Viral gastroenteritis

Question 1

what is viral gastroenteritis

Answer 1

acute inflammation of the lining of the stomach and intestines caused by enteropathogenic viruses

Question 2

how does viral gastroenteritis present

Answer 2

sudden onset diarrhoea +/- vomiting

acute diarrhoea –> 3 or more liquid stools in 24hr period, lasting less than 14days

vomiting occurs in majority of viral gastroenteritis but if not present does not rule it out
any blood in stool is NOT common in viral gastroenteritis

cramping abdominal pain + nausea + low grade fever can be present too

examination:
abdomen should be soft + only mildly tender
pain or guarding on palpation suggests other cause e.g. pancreatitis, appendictis or IBD

Question 3

what are the possible causes of viral gastroenteritis

Answer 3

norovirus

rotavirus

adenovirus - commonly cause upper respiraotry tract infections but can cause gastroenteritis in children

Question 4

what are the specific features of norovirus

Answer 4

sudden onset nausea –> projectile vomiting + diarrhoea

symptoms start 24-48hrs after infection
short duration of symptoms –> 12-60hrs (most resolve within 1-2 days)

others in close contact have similar symptoms

Question 5

what are the specific features of rotavirus

Answer 5

very similar to norovirus but normally affects children under 5

sudden onset nausea –> projectile vomiting + diarrhoea

symptoms start 24-48hrs after infection
short duration of symptoms –> 12-60hrs (most resolve within 1-2 days)

close contact with other with similar symptoms

Question 6

how is viral gastroenteritis diagnosed

Answer 6

clinical diagnosis
symptoms generally resolved within 3 days

consider medication with diarrhoea as side effect

BUT further investigation e.g. stool culture in patients with:
prolonged diarrhoea over 14 days
persistent fever
bloody in stool
severe abdominal pain

Question 7

how is norovirus transmitted

Answer 7

faecal to oral route –> virus particles enter air when infected perosn flushes loo or vomits

can be passed directly via physical contact with surface or person who has not washed their hands

Question 8

how is viral gastroenteritis prevented

Answer 8

good hand hygiene using soap and water

isolation of infected individuals - especially in cruise ship, hospitals etc

rotavirus - childhood immunisation

Question 9

how is viral gastroenteritis managed

Answer 9

advise regular fluid intake –> can use oral rehydration solution
important to stay hydrated due to dehydration + electrolyte imbalances caused by D&V, especially in elderly

good hand hygiene + to isolate from others