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PubMed2004

Acute gastroenteritis in northern Ireland and the Republic of Ireland: a telephone survey.

Most people with acute gastroenteritis do not seek medical care and are therefore not captured by routine surveillance. For this reason, population-based studies are needed to measure the burden of illness. A study of acute gastroenteritis in Northern Ireland and the Republic of Ireland surveyed 9,903 people by telephone over the 12-month period from December 2000 to November 2001. The rate of acute gastroenteritis was 0.60 episodes per person per year. A general practitioner was consulted by 29.2% of those reporting illness, and 2.0% submitted a stool sample. The use of antibiotics was reported by 7.4% of ill respondents and 14.8% took anti-diarrhoeals. Taking days off work due to illness, was reported by 17.4% of respondents. Acute gastroenteritis causes a large amount of illness in the community. There are established and effective measures to prevent this condition and the challenge is to find new ways of promoting these precautions.

Absenteeism↗
PubMed2004

Allergic eosinophilic gastroenteritis in a child with Crohn's disease.

A case of a child with Crohn's disease who developed an eosinophilic gastroenteritis is reported. Although symptoms of eosinophilic gastroenteritis at age 8 could mimic those of Crohn's disease, laboratory, radiographic and histologically studies are clearly different. Peripheral blood eosinophilia (7,476 cells per mm3), high serum IgE level (1,050 kU/l) and normal C-reactive protein and erythrocyte sedimentation rate are common in eosinophilic gastroenteritis and uncommon in Crohn's disease. Eosinophilic gastroenteritis was due to bovine serum albumin (BSA) hypersensitivity, confirmed with skin tests, serum levels to specific IgE and a SDS-PAGE IgE-immunoblotting. A strict meat-free diet was started, with progressive relief of symptoms and decrease of eosinophil count twelve months later; the patient became fully symptom-free and eosinophil count was normal.

Animals↗
PubMed2004

Genetic analysis of noroviruses taken from gastroenteritis patients, river water and oysters.

As oysters are eaten raw in Japan, their contamination with the non-bacterial agent of gastroenteritis has become a serious health problem. As it is well known that oysters tend to concentrate noroviruses (NV) in their digestive diverticula, NV may be linked with the acute gastroenteritis. However, since NV cannot be cultivated in cell cultures, and they have genetic diversity, the behaviour of NV in the aquatic environment is little known. In this study, NV samples were taken from gastroenteritis patients; from the river flowing into the oyster-farming area; and from oysters harvested from that river. Genetic identities of NV samples were analysed in capsid and RNA-dependent RNA polymerase (RdRp) regions respectively. In both regions, strains taken from patients were >96% identical with those from river and oyster samples. This proved that oysters were contaminated with NV excreted from patients with gastroenteritis.

Animals↗
PubMedDate not supplied

[Investigation of an outbreak of norovirus gastroenteritis in a geriatric hospital].

In aged-care facilities, gastroenteritis outbreaks are responsible for big trouble in the management of cares to the elderly. In November 2002, a gastroenteritis outbreak was observed in 5 of the 6 wards of the geriatric hospital La Charité, University Hospital of Saint-Etienne, France, with an attack rate of 38.5% in the elderly (70 infected from 182 patients) and of 26.0% in the nursing staff (40 infected from 154 agents). The outbreak lasted 30 days with a peak corresponding to 79.8% of the cases between the 11(th) and the 20(th) of November. The first cases were observed in the two short-term-care wards; then, the outbreak spread rapidly to 3 of the 4 long-term care units. Health care workers were contaminated later than the elderly (P < 0.001 by Kruskal-Wallis test). A self-administered questionnaire was documented by most of the nursing staff; the most frequently observed clinical symptoms in this population were nausea (82.5%), abdominal pain (80.0%), diarrhoea (70.5%), asthenia (67.5%) and vomiting (62.5%). Thirty-five percent of the health care workers ceased their work. The causative agent of the gastroenteritis was identified by RT-PCR in the stools of 5 aged persons as a norovirus close to the Lordsdale strain (genogroup II). These findings illustrate the respective role of elderly and health care workers in the spread of the gastroenteritis outbreak inside the geriatric hospital.

Adult↗
PubMed2006

Isolation & antimicrobial susceptibility of Shigella from patients with acute gastroenteritis in Western Nepal.

BACKGROUND & OBJECTIVE: Shigellae play an important role as a causative organism of acute gastroenteritis, which is a global health problem with significant morbidity and mortality in especially in developing countries. This study was carried out to determine the isolation and pattern of antimicrobial resistance of Shigella in patients with acute gastroenteritis in western Nepal. METHODS: The study included all patients with acute gastroenteritis who visited a tertiary care hospital at Pokhara, Nepal during a 2-year period (2002-2004). The isolates was confirmed as Shigella by biochemical reaction and slide agglutination test using specific antisera. Antibiotic sensitivity test was determined by agar diffusion method and minimum inhibitory concentration (MIC) of the drugs was detected. RESULTS: Of the 770 stool samples, 83 (10.8%) yielded Shigella. Shigella flexneri caused 56 (67.4%) of the total cases of shigellosis followed by S. dysenteriae 12 (14.5%), S. sonnei 10 (12%) and S. boydii 5 (6%). Of the 83 isolates, 67 (80.7%) showed resistance to various drugs and 62 (74.7%) were resistant to two or more drugs. Resistance to cotrimoxazole was 80.7 per cent followed by tetracycline 74.7 per cent, ampicillin 53.0 per cent, nalidixic acid 31.3 per cent and ciprofloxacin 2.4 per cent. The MIC(50) and MIC(90) values of those drugs were also very high. All isolates were sensitive to cefotaxime and ceftriaxone. INTERPRETATION & CONCLUSION: The findings of our study suggested that Shigellae was an important etiological agent for acute gastroenteritis, with a high rate of drug resistance and requires constant monitoring in this region.

Acute Disease↗
PubMed2006

[Antibiotics use for acute gastroenteritis in ambulatory care of children before and after implementation the healthcare system reform in Poland].

AIM OF THE STUDY: Our study aimed to investigate the ambulatory antibiotics use for acute gastroenteritis in children admitted to the hospital in 1998-2000. MATERIAL AND METHODS: The retrospective analysis of medical records was performed in 369 children up to two-years of age; including 87 admitted in 1998, 136 - in 1999 and 146 in 2000 year. Results. Antimicrobials use decreased year after year. In 1998 the antibiotics therapy was included in 44.9% of children, in 1999--in 35.3% and in 2000 year in 32.2% (p = 0.02). In 1998 year, the antibiotics were ordered mainly for children diagnosed as bacterial diarrhea (76.9%) compared to viral etiology (18%). In 2000 year the antibiotics were prescribed for viral gastroenteritis twice more often (61.7%) than for bacterial etiology (29.8). Children with acute gastroenteritis and coexistent signs and symptoms were given antibiotics for treatment diarrhea in the similar percentage as those without any: in 1998--54.2 and 45.8%, in 1999--50.8 and 49.2%, in 2000--40.3 and 59.7%, respectively. Microbiologic examination was not performed in any case before treatment. CONCLUSIONS: This study demonstrates the discrepancies between recommendations and ambulatory practice in the antibiotic treatment of acute diarrhea in children both before and after implementation the healthcare system reform. Education programs are needed for optimal management of acute gastroenteritis in children including training in necessity of coproculture before prescribing antimicrobials.

Acute Disease↗
PubMed2006

Under-nutrition affects time to recurrence of gastroenteritis among Aboriginal and non-Aboriginal children.

This study investigated whether under-nutrition affected time to hospitalization for recurrence of gastroenteritis in Australian children. Linked hospitalization records of all infants, born in 1995 and 1996 in Western Australia, who were admitted for gastroenteritis during their first year of life (n=1001), were retrieved. A survival frailty model was used for determining the factors influencing the recurrent times over the subsequent seven years. Aboriginality and under-nutrition were significantly associated with an increased risk of recurrence (hazard ratios of 2.59 and 1.28). Hospitalizations due to gastroenteritis were common among Aboriginal children who had a higher mean re-admission rate and much shorter intervals between re-admissions than other patients. The proportion of patients with recurrence was also significantly higher for Aboriginals (38.5%) than for other patients (14.2%). Gastroenteritis remains a serious problem in Aboriginal children. This presents a complex challenge to be addressed with public-health principles, political determination and commitment, and adequate resources.

Cohort Studies↗
PubMed1976

A reovirus-like agent (rotavirus) in gastroenteritis of children. Virus detection and serological studies.

A reovirus-like agent (rotavirus) was detected in 26 children (44%) when fecal specimens from 59 children with acute gastroenteritis were examined by electron microscopy. No rotavirus was detected in the feces of 49 children with other diseases. Sera from the acute and the convalescent phase from 40 children with acute gastroenteritis and from 18 other patients were examined for antibodies against a bovine rotavirus by an indirect fluorescent antibody test. 26 of the patients with gastroenteritis (65%) developed antibodies during their disease, whereas none of the other patients showed a rise in antibody titre. The specimens were submitted to the laboratory from hospitalized children during the period January 1973 through March 1975. Most of the cases of rotavirus gastroenteritis occurred during late autumn and early winter among children between 0.5 and 3 years of age. It is concluded that electron microscopy is a sensitive diagnostic technique during the acute phase of the disease, and that the serological test with bovine rotavirus antigen served as a useful diagnostic tool.

Acute Disease↗
PubMed1976

Transmissible gastroenteritis virus: plaques and a plaque neutralization test.

A plaquing system and plaque neutralization test in porcine thyroid cells were used to study different transmissible gastroenteritis isolates and hemagglutinating encephalomyelitis virus. Among transmissible gastroenteritis virus isolates, plaque size varied considerably and mixed size ranges sometimes occurred. The most recently isolated viruses produced smaller plaques than the laboratory viruses or hemagglutinating encephalomyelitis virus. All transmissible gastroenteritis virus isolates reacted in the plaque neutralization test with a transmissible gastroenteritis virus antiserum which showed no activity against hemagglutinating encephalomyelitis virus. Plaque neutralization results both from experimentally infected pigs and following a field outbreak demonstrated the reliability of this test and its greater sensitivity than the conventional tube test.

Animals↗
PubMed1976

Antibody response in pigs inoculated with transmissible gastroenteritis virus and cross reactions among ten isolates.

Groups of two or three day old pigs were inoculated intravenously with cell culture grown transmissible gastroenteritis virus. A single or a multiple dosage schedule was used. The magnitude of immune response was measured in terms of serum neutralization indices. A single dose of relatively attenuated virus caused mild clinical signs of transmissible gastroenteritis infection in the pigs and induced a low level of antibody in the serum by the seventh day after inoculation. Repeated injections of virus at seven day intervals stimulated little increase in antibody titers. However, high serum antibody titers were obtained for all pigs if the time interval between injections was extended to 15 days. Sera obtained early after exposure to live transmissible gastroenteritis virus contained mainly IgM antibody whereas sera obtained later after exposure contained mainly IgG antibody. Ten plaque purified isolates of transmissible gastroenteritis virus, comprising eight American isolates, one Japanese isolate and one British isolate were indistinguishable by means of reciprocal plaque reduction neutralization tests.

Animals↗
PubMed1989

[Infectious gastroenteritis in the immunocompetent child. Significance of Cryptosporidium spp. and Aeromonas ssp].

Over a one-year period we have examined 390 stool specimens from 210 children hospitalized for infectious gastroenteritis or in whom infectious gastroenteritis occurred during hospitalization. The most prevalent pathogens were rotaviruses (22.4%), followed by enteric salmonella (8.1%), Campylobacter jejuni/coli (2.4%), Cryptosporidium spp. (2.4%) and Aeromonas spp. (1.9%). Both Cryptosporidium spp. and Aeromonas spp. are important pathogens of infectious gastroenteritis in immunocompetent children in Switzerland. For both pathogens the most frequently observed clinical sign was self-limited, watery diarrhea with vomiting and fever often requiring parenteral rehydration. The laboratory findings in our patients revealed a left shift with a rise in total leukocyte count in Aeromonas infections only. Electrolytic disorders were frequently found in infections associated with either pathogen, while marked compensated metabolic acidosis was found with cryptosporidiosis only. This points toward a secretory component as part of the still unclear pathogenetic mechanism. Possible modes of infection in cryptosporidiosis are transmission by infected livestock (calves) and person-to-person communication, and in Aeromonas infections transmission by contaminated food or water. We recommend screening for both pathogens in infectious gastroenteritis of immunocompetent children.

Adolescent↗
PubMed1969

An extensive community outbreak of enteropathogenic Escherichia coli O86: B7 gastroenteritis.

During the last 20 years numerous reports of hospital-associated epidemics of enteropathogenic Escherichia coli (EEC) gastroenteritis have appeared in the medical literature. Some of the reports suggest that EEC gastroenteritis can also be a community problem. However, community epidemics of EEC gastroenteritis comparable to those of other communicable diseases like cholera or typhoid are rare.An extensive epidemic of acute gastroenteritis occurred among children in Surat, Gujarat State, India, between 29 October and 3 December 1965. A total of 418 patients was hospitalized during this period: 344 of them were under 2 years of age. Faecal specimens from 81 children admitted between 25 November and 30 November were subjected to microbiological examination. Of these samples, 34 yielded pure cultures of E. coli O(86):B(7) and 1 yielded a pure culture of O(126):B(16). The cases occurred throughout the town including a rural ward. The morbidity rate for the total population was 0.16% and the age-specific morbidity rate for the 0-2-years age-group, was 0.98%; the highest morbidity rate (2.4%) was in the 6-11-months age-group in the urban wards. No definite mode of transmission of the disease could be established.

Acute Disease↗
PubMed1984

The effect of adoptive transfer of mononuclear leukocytes from an adult donor on spontaneous cell-mediated cytotoxicity and resistance to transmissible gastroenteritis in neonatal piglets.

The purpose of this study was to attempt to establish spontaneous cell-mediated cytotoxicity effector activity in the intraepithelial lymphocytes of neonatal piglets by adoptive transfer of mononuclear leukocytes from an adult donor and to determine the effect of transfer on the resistance of piglets to transmissible gastroenteritis. Cytotoxicity was determined by a chromium release assay using PK-15 cells persistently infected with transmissible gastroenteritis virus as targets. The experimental animals were inbred miniature pigs, in which a high degree of uniformity in lymphocyte defined histocompatibility complex antigens was demonstrated by the mixed lymphocyte reaction. Adoptive transfer of 8 X 10(7)-4 X 10(8) adult pig leukocytes established effector activity in eight recipient piglets, and leukocytes labelled with fluorescein isothiocyanate homed to the epithelium of the small intestine. When four recipients of 5 X 10(8) adult leukocytes were challenged with transmissible gastroenteritis virus, the onset of diarrhea was delayed for 24 h and the diarrhea was usually milder than in four untreated control piglets. It was concluded that the adoptive transfer of leukocytes with spontaneous cell-mediated cytotoxicity effector activity, which homed to the small intestinal epithelium, may have contributed to an increased resistance to transmissible gastroenteritis.

Animals↗
PubMed1980

[Viruses and gastroenteritis (author's transl)].

In recent years it has been demonstrated that a group of viruses, Rotavirus for the children and Norwalk agent for adults, are a highly significant cause of acute gastroenteritis during the months of winter ("winter vomiting disease"). The Rotavirus was identified by Bishop et al. as a double-stranded RNA virus that can be isolate from faeces of children with acute gastroenteritis. Viral gastroenteritis is an autolimitate disease, although under certain conditions it may even lead to severe disease and death by profound dehydration and electrolyte imbalance; it is characterized by nausea, vomiting, diarrhea and others minor symptoms. This entity only affects children between 3 months and 6 years of age, with a little prevalence for the males. Breast-fed babies are commonly thought to be less likely than artificial-fed babies to suffer from infective diarrhea. Rotavirus infection is also known to occur in parents of infected children, but in this situation the symptoms are generally mild or absent and they needn't medical attention. The Rotavirus invade mainly the epithelium of the proximal intestine where they make a cytopatic and physiologic alteration (deficience in Na and K-ATPsa activity) that determines a disturbances of water and electrolyte transport across the epithelium thus contribute to the diarrhea. The best methods for detecting this type of viral gastroenteritis are electron microscopy and, specialy, the complement fixation test. In this moment we have not specific therapy for this new disease but because its epidemiological importance it must be in all clinical minds.

Adult↗
PubMed1981

Aetiology of viral gastroenteritis: a review.

Over the past seven to eight years, several virus groups have been shown to be associated with gastroenteritis. They are adenoviruses, astroviruses, caliciviruses, coronaviruses. Norwalk-like viruses and rotaviruses. In infants and young children, rotaviruses are the single most important aetiological agents of acute gastroenteritis in terms of numbers of cases and also of patients requiring admission to hospital. In older children and adults, the aetiology is less clear, but the present state of our knowledge indicates that Norwalk-like viruses are one of the major causes. Most of these gastroenteritis-producing viruses cannot be propagated satisfactorily in laboratory cell-culture systems, and electron microscopy is the chief method of detection. Immune electron microscopy is used to demonstrate specific antibody increases during infection and to show antigenic differences between morphologically similar viruses. These techniques are relatively insensitive, and the development of a cell-culture system for the propagation of these "gastroenteritis viruses" would greatly facilitate epidemiological studies and vaccine development.

Acute Disease↗
PubMed1995

Eosinophilic gastroenteritis involving the entire digestive tract.

Eosinophilic gastroenteritis, an inflammatory disease of unknown etiology, commonly involves the stomach and small intestine with eosinophilic infiltration. Herein we describe an unusual case of eosinophilic gastroenteritis involving the entire digestive tract. A 24-yr-old woman came to our hospital presenting with diarrhea with marked peripheral eosinophilia. Stool specimens were negative for parasites, ova, bacteria, and fungi. Barium and endoscopic studies showed thickened edematous folds of the duodenum and small intestine. Biopsy specimens of the esophagus, stomach, duodenum, ileum, and colon showed eosinophilic infiltration. A diagnosis of eosinophilic gastroenteritis involving the entire digestive tract was made, and therapy with prednisone was started. Symptoms and peripheral eosinophilia rapidly resolved, and biopsies of the digestive tract demonstrated no eosinophilic infiltration. This case illustrates the expanded spectrum of the disease to the entire digestive tract and emphasizes the diagnostic usefulness of endoscopic biopsies. The initial presentation of patients with eosinophilia requires the evaluation of the entire digestive tract. It is worth noting that eosinophilic gastroenteritis can involve the entire digestive tract.

Adult↗
PubMed1995

[Epidemic of viral gastroenteritis in an elderly community].

Rotaviruses and adenoviruses are the main aetiologic pathogens of gastroenteritis in infants. Adults may also be concerned with usually mild clinical symptoms. An epidemic of viral gastroenteritis occurred in a long-term hospitalization ward from July 25 to August 21, 1991: 101 patients. This study involved 26 females and 6 males with a mean age of 86 years (range 70-101 years), presenting clinical symptoms of gastroenteritis. The clinical attack rate was 27.7%. Outcome was favourable for the majority of patients who recovered in 4-5 days. The main clinical signs were diarrhoea (90.6%), hyperthermia (18.8%) and vomiting (18.8%). Virology investigations gave the diagnosis of 8 rotavirus infections, 6 adenovirus infections and 2 rotavirus and adenovirus mixed infections. Among staff members, 3 rotavirus and one adenovirus infections were diagnosed. The precise origin of the epidemic could not be determined from rotavirus electropherotypes obtained from stools of elderly and paediatric patients hospitalized during the same period. This outbreak recalls the viral involvement in diarrhoeal episodes of elderly people. These episodes of viral gastroenteritis are responsible for high morbidity in the elderly and may upset a precarious physiological state.

Adenovirus Infections, Human↗
PubMed1994

Oral immunoglobulins for treatment of acute rotaviral gastroenteritis.

OBJECTIVE: Preliminary evidence has been reported on the antirotavirus effect of human serum immunoglobulin administered orally. The aim was to see whether such treatment might be effective in rotavirus acute gastroenteritis. METHODS: A prospective, double-blind, placebo-controlled study was performed. Ninety-eight children admitted with acute gastroenteritis were enrolled and randomly assigned to groups A (treated) and B (control). Children in group A received a single oral dose of 300 mg/kg body weight of human serum immunoglobulin. Parameters of efficacy were clinical condition, frequency and consistency of stools, duration of diarrhea, duration of viral excretion, and length of hospital stay. Antirotaviral activity was determined in the immunoglobulin preparation by a specific neutralization assay. RESULTS: Seventy-one of the 98 children enrolled had rotaviral gastroenteritis; 36 belonged to group A. Children who received immunoglobulin had significantly faster clinical improvement of clinical condition and stool pattern than control children. Mean total duration of rotaviral diarrhea was 76 hours in group A and 131 in group B (P < .01). Viral excretion lasted 114 and 180 hours, respectively (P < .01). Hospital stay was significantly reduced in children in group A. Neutralizing antibodies against rotavirus were detected in the immunoglobulin preparation. CONCLUSION: Oral administration of immunoglobulin is associated with a faster recovery from acute gastroenteritis and should be given to children hospitalized with this illness.

Acute Disease↗