Small Group Viral Enteric Disease

Question 1

1. Define gastroenteritis.

Answer 1

varying degrees of inflammation of the stomach and intestine

Question 2

2. List the viral etiological agents that should be considered.

Answer 2

Rotavirus, Norovirus (calicivirus), astroviruses, adenovirus, coronavirus [enterovirus are not major causes]

Question 3

3. Define and list which enteric viruses causes the most GI illness in young children.

Answer 3

most common enteric viruses causes of GI illness in children: rotavirus (causes extensive, dehydrating diarrhea), norovirus and astrovirus respectively; with the rotavirus vaccine, norovirus has become the most common cause recently

Question 4

4. List any vaccines or antiviral drugs available to treat the viral enteric illnesses listed above.

Answer 4

there are no antivirals available, a rotavirus vaccine was approved in 2006

Question 5

5. Recognize that gastrointestinal illnesses may also be caused by bacteria (Vibrio cholerae, Salmonella, Shigella, Campylobacter, E.coli, etc.) and protozoa (Giardia, Entamoeba and Cryptosporidium).

Answer 5

bacterial causes of GI illness in order of frequency: campylobacter, Salmonella, shigella, E.coli and vibrio

of giardia, entamoeba and cyptosporidum, the last is the most common protozoa cause of GI illness in the US

Question 6

1. Discuss how seasonality, age and epidemiologic features can aid in diagnosis of viral enteric diseases.

Answer 6

rotavirus and norovirus peak in the winter time, norovirus can present year around especially in congregate settings

Question 7

2. List and describe laboratory tests that are appropriate to identify viral enteric infections and assess the utility of each.

Answer 7

available tests are limited, ezyme immnunoassay EIA or latex agglutination test (Rotazyme) are available for detecting rotavirus in stool

microscopic exam of stool for leukocytes (PMNs) in the cases of bacterial infection and looking for Giardia in the stool; bacterial culture can also dx. bacterial infections

in caring for someone with severe dehydration serum electrolytes and BUN/creatine is

Question 8

3. Explain the mechanism of pathogenesis involved in each case below: Rotavirus and Norovirus

Answer 8

rotavirus: local destruction of brush border leading to loss of fluids (transient disaccharide deficiency in intestines) caused by a viral structural protein that has toxin like activity

Question 9

4. Discuss strategies to prevent enteric viral diseases.

Answer 9

vaccinate for rotavirus
wash hands and practice sanitary food preparation practices
wearing gloves/washing hands at daycare, proper disposal of diapers
clean water
breast feeding does provide protective antibodies

Question 10

5. Describe how enteric viruses are transmitted person to person.

Answer 10

enteric viruses are transmitted by the oral fecal route