Transcript Digestive Diseases

Digestive Diseases
Shigellosis
Staphylococcus aureus food intoxication
Cholera
Shigellosis (Bacillary Dysentery)
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An acute intestinal disease caused by the bacterium
Shigella
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Dysentery means diarrhea with abdominal cramping
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The term bacillary dysentery is reserved for infection
by the four species of Shigella: S. dysenteriae, S. flexneri, S.
boydii, and S. sonnei
Shigellosis contiued
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Endemic in North America, Europe, and the tropics
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Infection is more common in children ages 1-4 years and
in the elderly , debilitated and malnourished
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The only reservoir for Shigella organism is the human
intestinal tract, and infected feces are always the source of
the infection
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Incubation period is usually 1 to 3 days
Transmission
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Directly by fecal-oral route transmission or indirectly through
contact with contaminated objects.
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Widest distribution of the organism is through contaminated water
or food
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Transmission occurs primarily through individual who fail to
wash their hands or clean their fingernails after defecation
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Food can also be contaminated by flies that carry enough of
the organism for it to multiply to an infectious dose in food
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When dogs ingest human feces, the infection can be passed by
them to children or other susceptible persons
Symptoms
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Shigellae invade the intestinal mucosa and cause
inflammation
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In children: usually produces diarrhea, high fever, nausea,
vomiting, abdominal pain with distention, irritability, and
drowsiness
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Pus, mucus, and blood may appear in stools as a result of the
intestinal ulceration (typical of this infection)
In adults: produces many of the same symptoms except
that adults generally do not have fever
Treatment
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Persons with mild infections usually recover quickly without
antibiotic treatment
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Many strains of Shigella are resistant to antibiotics
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If an effective one can be found, then the shigellae can be eliminated
quickly
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When many persons in a community are affected by shigellosis, antibiotics
are sometimes used to treat only the most severe cases
The antibiotics commonly used for treatment are ampicillin,
trimethoprim/sulfamethoxazole (also known as Bactrim* or Septra*),
ceftriaxone (Rocephin*), or, among adults, ciprofloxacin
Some antidiarrheal drugs can make the illness worse and
should be avoided
Prevention

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No vaccine at present
Control of the human reservoir and sanitary control of
environmental sources through:
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Adequate treatment of water and sewage, fly control and
protection of food, water, and milk from human or mechanical
vectors
Staphylococcus aureus
Food Intoxication
Staphylococcus Aureus Food Intoxication
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One of the most common causes of foodborne illness in the
U.S. and the world
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S. aureus is a natural inhabitant of the human body and is also
responsible for boils and other infections
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Occasionally, the reservoir may also be cow with infected
udders
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Most persons are susceptible to this kind of foodborne illness
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Short lasting and rarely fatal
Transmission
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The illness is caused by ingesting food in which
staphylococci have been multiplying and producing toxin
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Staphylococci grow in many foods, especially pre-cooked
hams, milk, custards, cream fillings, and salad dressings
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Source of food contamination is usually a person with an
infected lesion on the hands, arms, and face
Foods implicated in staphylococcal outbreaks
reported to CDC during a 5 year period
Meat (ham, pork, beef)
15%
38%
10%
Multiple sources,
unknown
Vegetables and fuits
Shellfish
10%
20%
3%
2%
2%
Dairy (milk, cheese,
butter)
Poultry
Symptoms
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The interval between eating the food and the onset of
symptoms may be as little as 30 minutes or as long as 7
hours
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Usually the incubation period is 2-4 hrs.
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Abrupt and sometimes violent onset, which helps to
disntinguish it from other types of foodborne illness
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Nausea, vomiting, cramps, and diarrhea are the typical
symptoms
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Loss of fluid and violent vomiting may lead to prostration, lowgrade fever, and lowered blood pressure
Treatment
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Not necessary unless the individual becomes
dehydrated
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If dehydration occurs: oral rehydration
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in extreme cases: Intravenous (IV) therapy may be
used to replace fluids
Prevention
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Time from preparation of food to serving needs to be as
short as possible
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Proper heating or cooling procedures need to be
followed
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Any individual with boils, or other infected lesions on
hands, face, or nose should be prohibited from food
handling
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Food handlers and others should be educated about food
hygiene, sanitation and cleanliness
Cholera
Cholera
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Acute gastrointestinal infections caused by Vibrio cholerae
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Caused by an exotoxin produced by the organism
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Most likely to be found and spread in places with
inadequate water treatment, poor sanitation, and
inadequate.
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Humans are the only know reservoir, although there is a
possibility of environmental reservoirs
Transmission
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Transmitted through feces or vomitus of carriers or
persons with active infections
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Epidemic spread usually results from contaminated water
supplies
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Food is involved more often in sporadic cases in endemic
areas
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Hands, utensils, clothing, and flies may contaminate food
or carry the infection directly to the mouth
Symptoms
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Infection is often mild or without symptoms, but can sometimes be
severe
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Incubation period is generally 2-3 days
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Communicability lasts as long as the stools are positive , usually only a
few days after recovery
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White flecks appear in the stools as they increase (“rice water
stools”)
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Due to massive loss of fluid, other symptoms occur:
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Thirst, weakness, sunken eyes, muscle cramps, and cardiovascular
problems
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Collapse, shock, and death may follow if the patient is not continuously
rehydrated until the infection subsides
Treatment
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Electrolyte solution must be given immediately and
continuously to replace lost fluids
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Mild cases
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Oral fluid replacement is adequate
Tetracycline and other antibiotics are used if symptoms
persist
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Effective in reducing duration and volume of diarrhea
Speeds the elimination of the bacteria from the feces
Prevention
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Proper sanitation and vaccine are the best methods of
prevention
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Currently, there are two oral cholera vaccines available
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People traveling to epidemic areas in other countries may
be required to have a vaccination
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Control methods are the same as they are for other
diseases acquired through the alimentary route