Lecture 23 - gastrointestinal illness

Question 1

Symptoms of acute gastrointestinal illness

Answer 1

Vomiting, diarrhoea, fever, abdominal pain

Question 2

Viral cause e.g norovirus, rotavirus

Answer 2

Nausea and vomiting

• watery dihorrhea - not bloody
• abdominal cramps
• muscle ache
• low grade fever
• headache
• generally self limiting - over 47
• can have outbreaks

Question 3

Bacterial cause

Answer 3

• Colonisation of intestines and the production of toxins
• clostridium difficle
• escherichia coli
• vibrio cholerae
• Colonisation of intestines invasion of intestinal tissue (may see blood in stool)
• campylobacter jejuni
• salmonella
• escherichia coli
• toxin produced in food and ingested, no infection - food poisoning (generally short lived, symptoms cleared within 1-2 days)
• staphylococcus aureus
• clostridium perfringens

Question 4

Protozoan

Answer 4

• food and water contaminated by human/animal faeces
• symptoms last 4-6 weeks
• diarrhoea, flatulence, abdominal cramps

Question 5

Diseases in new zealand

Answer 5

• Campylobacter - lots of cases, a few hospitalisations but no deaths
• Salmonella - also common, not much hospitlaisation
• Listeriosis - very uncommon but can result in deaths

Question 6

Outbreaks

Answer 6

When there are 2 or more cases from the same cause

• can be from animal GI tract or human GI tract or faeces
• contaminated food and water

-mainly transmitted by faecal oral route

Question 7

Risk factors

Answer 7

• consume at risk products
• contact with farm animal
• consume untreated water
• contact with faecal matter
• contact with symptomatic people
• overseas travel within incubation period
• contact iwth sick animals

Question 8

Bacteria diagnostic tests

Answer 8

1 stool culture - want to confirm the carrier

-grow on sheep blood agar, macconkey agar with lactose, macconkey agar with sorbitol ect.

Question 9

Further complications

Answer 9

Dehydration, bacteraemia, haemolytic uremic syndrome, guillian barre syndrome, reactive arthritis

Question 10

treatment

Answer 10

• Most important - replace fluid, sugar and salt
• easily digestable food
• anti-motility drugs - can be bad if the toxins and bugs are trapped

antibiotics - not usually required, may have small effect on severity and duration of symptoms, however may reduce the numbers shed

• is used for C. difficlie
• salmonella/campylobacter if patient progresses to or risks of systemic infectin

Question 11

Prevention

Answer 11

sanitation, hygiene, effective cooking

-food safety regulations