Infectious Diarrhea

Question 1

3 or more loose or watery stools within a 24 hours period

Answer 1

Diarrhea

Question 2

Timeline for Diarrhea

Acute Diarrhea =
Persistent Diarrhea =
Chronic Diarrhea =

Answer 2

Acute Diarrhea - < 14 days
Persistent Diarrhea - more than 14-30 days
Chronic Diarrhea - > 30 days

Question 3

Presents with blood in loose-watery stools and fever

Answer 3

Inflammatory Diarrhea

Question 4

What is Inflammatory Diarrhea normally secondary to?

Answer 4

Damage to lining of colon due to bacteria or toxins

Question 5

Watery stools with no blood & absence of fever

Answer 5

Non-inflammatory Diarrhea

Question 6

The DOD relies on _____________ as the first-line mitigation technique for Infectious Diarrhea.

Answer 6

Prevention

Question 7

Community Outbreaks are highly suggestive of __________, or ______________.

Answer 7

1) Common Food Source

2) Viral Etiology

Question 8

What are the common contributing factors for Infectious Diarrhea?

Answer 8

1) Lack of access to PLUMBING causing an increase in flies (Vector)
2) Lack of REFRIGERATION
3) Lack of SAFE WATER
4) Inadequate WATER SUPPLY leading to lack of cleaning (handwashing, washing foods/surface, etc)
5) Handwashing not a social norm

Question 9

What are the Bacterial Etiologies for Infectious Diarrhea?

Answer 9

1) Enterotoxigenic E. Coli
2) Campylobacter Jejuni
3) Shigella spp.
4) Salmonella spp.
5) Toxin-Releasing Bacteria

Question 10

What are the Viral Etiologies for Infectious Diarrhea?

Answer 10

1) Noravirus

2) Rotavirus

Question 11

What Viral Etiology for Infectious Diarrhea is more commonly seen in children?

Answer 11

Rotavirus

Question 12

What are the Protozoal Etiologies for Infectious Diarrhea?

Answer 12

1) Giardia

2) Entamoeba Histolytica

Question 13

What time of year does Noravirus activity peak?

Answer 13

During winter

Question 14

How is Noravirus (Viral Infectious Diarrhea) transmitted?

Answer 14

1) Primarily fecal to oral
2) Contaminated food and water
3) Vomitus Aerosols
4) Person to Person Contact

Question 15

What is the incubation period for Noravirus (Viral Infectious Diarrhea)?

Answer 15

12-48 hours

Question 16

What do you suspect?

Patient presents with:

1) Acute onset of Nausea, Vomiting, and non-bloody diarrhea
2) Abdominal cramps
3) Low grade fever
4) Ate raw oysters 12 hours ago with some friends who all have similar signs and symptoms

Answer 16

Noravirus (Viral Infectious Diarrhea)

Question 17

How is E.Coli commonly transmitted?

Answer 17

1) Fecal to Oral route (Contaminated food and water)
2) Person to Person contact
3) Swimming in untreated water
4) Contact with animals/environment

Question 18

What are the main reservoir for Non-Shigatoxigenic Escherichia Coli (AKA EHEC/STEC) pathotypes of bacterial infectious diarrhea?

Answer 18

Humans

Question 19

What is the most common pathotype that causes diarrhea among travelers returning from most regions?

Answer 19

Enterotoxigenic E. coli (ETEC) (AKA Travelers Diarrhea)

Question 20

What bacterial infectious diarrhea has symptoms typically consisting of of acute diarrhea, abdominal pain, fever, and vomiting for 4–7 days.

Answer 20

Salmonella

Question 21

What is the treatment for Salmonella?

Answer 21

1) Oral rehydration

2) Flouroquinolones for patients with severe diarrhea, high fever, or manifestations of extra intestinal infection

Question 22

What is the leading cause of bacterial Infectious Diarrhea worldwide?

Answer 22

Campylobacter

Question 23

What bacterial infectious diarrhea presents with Characterized by diarrhea (frequently bloody), abdominal pain, fever, dehydration, bloodstream infection, and mimic acute appendicitis or ulcerative colitis?

Answer 23

Campylobacter

Question 24

Large Bowel or Small Bowel origin?

larger volume and watery stool with abdominal cramping, bloating and gas

Answer 24

Small Bowel

Question 25

Large Bowel or Small Bowel Origin?

Frequent, smaller volume stools and are often more painful. Fever, bloody stools, or mucus tends to be more common

Answer 25

Large Bowel

Question 26

Timeline of symptoms from food history:

1) Within 6 hours of food consumption – suggests ___________________
2) Between 8 – 16 hours – suggests _____________

3) More than 16 hours – ____________

Answer 26

1) Within 6 hours of food consumption – suggest preformed toxin possibly from S.aureus or B.cereus
2) Between 8 – 16 hours – suggest C.perfringens
3) More than 16 hours suggest viral or other bacterial etiology

Question 27

Infectious Diarrhea after Hiking or outdoor recreation where patient may have drunk stream water is suggestive of ____________.

Answer 27

Giardia

Question 28

Infectious Diarrhea in a patient that recently handled reptiles is suggestive of _________.

Answer 28

Salmonella

Question 29

Infectious Diarrhea in a patient that is on a ship where others have had recent illness is suggestive of __________.

Answer 29

Norovirus