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PubMed2002

Etiology of chronic diarrhea.

OBJECTIVE: The aim is to find the common causes of chronic diarrhea in our hospital, and to find out the most useful methods for diagnosis. METHODS: This study was carried out in the medical ward at Al-Yarmouk Teaching Hospital, Baghdad, Iraq, during the period January 1999 through to August 2000. Fifty inpatients with diarrhea for 4 weeks or more were evaluated by history, physical examination and investigations which included endoscopy with biopsy. RESULTS: The first cause of chronic diarrhea was ulcerative colitis (28%), the next was celiac disease (20%), followed equally by microscopical colitis (12%) and functional diarrhea (12%), amebiasis was the 5th cause (10%), followed by carcinoma of the colon (6%), Crohn's disease (2%), diabetic diarrhea (2%) and thyrotoxicosis (2%). Endoscopy (esophagoduodenoscopy, sigmoidoscopy and colonoscopy) with biopsy was the most useful method to diagnose >70% of the cases as ulcerative colitis, celiac disease, microscopic colitis, carcinoma of the colon and Crohn's disease. CONCLUSION: This study revealed the importance of history taking, physical examination, and judious and sequential use of investigations especially endoscopic procedures to discover the cause of chronic diarrhea. Chronic bloody diarrhea should raise the high possibility of ulcerative colitis. A considerable number of patients with chronic diarrhea in our study were discovered to have microscopical colitis.

Adolescent↗
PubMed2003

[Chemotherapy-induced diarrhea].

Chemotherapy-induced diarrhea is a well-documented side effect of many cancer treatments and is associated with increased morbidity and mortality. Chemotherapy-induced diarrhea negatively impacts patient quality of life and treatment outcome by requiring dose limitations or treatment interruption. The chemotherapeutic agent CPT-11 (irinotecan) has shown promising results as a single agent and in combination chemotherapy for the treatment of colorectal and small cell lung cancer. However, delayed onset diarrhea is considered to be its major dose-limiting toxicity. In some cases, it can be life threatening. To prevent CPT-11-induced delayed diarrhea, oral alkalization (OA) and control of defecation (CD) [Int J Cancer 92: 269-275, 2001] were developed based on fundamental studies [Int J Cancer 83: 491-496, 1999; Cancer Res 62: 179-187, 2002]. Oral administration of antibiotics [Cancer Res 56: 3752-3757, 1996; Clin Cancer Res 7: 1136-1141, 2001] or kampo medicine [Jpn J Cancer Res 86: 978-984, 1995; Jpn J Cancer Res 86: 985-989, 1995] to decrease beta-glucuronidase activity derived from bacteria in the large intestine was also reported to be successful in preventing delayed diarrhea. When CPT-11-induced delayed diarrhea occurs, the conventional treatment is loperamide [J Natl Cancer Inst 86: 446-449, 1994], and the early recognition and treatment of diarrhea with this opioid has reduced, although not entirely eliminated, patient morbidity. Other therapies are needed to treat patients with loperamide-refractory CPT-11 induced diarrhea, and the successful use of the somatostatin analogue octreotide has been reported [Support Care Cancer 9: 258-260, 2001; Ann Oncol 12: 227-229, 2001; Proc Am Soc Clin Oncol 21: 387a, 2002].

Antidiarrheals↗
PubMed2003

Factors affecting utilization of health care services by mothers of children ill with diarrhea in rural Vietnam.

To examine the use of health services for the treatment of childhood diarrhea in three southern provinces of Vietnam, and identified household, maternal, child and health service characteristics associated with this use, a cross-sectional household survey was conducted between November 1998 and January 1999. Women with a pre-school aged child living at home were the primary respondents for the survey questionnaires. Respondents were asked to recall diarrheal disease events experienced by their child during the two weeks prior to interview, and their responses to these events. Prevalence ratios (PR) were used to identify associations between maternal age, education, occupation, ethnicity, knowledge about diarrhea, feeding practises during diarrhea, household residence and economic status, disease severity, use of oral rehydration solution (ORS), time to nearest health care facility and overall satisfaction with local medical services, and the use of health care services for children ill with diarrhea. The two-week period prevalence of childhood diarrhea was 10% and varied by the province and ethnicity of the child's mother. Forty-three percent of mothers reported using ORS during diarrheal episodes. Seventy percent of mothers sought advice or treatment when their child became ill with diarrhea. After controlling for potential confounders in regression models, maternal ethnicity, maternal high school education (in comparison to no education or incomplete primary education), more severe disease and the use of ORS were factors associated with increased utilization of health care services. There was a low level of the utilization of ORS to treat children with diarrhea, especially by ethnic minority mothers. A high percentage of mothers reported low levels of satisfaction with medical services, especially those from ethnic minorities. Mothers from ethnic minorities and those with lower levels of education were less likely to seek advice or treatment. These findings suggest the need for programs to promote the use of ORS and use of appropriate services for the treatment of childhood diarrheal disease. Interventions are needed to improve the access of ethnic minority children to child health care services for the treatment of diarrhea.

Chi-Square Distribution↗
PubMed1992

The management of acute diarrhea in children: oral rehydration, maintenance, and nutritional therapy. Centers for Disease Control and Prevention.

Worldwide, diarrhea remains one of the most common illnesses among children. In the United States, children < 5 years of age experience > 20 million episodes of diarrhea each year, leading to several million doctor visits, 200,000 hospitalizations, and approximately 400 deaths. Much of this morbidity is due to the dehydration associated with acute watery diarrhea. Consequently, the proper management of children with acute diarrhea is important for all practitioners as well as for parents of small children. The development of oral therapy for the rehydration and maintenance of children with dehydrating diarrhea has become the worldwide mainstay of national diarrheal control programs. More recently, proper nutrition for children with diarrhea is viewed as an important adjunct to therapy, whereas antibiotics and other drugs play only a limited role. Intravenous therapy remains essential for diarrheal episodes associated with severe dehydration. This document reviews the proper management of diarrhea among children. Particular attention is given to the use of oral therapy for rehydration and maintenance therapy for the dehydrated child and nutritional management. In the United States, the improved management of children with diarrhea could lead to a noticeable decrease in the number of children who are hospitalized or die as a result of diarrheal illness. This report contains recommendations prepared by the Centers for Disease Control and Prevention (CDC), with input from a panel of pediatric and diarrheal management experts, which are consistent with recommendations endorsed by the American Academy of Pediatrics.

Acute Disease↗
PubMed2003

Epidemiologic and clinical characteristics of acute diarrhea with emphasis on Entamoeba histolytica infections in preschool children in an urban slum of Dhaka, Bangladesh.

The epidemiology, clinical features, nutritional status, and causative agents of diarrhea were studied in 289 Bangladeshi children (147 boys and 142 girls) 2-5 years old. The use of improved diagnostic tests for amebiasis enabled for the first time analysis of the contribution of Entamoeba histolytica to total diarrheal illness in this community setting. The average incidence rate of diarrhea was 1.8/child-year, and the average number of diarrheal days was 3.7 days/child-year over an average observation period of 2.8 years/child. Seventy-five percent of the diarrheal episodes were < or = 2 days in duration. Persistent diarrhea was relatively uncommon (0.2% of the children) and chronic diarrhea was observed in only one episode. Compared with malnourished and/or stunted children, better-nourished children experienced significantly fewer diarrheal episodes. The diarrheal incidence rate for children with blood group A was significantly less that that of the children with blood groups O and AB. The most frequent bacterial enteropathogens isolated from diarrheal stool specimens were enterotoxigenic Escherichia coli (9%) and Aeromonas species (9%), followed by Plesimonas shigelloides (4%) and Shigella flexneri (3.8%). Rotavirus was the most common viral agent isolated from diarrheal stool samples (5%). Giardia lamblia, Cryptosporidium parvum, and E. histolytica were identified in 11%, 8.4%, and 8%, respectively, of the diarrheal stool specimens. Dysentery was observed in 7.7% of all diarrheal episodes. The most common pathogens isolated from dysenteric stool were S. flexneri (11.6%), Aeromonas sp. (10%), E. histolytica (8.7%), Campylobacter jejunii (5.8%), P. shigelloides (4.3%), and A. caviae (4.3%). The overall incidence rate of E. histolytica-associated diarrhea was 0.08/child-year. Visible blood and hemoccult test-detected blood loss was found in 7% and 25%, respectively, of cases of E. histolytica-associated diarrhea. Children who had recovered from a diarrheal episode with E. histolytica, but not E. dispar, had half the chance of developing subsequent E. histolytica-associated diarrhea, consistent with the development of species-specific acquired immunity. In conclusion, the use of modern diagnostic tests demonstrated that E. histolytica contributed to overall morbidity from diarrheal illness. Understanding the etiology, frequency, and consequences of acute diarrhea in children from a developing country should aid in the design of interventions to improve child health.

Age Distribution↗
PubMed2004

Cryptosporidiosis among Bangladeshi children with diarrhea: a prospective, matched, case-control study of clinical features, epidemiology and systemic antibody responses.

We conducted a prospective case-control study to investigate the epidemiology, clinical features, and systemic antibody responses of cryptosporidiosis in Bangladeshi children. Forty-six children presenting to the International Center for Diarrheal Disease Research, Bangladesh in Dhaka, Bangladesh with diarrhea and Cryptosporidium spp. oocysts in the stool were enrolled as cases. Forty-six age-matched children with diarrhea, but without cryptosporidial infection, were enrolled as controls. Thirty cases and 23 controls returned for follow-up three weeks after discharge. Infection with Cryptosporidium spp. occurred most commonly in those less than two years of age, was accompanied by watery diarrhea and vomiting, and was more likely to be associated with persistent diarrhea. Other than duration of diarrhea, there were no significant differences in clinical or epidemiologic features between cases and controls. Cryptosporidium-specific serum IgM levels were significantly higher in cases compared with controls at presentation. In addition, there was a significant increase in serum Cryptosporidium-specific serum IgG levels over the three-week follow-up period in cases compared with controls. Within the case group, there was no difference between children with acute and persistent diarrhea in the change in IgG levels over the follow-up period. However, there was a significant difference between children with acute and persistent diarrhea in changes in both IgA and IgM levels, with persistent diarrhea being associated with a decrease in levels of both antibodies.

Animals↗
PubMed2005

Military importance of diarrhea: lessons from the Middle East.

PURPOSE OF REVIEW: Historically, diarrhea has been one of the most important diseases encountered during military operations. With more than 140,000 US military personnel currently deployed to the Middle East in support of the global war on terror, it is important for health care providers and planners to be aware of the incidence and potential impact of diarrheal disease in that region. RECENT FINDINGS: Recently published data from mid-deployment surveys assessing the incidence and clinical impact of diarrhea on troops deployed to Iraq and Afghanistan have been updated and presented along with a review of the recent literature concerning diarrheal pathogens of military concern in the Middle East. Of 4348 volunteers, 76% reported at least one diarrhea episode during their deployment and more than half reported multiple episodes. In 45% of subjects, diarrhea resulted in decreased job performance for a median of 3 days. Diarrhea resulted in 62% of subjects seeking medical care at least once, and 31% required intravenous rehydration. In 17% of subjects, diarrhea resulted in confinement to bed for a median of 2 days, causing an estimated 3.7 days (Poisson 95% CI, 3.4 to 4.0 days) of complete work loss per 100 person-months. SUMMARY: Despite modern preventive medicine efforts, diarrhea rates remain high, and the impact of illness remains a threat to military efficiency. Novel enteric disease research programs designed to decrease the impact of diarrhea on the military mission are needed. The development of enteric vaccines and appropriate treatment regimens remain a top priority.

Absenteeism↗
PubMed2005

[Effect of glutamine on small intestinal repair in weanling rats after chronic diarrhea].

OBJECTIVE: To investigate the nutrient effect of glutamine on small intestinal repair in weanling rats after chronic diarrhea. METHODS: Forty 21-day-old wistar rats were randomly divided into five groups (8 in each). Animal model of chronic diarrhea was induced by a lactose enriched diet in the weanling Wistar rat, normal control group was fed with a standard semipurified diet, and after 14 days the rats in both groups were killed to test the establishment of the model. After the establishment of the model, the other groups were fed with the standard semipurified diet to recover for 7 days, and were randomly divided into three groups: non-intervention group, glutamine (Gln)-intervention group and control group. Glutamine concentrations in blood was detected by high-performance liquid chromatography (HPLC). Morphological changes including villus height and villus surface area of the jejunum were measured under a light microscope and electron microscope, expression of proliferating cell nuclear antigen (PCNA) as an index of cell proliferation was observed using immunohistochemical staining and image analysis. RESULTS: The diarrhea rate in model group was 100 percent, average diarrhea index was 1.16 +/- 0.06, but both diarrhea rate and average diarrhea index in control group were 0 (P < 0.01), which affirmed establishment of the model. There was significant decrease of body weight, plasma Gln concentration, villus height, villus surface area and expression of PCNA in non-intervened group compared with the control group (P < 0.01). There was still significant decrease of body weight, villus height and villus surface area in Gln-intervened group compared with control group (P < 0.01), but plasma Gln concentration and expression of PCNA in Gln-intervened group had recovered to normal (P > 0.05). And compared with non-intervened group, except for body weight (P > 0.05), plasma glutamine, villus height, villus surface area and expression of PCNA were all significantly increased in Gln-intervened group. CONCLUSION: Chronic diarrhea can induce malnutrition and reduce the villus height, villus surface area, expression of PCNA and plasm glutamine concentration. Oral glutamine could improve the proliferation of crypt cell and promote repair of intestinal mucosa after chronic diarrhea.

Animals↗
PubMed2005

Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda.

Diarrhea is frequent among persons infected with human immunodeficiency virus (HIV) but few interventions are available for people in Africa. We conducted a randomized controlled trial of a home-based, safe water intervention on the incidence and severity of diarrhea among persons with HIV living in rural Uganda. Between April 2001 and November 2002, households of 509 persons with HIV and 1,521 HIV-negative household members received a closed-mouth plastic container, a dilute chlorine solution, and hygiene education (safe water system [SWS]) or simply hygiene education alone. After five months, HIV-positive participants received daily cotrimoxazole prophylaxis (160 mg of trimethoprim and 800 mg of sulfamethoxazole) and were followed for an additional 1.5 years. Persons with HIV using SWS had 25% fewer diarrhea episodes (adjusted incidence rate ratio [IRR] = 0.75, 95% confidence interval [CI] = 0.59-0.94, P = 0.015), 33% fewer days with diarrhea (IRR = 0.67, 95% CI = 0.48-0.94, P = 0.021), and less visible blood or mucus in stools (28% versus 39%; P < 0.0001). The SWS was equally effective with or without cotrimoxazole prophylaxis (P = 0.73 for interaction), and together they reduced diarrhea episodes by 67% (IRR = 0.33, 95% CI = 0.24-0.46, P < 0.0001), days with diarrhea by 54% (IRR = 0.46, 95% CI = 0.32-0.66, P < 0.0001), and days of work or school lost due to diarrhea by 47% (IRR = 0.53, 95% CI = 0.34-0.83, P < 0.0056). A home-based safe water system reduced diarrhea frequency and severity among persons with HIV living in Africa and large scale implementation should be considered.

AIDS-Related Opportunistic Infections↗
PubMed2006

[Effect of diarrhea on nutrient utilization in protein deficient or protein-calorie deficient rats].

Diarrhea increases the effects of malnutrition. Accordingly, the effect of diarrhea on two types of malnutrition (protein deficiency and protein-calorie deficiency) was studied. The experiment included 42 young Sprague Dawley rats. The rats were distributed into three groups with 14 rats per group. During the first 16 of the experiment, the first group was fed a control diet ad libitum, the second received the same diet but with food intake reduced in 50% whereas the third group was offered a protein deficient diet. Thus, at the end of this period there were well-fed rats (control), as well as protein and protein-calorie malnourished rats. Then one half of the rats in each group were given lactose to produce diarrhea and all rats continued with their previously assigned diet and feeding regime during one more week. Therefore, during this period there were control rats, protein deficient rats and protein-calorie deficient rats with and without diarrhea. The results showed that diarrhea caused a substantial reduction in food intake and growth in the well-fed rats and also in the group fed the protein deficient diet. However, the protein-calorie deficient group did not reduce its intake nor its growth rate. As a result, diarrhea caused malnutrition in the control group and increased malnutrition in the protein deficient but it did not have an additional effect in the protein-calorie deficient rats. The apparent absorption of lipids and nitrogen measured in these rats showed that the absorption reduction caused by diarrhea was more pronounced in the protein deficient group. This group also had the lowest activities of intestinal disaccharidases. These results showed that diarrhea had a more detrimental effect in protein deficient than in protein-calorie deficient rats.

Animals↗
PubMedDate not supplied

Profile of chronic small-bowel diarrhea in adults in Western India: a hospital-based study.

BACKGROUND: Small-bowel diarrhea is reported to account for 10% of all cases of chronic diarrhea. Data on the etiology and clinical presentation of chronic small-bowel diarrhea in adult Indians is scarce. METHODS: 50 patients (mean age 32.8 years; 26 men) with chronic small bowel diarrhea were evaluated clinically, and investigated to determine etiology. The diagnosis of small-bowel diarrhea was based on history, stool volume and associated symptoms. RESULTS: Abdominal pain (n=22, 44%) and weight loss (n=37, 74%) were the most common symptoms, apart from diarrhea. Anemia (70%) and hypoalbuminemia (48%) were other important biochemical abnormalities. Intestinal tuberculosis (26%) and celiac disease (26%) were the most common causes of chronic small-bowel diarrhea. CONCLUSION: Tuberculosis of intestine and celiac disease are common causes of small-bowel diarrhea in our population. Tropical sprue seems to be a rare cause.

Adolescent↗
PubMedDate not supplied

Diarrhea associated with tube feeding in mechanically ventilated critically ill patients.

This study was undertaken to determine the incidence and duration of diarrhea associated with tube feeding in critically ill adult patients who require mechanical ventilation. Of the 73 subjects studied, 63% had diarrhea associated with tube feeding. This incidence is higher than that reported from other studies of critically ill patients who were not mechanically ventilated. Multiple logistic regression analysis revealed that three variables (higher rates of infusion, greater tube-feeding osmolality, and change of tube-feeding product) were statistically significant predictors of diarrhea incidence. Antibiotic use and serum albumin levels were not predictors. In a stepwise multiple regression analysis, the duration of diarrhea was predicted by frequency of diarrhea, within the first 5 days of tube-feeding onset, tube-feeding product osmolality, and rate of tube-feeding infusion. Serum albumin levels and frequency of diarrhea beyond 6 days of tube-feeding onset did not predict duration of diarrhea. Higher osmolality and infusion rates of tube-feeding products did contribute to prediction of both incidence and duration of diarrhea.

Adolescent↗
PubMed1990

[Chronic diarrhea: clinical aspects].

A retrospective study on the syndrome of chronic diarrhea was carried out on 50 revised clinical histories. The patients were hospitalized at the E. Rebaglati M. Hospital between April 1983 and March 1988. The purpose of the study was to evaluate the signs and symptoms of the syndrome, as well as the etiological agents and the methodology used for diagnoses. The selection criteria involved patients diagnosed as suffering from "chronic diarrhea of undetermined causes" upon entry. Seven were excluded due to incomplete study whereas 2 were diagnosed as acute infections diarrhea. Forty one patients were definite cases of chronic diarrhea and they were divided between 2 groups: the first one or Chronic Organic Diarrhea (58.53%) and the second one or Chronic Functional Diarrhea (41.46%). Out of the 41 revised clinical histories with chronic diarrhea, the following were the foundings: (1) the syndrome affects the economically active populations mainly and the length of the disease was more than 3 weeks in all the patients; (2) anemia, fever, weight loss, nightime bowel movements and bloody stools suggest organic problems whereas psychiatric disorders, daytime bowel movements, abdominal pain, disease recurrence and absence of detectable organic pathology suggest functional problems; (3) the most common cause of chronic diarrhea is the Irritable Bowel Syndrome followed by infectious diseases, with parasitosis in the first place; and (4) bearing in mind the mainly colonic affection and the predominant infectious diseases, the methodology used for their diagnosis would bring out good results.

Adult↗
PubMed1989

Nosocomial diarrhea associated with enterotoxigenic Clostridium perfringens infection in dogs.

A retrospective analysis of the medical records of 30 consecutive cases of diarrhea occurring in dogs that were hospitalized in a teaching hospital was performed. A prospective analysis of culture results for Clostridium perfringens of dogs with diarrhea were compared with those of a control nondiarrheal group. Hospital-acquired diarrhea in dogs was found to be associated with multiple serotypes of enterotoxigenic Clostridium perfringens. Other potential etiologic agents could not be isolated. Clinical signs were variable, and included mild depression, anorexia, and soft to watery diarrhea with or without frank blood, mucus, and tenesmus. Fever was not present. There were no hematologic or serum biochemical abnormalities, nor were there any consistent virologic or parasitologic findings. Salmonella spp or Campylobacter spp were not identified by fecal culture. No risk factors could be identified. A dog that was euthanatized on the day it developed diarrhea had intestinal histologic findings suggestive of clostridial enteritis. Dogs with diarrhea had significantly higher fecal clostridial counts than did dogs without diarrhea (mean log10 counts +/- SD = 6.34 +/- 1.79 vs 4.75 +/- 2.07). Enterotoxin was found in the feces of 41% of diarrheic dogs but in only 7% of dogs without diarrhea.

Animals↗
PubMed1989

Evaluation of antibiotic-associated diarrhea with a latex agglutination test and cell culture cytotoxicity assay for Clostridium difficile.

Diagnosis of Clostridium difficile (C. difficile) by its antigen or toxin has improved treatment for patients who have antibiotic-associated diarrhea and opportunistic colonization of the colon with C. difficile. Unfortunately, results from the tissue culture cytotoxicity assay are not available for 48 h. We prospectively compared a latex agglutination test with the tissue culture cytotoxicity assay in 83 patients (15 with antibiotic-associated diarrhea, 23 with non-antibiotic-associated diarrhea, and 45 without diarrhea). In the antibiotic-associated diarrhea group, 43% of patients with pseudomembranes and 25% without pseudomembranes tested positive with both tests. In the non-antibiotic groups 92% with diarrhea and 90% without diarrhea were negative with both tests. The number of discordant results illustrates the value of using two tests to identify C. difficile, since additional patients can be identified by using two tests. We found false positives were rare, and C. difficile toxin or antigen could not be detected in more than half the patients with pseudomembranes. The latex agglutination test for C. difficile is reliable, specific, and faster than the tissue culture cytotoxicity assay. The data suggest that other organisms may also be responsible for pseudomembranous colitis, and that negative tests do not obviate the need for visual evaluation of colonic mucosa in suspected cases of antibiotic-associated diarrhea.

Antigens, Bacterial↗
PubMed1968

Bovine viral diarrhea virus and Escherichia coli in neonatal calf enteritis.

This study was initiated to determine the etiologic and pathogenic significance of an American strain of bovine viral diarrhea (BVD) virus (strain NADL-MD) in enteritis of neonatal calves (calf scours). Three colostrum-fed calves from dams exposed intravenously to BVD virus at 6, 16 and 25 days prepartum, respectively, had moderate diarrhea persisting until the eighth day of life. The BVD virus was isolated from all 3 calves and persisted up to 93 days in 1 calf, indicating either that BVD was transmitted in utero or via the dam's milk. Three specific pathogen free (SPF) calves permitted dams' colostrum for the first 4 feedings and then given milk replacer were exposed orally on the day of birth to BVD virus. One calf died of neonatal enteritis 28 hours post-exposure and at necropsy the BVD virus was isolated from several of its organs. The remaining 2 calves had a mild diarrhea persisting to the eighth day of age. Two calves permitted dams' colostrum ad lib. for 72 hours, and then weaned, were exposed orally to BVD virus. Both calves had a mild persistent diarrhea and BVD virus was isolated from their blood for 56 days post-exposure.Of 13 SPF, colostrum-deprived calves exposed orally or intranasally at birth to the BVD virus, 4 had severe diarrhea and died of neonatal enteritis from 38 hours to 13 days postexposure. Isolations of BVD virus were made from several of the organs of the calves at necropsy. All of the 9 surviving calves had a moderate to severe diarrhea frequently persisting for 7 to 10 days, and BVD virus was isolated from the survivors up to 103 days postexposure. Several strains of Escherichia coli were isolated from calves after the second day of life, but were neither pathogenic for mice, nor serologically related to strains of E. coli usually associated with outbreaks of calf scours. Four colostrum-deprived SPF calves were exposed orally at birth to a strain of E. coli isolated from the intestine of the calf with the most acute symptoms and fatal neonatal enteritis. None of the four calves receiving the E. coli had diarrhea. One calf, however, had respiratory distress and died on day 5. Two SPF colostrum-deprived control calves had neither diarrhea nor respiratory distress. The above findings support the conclusion that BVD virus should not be overlooked as a primary cause of the neonatal calf enteritis complex.

Animals↗
PubMed1966

The diarrhea of travelers: incidence in foreign students in the United States.

To ascertain whether foreign visitors to the United States experience the diarrhea of travelers, 215 foreign students matriculating at the University of California, Los Angeles, were interviewed. The attack rate of diarrhea was 14.0 per cent during the first month after arrival in the United States. In a comparison group of 238 U.S. students, the attack rate of diarrhea in one month was 8.4 per cent. The difference in attack rate was not statistically significant. The diarrheal episodes reported by the foreign students were less abrupt in onset, less severe and of longer duration than the usual diarrhea of travelers. The typical severe explosive diarrhea of short duration usually described as "diarrhea of travelers" was not encountered among the foreign students in this study. The occurrence of diarrhea was not associated with the age, sex or race of the students, with the location of eating places, with the geographic area from which the foreign students came or with any characteristics of the trip to the United States. In the group of U.S. students there was an increased incidence of diarrhea among students who came from outside California to Los Angeles.

California↗
PubMed1984

Diarrhea in nonhuman primates: a survey of primate colonies for incidence rates and clinical opinion.

Veterinary clinicians associated with 18 colonies of nonhuman primates were surveyed for their experience with diarrhea disease in colony animals for calendar year 1981. The 1981 diarrhea incidence rate, diarrhea-specific mortality rate and diarrhea case fatality rate for 13,385 monkeys were 10.6%, 1.2% and 11.1%, respectively. It was not possible to incriminate age or type of housing as risk factors for diarrhea, but some species seemed at greater risk than others. Erythrocebus patas monkeys had relatively high diarrhea incidence rates (18.8%) and the highest case fatality rate (48.4%) of all species surveyed. Squirrel monkeys (Saimiri sciureus) and baboons (Papio sp.) had low diarrhea incidence rates (2.1% and 3.2%, respectively). This opinion survey indicated a lack of uniformity among primate clinicians with respect to approaches to diagnosis and therapy of monkey diarrhea. The survey also suggested that many of the agents associated were perceived differently among primate clinicians, and that the roles of some agents are still poorly understood.

Age Factors↗