Post on 30-Dec-2015
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Digestive Diseases
Shigellosis
Staphylococcus aureus food intoxication
Cholera
Shigellosis (Bacillary Dysentery) An acute intestinal disease caused by the
bacterium Shigella
Dysentery means diarrhea with abdominal cramping
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 Endemic in North America, Europe, and the
tropics
Infection is more common in children ages 1-4 years and in the elderly , debilitated and malnourished
The only reservoir for Shigella organism is the human intestinal tract, and infected feces are always the source of the infection
Incubation period is usually 1 to 3 days
Transmission Directly by fecal-oral route transmission or indirectly
through contact with contaminated objects. Widest distribution of the organism is through contaminated
water or food
Transmission occurs primarily through individual who fail to wash their hands or clean their fingernails after defecation
Food can also be contaminated by flies that carry enough of the organism for it to multiply to an infectious dose in food
When dogs ingest human feces, the infection can be passed by them to children or other susceptible persons
Symptoms Shigellae invade the intestinal mucosa and
cause inflammation
In children: usually produces diarrhea, high fever, nausea, vomiting, abdominal pain with distention, irritability, and drowsiness 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
Persons with mild infections usually recover quickly without antibiotic treatment
Many strains of Shigella are resistant to antibiotics If an effective one can be found, then the shigellae can be
eliminated quickly 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 No vaccine at present Control of the human reservoir and sanitary
control of environmental sources through: 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 One of the most common causes of foodborne illness
in the U.S. and the world
S. aureus is a natural inhabitant of the human body and is also responsible for boils and other infections
Occasionally, the reservoir may also be cow with infected udders
Most persons are susceptible to this kind of foodborne illness
Short lasting and rarely fatal
Transmission The illness is caused by ingesting food in
which staphylococci have been multiplying and producing toxin
Staphylococci grow in many foods, especially pre-cooked hams, milk, custards, cream fillings, and salad dressings
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)
Multiple sources, unknown
Vegetables and fuits ShellfishDairy (milk, cheese, butter)
Poultry
Baked goods Salad (potato, egg, other)
38%
20%
2%
2%3%
10%
10%
15%
Symptoms The interval between eating the food and the onset
of symptoms may be as little as 30 minutes or as long as 7 hours Usually the incubation period is 2-4 hrs.
Abrupt and sometimes violent onset, which helps to disntinguish it from other types of foodborne illness
Nausea, vomiting, cramps, and diarrhea are the typical symptoms Loss of fluid and violent vomiting may lead to prostration,
low-grade fever, and lowered blood pressure
Treatment Not necessary unless the individual
becomes dehydrated If dehydration occurs: oral rehydration
in extreme cases: Intravenous (IV) therapy may be used to replace fluids
Prevention Time from preparation of food to serving
needs to be as short as possible
Proper heating or cooling procedures need to be followed
Any individual with boils, or other infected lesions on hands, face, or nose should be prohibited from food handling
Food handlers and others should be educated about food hygiene, sanitation and cleanliness
Cholera
Cholera
Acute gastrointestinal infections caused by Vibrio cholerae
Caused by an exotoxin produced by the organism
Most likely to be found and spread in places with inadequate water treatment, poor sanitation, and inadequate.
Humans are the only know reservoir, although there is a possibility of environmental reservoirs
Transmission Transmitted through feces or vomitus of
carriers or persons with active infections
Epidemic spread usually results from contaminated water supplies
Food is involved more often in sporadic cases in endemic areas
Hands, utensils, clothing, and flies may contaminate food or carry the infection directly to the mouth
Symptoms Infection is often mild or without symptoms, but can
sometimes be severe
Incubation period is generally 2-3 days Communicability lasts as long as the stools are positive , usually only
a few days after recovery
White flecks appear in the stools as they increase (“rice water stools”)
Due to massive loss of fluid, other symptoms occur: Thirst, weakness, sunken eyes, muscle cramps, and cardiovascular
problems
Collapse, shock, and death may follow if the patient is not continuously rehydrated until the infection subsides
Treatment Electrolyte solution must be given
immediately and continuously to replace lost fluids
Mild cases Oral fluid replacement is adequate
Tetracycline and other antibiotics are used if symptoms persist Effective in reducing duration and volume of
diarrhea Speeds the elimination of the bacteria from the
feces
Prevention Proper sanitation and vaccine are the best
methods of prevention Currently, there are two oral cholera vaccines
available
People traveling to epidemic areas in other countries may be required to have a vaccination
Control methods are the same as they are for other diseases acquired through the alimentary route