Diarrheal Diseases Flashcards
(82 cards)
1
Q
Define acute diarrhea
A
Three or more liquid or watery stools within 24 hours
2
Q
What is chronic diarrhea?
A
Diarrhea lasting more than four weeks
3
Q
What is persistent diarrhea?
A
An episode lasting at least 14 days
4
Q
What is dysentery?
A
Diarrhea with blood and/or mucus in stool
5
Q
What are the common types of diarrheal diseases?
A
- Shigellosis
- Amebiasis
- E. Coli O157:H7
- Rotavirus
- Cholera
- Campylobacter
6
Q
What are some impacts of diarrheal diseases?
A
- Reduction in appetite
- Altered feeding practices
- Decreased absorption of nutrients (children in underdeveloped countries may already be malnourished)
higher medical care and costs of meds, lost work
7
Q
What are the main causes of diarrhea?
A
- Lack of clean drinking water
- Overcrowding
- Bottle-feeding rather than breastfeeding
8
Q
What are the categories of sources of diarrhea?
A
- Bacterial
- Viral
- Parasitic
- Others (metabolic disease, food allergy, antibiotics, IBS)
9
Q
List some bacterial agents that cause diarrhea.
A
- Vibrio cholera
- Shigella
- E. Coli
- Salmonella
- Campylobacter
- Clostridium difficile
*yersinia enterocolitica
*staphylococcus - vibrio parahemolyticus
10
Q
List some viral agents that cause diarrhea.
A
- Rotavirus
- Adenoviruses
- Astroviruses
- Norovirus
11
Q
What are some parasitic agents that cause diarrhea?
A
- Entameba histolytica
- Giardia duodenalis
- Cryptosporidium
- Cyclospora cayetanensis
*isopsora
12
Q
What is the primary mode of transmission for diarrheal diseases?
A
Fecal-oral route, some of the viruses like norovirus can be transmitted through droplets released when a person vomits
13
Q
What are some modes of transmission for diarrheal diseases?
A
- Contaminated water
- Contaminated food
*bottle feeding (vs breastmilk that has igG) - Feeding utensils
- Animals
- Flies
- Hygiene practices
14
Q
What is Oral Rehydration Therapy?
A
Replacing the loss of water and electrolytes due to diarrhea
15
Q
What is the global burden of diarrhea among children under 5 years?
A
- 1.7 billion episodes of acute diarrhea
- Over 1,200 young children die each day
usually within the first two years of life
8th leading cause of death in adults and the 2nd leading cause of death iin kids
16
Q
What is the mortality rate from diarrhea in children under 5 years worldwide?
A
9% of all deaths among children under 5 years
17
Q
What is the estimated annual burden of diarrhea in the US?
A
- 20 million episodes of diarrhea
- 200,000 hospitalizations
- 300-500 deaths
18
Q
What are the symptoms of Vibrio cholera?
A
- Rice-water stool
- Marked dehydration
- Projectile vomiting
- muscle cramps but no abdominal pain
cant pee
death as early as 4-8 hrs
1 in 20 ppl has severe diseases
19
Q
What is the incubation period for Vibrio cholera? the communicability?
A
Incubation: A few hours to 5 days
Communicability: up to a few days after symptoms
20
Q
What is the primary reservoir for Vibrio cholera?
A
Mainly humans, but may live in brackish rivers and coastal waters, natural reservoirs in zooplankton
21
Q
What are the symptoms of nontyphoidal Salmonella?
A
- Acute onset of fever
- Abdominal pain
- Diarrhea
- Nausea
sometimes vomiting lasting 4-7 days
22
Q
How many serotypes of Salmonella have been identified?
A
2,501 different serotypes
23
Q
What is the incubation period for nontyphoidal Salmonella? communicability?
A
12-72 hours
variable,
may last for infection only, usually several weeks, or for some up to a year
24
Q
What is the primary mode of transmission for Salmonella?
A
Consumption of contaminated food of animal origin,
many other foods also linked to transmission,
fecal oral also possible
25
What are the symptoms of Rotavirus infection?
* The most common form of severe diarrhea
Vomiting
* Fever
* Watery diarrhea
"yogurt in water"
26
What is the incubation period for Rotavirus? communicability?
24-72 hours
onset of symptoms through 8 days
27
rotavirus reservoir
transmission
susceptibility
humans
fecal-oral, possible contact with contaminated surfaces or fomites
universal, usually 6-24 mo. children have it by 5 if not vaccinated
28
What impact did the rotavirus vaccine have in the US post-vaccine introduction?
* 280,000 clinical visits averted
* 62,000 emergency department visits averted
29
What percentage of children's deaths is attributed to rotavirus globally?
3.4%
30
What is Giardia?
A parasitic infection of the upper small intestine that can cause various intestinal symptoms
## Footnote
Symptoms include asymptomatic, acute self-limited diarrhea, chronic diarrhea, gas, greasy stools, stomach cramps, upset stomach, nausea, and weight loss or malabsorption.
31
What are the common symptoms of Giardia infection?
* Asymptomatic
* Acute, self-limited diarrhea
* Chronic diarrhea
* Gas or flatulence
* Greasy stools that tend to float
* Stomach cramps
* Upset stomach or nausea
* Weight loss or malabsorption
## Footnote
These symptoms can vary in severity and duration.
32
What is the incubation period for Giardia infection?
3-25 days, with a median of 7-10 days
## Footnote
This period can influence the spread and diagnosis of the infection.
33
What is the period of communicability for Giardia?
Often months (duration of infection)
## Footnote
Many people are asymptomatic carriers, which can complicate control measures.
34
What are the modes of transmission for Giardia?
* Person-to-person (fecal-oral route)
* Local drinking water
* Contaminated foods
* Daycares
## Footnote
Outbreaks often occur in settings where hygiene practices are compromised.
35
How long can Giardia cysts survive in water at temperatures less than 10 degrees C?
2-3 months
## Footnote
This resilience contributes to its spread in contaminated water sources.
36
How can Giardia cysts be killed?
Killed in 1 minute at a rolling boil and in 3 minutes at higher altitudes
## Footnote
Boiling water is an effective method for ensuring safety from Giardia.
37
What is Giardiasis?
The most commonly reported intestinal protozoan infection worldwide
a common parasite of the farm animal
## Footnote
It is prevalent, especially among children under 5 years old.
38
What is the estimated number of giardiasis cases annually worldwide?
>300 million cases
## Footnote
This makes it a significant public health concern globally.
39
How many giardiasis cases were reported in the US in 2019?
14,000 cases (~6 per 100,000)
## Footnote
This indicates a notable incidence rate in the population.
40
What percentage of children aged 1-3 years tested for daycare admission were found to be infected with Giardia in US studies?
7%
## Footnote
This highlights the prevalence of Giardia in young children.
41
What percentage of infants and toddlers tested for daycare admission were found to be infected with Giardia in US studies?
11%
## Footnote
This suggests a higher risk of infection among younger age groups.
42
What are the peak seasons for Giardia infections?
Spring and summer with warm, humid conditions
## Footnote
Environmental conditions play a significant role in the transmission of Giardia.
43
What is the significance of the Giardia lifecycle?
It includes both trophozoite and cyst stages, which affect transmission and infection
## Footnote
Understanding the lifecycle is crucial for prevention and treatment strategies.
44
dysentery
diarrhea with blood or mucus in stool,
with severe infection, there is damage to the mucosa and we can see it shed in the stool
45
persistent diarrhea
who defines an episode lasting at least 14 days
46
which microbes cause watery diarrhea
rotavirus, e.coli, cholera, campylobacter
47
what microbes cause dysentery
shigellosis, amebiasis, e.coli O157:h7,
risk of sepsis and intestine damage
48
what causes persistent diarrhea
most causes are unknown
49
control strategies for diarrheal disease
BRAT (banana, rice, apples, toast)/CRAM (cereal, rice and milk)
-breastfeeding camapaign
-vitamin A
-zinc
-better water sanitation
- handwashing
vaccine: rotavirus and measles
training and education for healthcare providers
50
for every dollar invested in diarrheal diseases
average return of 25.50
51
signs of dehydration
sunken fontanelle (soft spot)
sunken eyes
dry and furry tongue
skin slow to retract
rapid breathing
feeble pulse
dark urine
weight loss
52
surveillance and reporting for diarrheal diseases
prospective studies, passive/active surveillance, outbreak investigations
53
high prevalence of diarrheal diseases
in india, high death rates in north asia and africa
54
transmission of vibrio cholera
food or water contaminated by infected feces
55
suceptibility of cholera
variable, breastfed babies are usually protected
56
epidemic strains of cholera
O1 or O139
57
global pandemic for four decades of cholera where?
indian, latin america, sub saharan africa
58
to break the cholera cycle
you have to stop the amplification of fecal oral spread that occurs in humans
59
environmental cycle of cholera
persists in aquatic reservoir (planktonic vibrios, aggregate vibrios, phytoplankton, zooplankton, insect eggs, etc)
ingestion of environmental vibrios (maybe from fish who ate infected things in the water) into HUMAN HOST
human host: gets in the small intestine, secretory diarrhoea
human hosts shed in their stool,
fecal oral transmission of someone else leads to the amplification
60
control and prevention and prevention of cholera
WASH: water, sanitation, and hygiene
treatment via rehydration and antibiotics
hygiene promotion
surveillance
oral cholera vaccine used in outbreaks
61
what percent of cholera cases can be treated using ORS
80
62
how many cases of cholera annually
1.3-4 million
increase of cholera deaths,
there has been a decrease in cases reported from the middle east and asia, but high increase in africa
63
trend between the sixth and seventh pandemic of cholera
drop in the case fatality rate
64
distribution of cholera deaths in the world
79% in african region
13% in eastern Mediterranean region
65
treatment for salmonella
most people recover without treatment, some may need hospitals
antibiotics only when absolutely necessary.
66
salmonella epi
80% of cases occur individually, not in outbreaks
93.8 mil cases each year, 160,000 deaths
40% of cases from meat and poultry
67
what serotype causes typhoid fever
s.typhi
68
which serotype has seen large increase in the U.S.
Newport
69
salmonella typhi reservoir and mode of transmission
only humans,
spread through the fecal oral route
70
is there a vaccine for s. typhi
yes.
carrier state exists
71
s. typhi symptoms
fever, weakness, stomach pains, headache, loss of apetite
72
rotavirus persistence and seasonality
can last in stools for months
one of the winter vomiting diseases
73
magic vaccination number for rotavirus
2006
used to be a high burden on healthcare even tho not a high death rate
74
U.S. post roatvirus vaccine
illness decreased even among older children and adults not vacccinated
globally tho, rotavirus is still the leading cause of diarrhea in children
75
seasonal pattern of rotavirus
prevaccine we saw a seasonal pattern spanning horizontally across the u.s.
76
microbe of giardia
giardia duodenalis
parasitic infection of the small intestine
77
giardia treatment
antiparasitic meds
77
symptoms of giardia
can be asymptomtic
self limiting diarrhea or asymptomatic
or chronic diarrhea, gas cramps
78
giardia incubation period and communicability
3-25 days, median 7-10
communicable for months, during infection even though most ppl are asymptomatic
79
giardia transmission
fecal oral route, outbreaks through water, food, or daycares
80
how many shedded trophozoites in a bowel movement
over a million
81
where is giardia most in the U.S.
northwest
