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Gastroenteritis


Overview :

Gastroenteritis is an uncomfortable and inconvenient ailment, but it is rarely life-threatening in the United States and other developed nations. However, an estimated 220,000 children younger than age five are hospitalized with gastroenteritis symptoms in the United States annually. Of these children, 300 die as a result of severe diarrhea and dehydration. In developing nations, diarrheal illnesses are a major source of mortality. In 1990, approximately three million deaths occurred worldwide as a result of diarrheal illness.

The most common cause of gastroenteritis is viral infection. Viruses such as rotavirus, adenovirus, astrovirus, and calicivirus and small round-structured viruses (SRSVs) are found all over the world. Exposure typically occurs through the fecal-oral route, such as by consuming foods contaminated by fecal material related to poor sanitation. However, the infective dose can be very low (approximately 100 virus particles), so other routes of transmission are quite probable.

Typically, children are more vulnerable to rotaviruses, the most significant cause of acute watery diarrhea. Annually, worldwide, rotaviruses are estimated to cause 800,000 deaths in children below age five. For this reason, much research has gone into developing a vaccine to protect children from this virus. Adults can be infected with rotaviruses, but these infections typically have minimal or no symptoms.

Children are also susceptible to adenoviruses and astroviruses, which are minor causes of childhood gastroenteritis. Adults experience illness from astroviruses as well, but the major causes of adult viral gastroenteritis are the caliciviruses and SRSVs. These viruses also cause illness in children. The SRSVs are a type of calicivirus and include the Norwalk, Southhampton, and Lonsdale viruses. These viruses are the most likely to produce vomiting as a major symptom.

Bacterial gastroenteritis is frequently a result of poor sanitation, the lack of safe drinking water, or contaminated food-conditions common in developing nations. Natural or man-made disasters can make underlying problems in sanitation and food safety worse. In developed nations, the modern food production system potentially exposes millions of people to disease-causing bacteria through its intensive production and distribution methods. Common types of bacterial gastroenteritis can be linked to Salmonella and Campylobacter bacteria; however, Escherichia coli 0157 and Listeria monocytogenes are creating increased concern in developed nations. Cholera and Shigella remain two diseases of great concern in developing countries, and research to develop long-term vaccines against them is underway.




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