CSIM 1.53: Viral Gastroenteritis

Question 1

What are the viruses that cause viral gastroenteritis?

Answer 1

• Rotavirus
  
  • Norovirus

Rarer:
• Astrovirus
• Adenovirus group F
• Sappovirus

Question 2

How are viruses which cause viral gastroenteritis caused?

Answer 2

• Faecal-oral transmission

* Aerosol during severe D&V

Question 3

Where is mortality due to viral gastroenteritis highest? What causes death?

Answer 3

Developing countries - dehydration

Question 4

How is specific diagnosis made on causative agent?

Answer 4

• PCR

* Point of care kits for HCPs to identify strains

Question 5

Who is most affected by rotavirus?

Answer 5

VAST majority are preschool children

Question 6

What is the incubation period of rotavirus and how long does it last?

Answer 6

48 hours, lasts 1 week

Question 7

Describe the rotavirus vaccine

What are the two licensed vaccines?

Answer 7

• Live attenuated
  
  • Oral

Rotarix
  •  For G1P8 strain
  •  2 doses
Rotateq
  •  Includes a human/bovine reassortment
  •  3 doses

Question 8

What adverse effects are possible in rotovirus vaccines?

Answer 8

Intussuseption
• a part of the intestine invaginates (folds into) into another section of intestine, similar to the way the parts of a collapsible telescope retract into one another.

Question 9

Describe the genetic structure of:

1) Norovirus
2) Rotavirus

Answer 9

1) Positive sense single-stranded RNA

2) Double-stranded RNA

Question 10

What is the incubation period of norovirus and how long does it last?

Answer 10

48 hours, lasts for 2 days

Question 11

What are the symptoms of norovirus?

Answer 11

‘winter vomiting bug’
• PREDOMINANTLY severe vomiting
• Some diarrhoea

Question 12

How is a viral outbreak prevented in a ward when vomiting is identified? Consider:

1) Infected patients
2) Infected staff
3) Infection control

Answer 12

1) Isolate in a single room until 48 hours after symptoms end, if there aren’t enough beds available, undergo cohort nursing in an ‘infected’ bay. Send anyone home who does not need to be in hospital.
2) Send home until 48 hours after symptoms have ended

3) • Hand hygiene with SOAP AND WATER.
• Clean potentially contaminated areas and surfaces.
• Provision of PPE (personal protective equipment - apron, gloves) for staff.
• Different staff for infected and uninfected patients
• Close the ward for further admissions