hand soap, sodium hypochlorite (bleach), ethanol, and water for.
В inactivation of the virus and removal from the surface of skin. Methods: Human volunteers: Norwalk virus was obtained from the stool of an experimentally infected human volunteer (who would volunteer for that?)В and then their stool was collected, tested for viral load,В and diluted 2. RNase- free water prior to inoculation onto the finger pads of volunteers.
Ten volunteers enrolled in the study to be infected with Norwalk virus on their hands. Five volunteers participated in two trials on separate days and the right and left hand served as duplicate treatments. Suspension assays to test for virucidal activity: В were performed using ethanol at 3%, 1. В Ten microliters of the 2. RT- q. PCR analysis. Disinfectants: Hand sanitizer was purchased locally which contained 6.
Fisher Scientific contained 0. Both of these reagents were pre- tested for PCR inhibition properties.
Inoculation of human volunteers: Volunteers first cleaned their hands with soap and ethanol and then allowed them to dry. Ten microliters of the 2.
Norwalk virus infected stool solution was placed on the fingers of the volunteers. Recovery of NV from the fingers of volunteers: A 2 ml plastic vial containing 1 ml of HBSS was used to cover the area on the finger where the NV was inoculated and inverted 2. В to elute the virus from the finger. Treatments of NV on human finger pads: After inoculation of the fingers with the 1.
NV stool suspension, fingers were air dried and then exposed to 1 ml of hand sanitizer or liquid hand soap in the 2 ml vial for 2. Excess cleaner was scraped off into the vial. Following this, the same finger was then placed over the 2 ml tube containing 1 ml HBSS to elute remaining virus into the test vial.
For liquid hand soap, the finger pad was rinsed in 1 ml of water. В for 1. 0 seconds before eluting remaining virus into the HBSS vial. The pinky fingers were used to determine the effectiveness of removing NV with water alone. Water in a 2 ml vial. В was used to wash the finger pad by inversion and then the HBSS was used to collect eluates. All finger pads samples were stored at - 8. C until assay. Hydrolysis Probe assays: Samples were tested with and without RNase treatment (to differentiate live, infectious virus.
В vs. dead virus) and analyzed using a one- step RT- PCR kit on the Mx. P instrument. Quantification was done using the full- length c. DNA cloned into a plasmid used for a standard curve. The assay was linear in the range of 1. В Log 1. 0 copies of NV DNA. Results: Virucidal suspension assays: Sodium hypochlorite showed a concentration dependent. В inactivation of virus between 2.
The virus was reduced 5 logs. Ethanol, on the other hand, did not show a concentration dependent effect of inactivation of virus. The most reduction in virus was 0. В Log 1. 0 at 1. 7% ethanol,В but this sample had the least consistency between replicates.
Results of hand cleaners: The results reported were for the RNase treated samples only, so this data reflects the effects of the cleaners on live infectious virus. Compared to the baseline control, the liquid hand soap had the greatest reduction in NV c.
DNA (0. 6. 7 Log 1. В Log 1. 0). The alcohol based sanitizer reduced the virus the least, only 0. Log 1. 0. To determine if rubbing the test reagent on the finger pads helps reduce the presence of virus, volunteers repeated the experiment with rubbing for 1. HBSS. This did increase the Log 1. NV. The greatest reduction was seen with just the water rinse (1. Log 1. 0 reduction) followed by antibacterial soap with 1.
Log 1. 0 reduction). The ethanol based hand sanitizer was the least effective with only a.
В . 3. 4 Log 1. 0 reduction of virus with rubbing and was not statistically significant compared to the baseline control. Conclusions. Using a suspension assay to analyze for virucidal effects, the sodium hypochlorite solution demonstrated a concentration dependent increase in viral killing with virus elimination at > 1.
В For enveloped viruses, such as influenza, hepatitis B, and herpes simplex 1, ethanol- based sanitizers are known to be effective. В However, the enteric nonenveloped. В viruses including hepatitis A, poliovirus, and FCV,В are resistant to the effects of ethanol. Additional research by others has shown that enteric viruses can be inactivated using a combination of solutions that include isopropanol, citric acid, or phosphoric acid along with ethanol. Because this virus is typically shed in very high titers by infected individuals. В and predominantly affects the food service. В industry, commercial development of a virucidal sanitizer designed specific.
В for the enteric viruses is needed. Comments. My first thought was that of course the liquid hand soap. В performed better because it was not only soap but also water rinsed to help remove the left over soap before eluting into HBSS. These fingers received the benefit of a double cleaning.
We saw that water alone was very effective so perhaps the water following soap helped to solubilize more virus. However, water alone with rubbing has the best reduction in virus and the rubbing with soap followed by water does not have an additive effect, so this may not be a factor.
A good control would have been to perform. В the ethanol treatment followed by a water rinse, exactly the way they did the liquid hand soap samples, to. В negate any amplification in virus. В killing due to the combination. В But, it makes sense that if you use liquid hand soap, you will always rinse in water too. Whereas if you use a liquid hand sanitizer, you will not. As for the commercial development of better hand sanitizers that protect against viruses spread by fecally contaminated sources, perhaps the cruise industry would be interested in providing research funding.
В for the development of anti- Norwalk virus. В reagents that are safe. В for both food handlers and for food preparation.