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Viral gastroenteritis - Coggle Diagram
Viral gastroenteritis
epidemiology
common
children<5yrs
1-5 episodes a year
approx 10% hospitalisations in <18 yrs
healthcare burden
peaks in winter
sporadic cases
outbreaks
food/water contamination
person - person transmission
Causative agents
rotavirus
reovirus
double stranded RNA
serotypes
A,B,C
worldwide
transmission
faecal-oral route
potentially also resp route
survives on hands+fomitess
large amounts of virus in faeces
seasonal peak in earlier months
around april/may/june
pathogenesis
infects enterocytes in villous epi. in jejunum/ileum
cell destruction
movement of fluid into lumen
loss of fluid+salt in faeces
may lose ability to digest food
esp. complex sugars
lactose intolerence
temporary
fusion and repair of villous architecture
enterotoxin
secretory diarrhoea
clinical features
IP=48hrs
most common in <2yrs
diarrhoea
vomiting
fever
dehydration
+/- resp tract symptoms
part. in children
usually self limiting
can be fatal
diagnosis
lateral flow test
PCR
also EM + ELISA
prevention
hand hygiene
environmental cleaning
isolation/cohorting
vaccination
oral
given before 6 mths
norovirus
most common viral for adults
epidemiology
winter vomiting bug
year round occurence
with peaks in cold weather
outbreaks
healthcare facilities
cruises
daycares
hotels
affects all ages
transmission
faecal oral
airborne droplets
projectile vommiting
food/water
contaminated environments/fomites
low infectious dose
18 particles
prolonged shedding in faeces
IP=1-2 days
calicivirus family
single stranded RNA
genogroups G I-V
have multiple genotypes
pathogenesis
blunting of villi in jejunum
epi. cells not damaged
no enterotoxin
short lived immunity
clinical features
acute onset
nausea
vomiting
may be projectile
abd. cramps
myalgia
diarrhoea
+/- fever
may be asymptomatic
diagnosis
PCR
also EM+ELISA
outbreak
contact precautions
isolate
until symptom free 48hrs
dedicate toilets
close room/ward admissions&transfers
environmental cleaning
limit staff and patient movement
adenovirus
double stranded
50 serotypes
type 40&41 cause gastroenteritis
10% acute diarrhoeal illness in <5yrs
also causes
resp inf.
eye inf.
cystitis
myocarditis
diagnosis
PCR
lateral flow
Lab diagnosis
Electron microscopy
not evenly distributed in faeces
not routinely available
expensive
antigen detection
latex agglutination
lateral flow
ELISA
PCR
efficient
rapid
management
supportive
rehydration
preferably oral
electrolyte replacement
refeeding
children
hand hygiene
isolation