Etiology Of Gastroenteritis Research Articles

Etiology of Diarrhea in a Rural Community in Western Thailand: Importance of Enteric Viruses and Enterovirulent Escherichia coli

The etiology of gastroenteritis was determined in children and adults with diarrhea seen at a district hospital and three government health clinics in Suan Phung, western Thailand, in 1991. Enteric viruses (rotavirus and astrovirus) were identified in 40%, shigellae in 18%, attaching and effacing Escherichia coli in 13%, Campylobacter jejuni in 9%, and enterotoxigenic E. coli in 7% of children < 5 years old with diarrhea seen at the hospital. Enteric viruses were detected in 15% (24/156) of patients with diarrhea > or = 5 years old and were the only enteric pathogens identified in 12 patients ages 7-79 years (2 astrovirus, 10 rotavirus infections). Attaching and effacing E. coli, rotavirus, and astrovirus were potential causes of diarrhea in children and adults in this population.

Small round gastroenteritis viruses

All of the SRGVs are recognized by electron microscopic examination of the feces. However, this is not a sensitive test for the etiology of gastroenteritis. The Norwalk virus, Snow Mountain agent, caliciviruses, and astroviruses are detectable by assays employing their immunoelectronmicroscopy, RIA, or avidin-biotin techniques. These essays are available as research tools in only a handful of centers around the world. Rapid diagnostic tests and methods for culture are needed, particularly for classification of these ubiquitous agents and development of measures preventive of disease.

Gastroenteritis etiology in a university hospital during 1983.

This paper reports the results of a microbiological study of the patients seen with diarrhea at the Hospital de la Santa Creu i Sant Pau (Barcelona) through 1983. Two thousand seven hundred sixty three specimens were studied in search of an enteropathogenic bacteria, 1341 were submitted to parasitologic study and 684 to rotavirus search. Two hundred fifty one Salmonella spp., 233 C. jejuni, 152 Shigella spp., 47 Yersinia spp., 96 G. intestinalis and 181 positive Rotavirus specimens were detected. Data about efficacy of the methods employed, seasonal and age incidence and sensitivity to the antimicrobials of the bacterial isolated strains are reported.

Detection of enteric adenoviruses by dot-blot hybridization using a molecularly cloned viral DNA probe.

Enteric adenoviruses (EAds) (candidate adenoviruses 40 and 41, subgroups F and G) have been implicated in the etiology of gastroenteritis in infants, but their clinical significance has been unclear because a rapid test to distinguish these agents from other adenovirus (Ad) types has not been available. We developed a dot-blot hybridization assay for EAd DNA using a cloned DNA fragment that has little homology to non-EAd DNAs. The dot-blot system detected less than 20 pg of EAd DNA, while showing minimal cross hybridization to representative strains from all other Ad groups. There was no detectable hybridization to extracts of samples known to contain other enteric viruses. It was further shown that low levels of EAds in specimens could be amplified by culturing for 1 day in 293 cells. Stool samples and tissue culture lysates prescreened by electron microscopy, cell culture or ELISA were tested in a blind fashion. Using endonuclease analysis as the standard for typing the isolates, we found the dot-blot system to have a 91% sensitivity and 71% specificity for detecting EAds and distinguishing them from other Ads. False-positive and equivocal dot-blot results appeared to be caused by other Ads.

Occurrence of viruses in human stools in the Ahaggar (Alberia).

From October 1977 to May 1980, 243 stools collected in sedentary and semi-nomadic populations of the Ahaggar (Algerian Sahara) were examined using immunoelectronmicroscopy and tissue culture inoculation. Immunoelectronmicroscopy revealed the presence of rotaviruses in 8, coronaviruses in 26, adenoviruses in 5 and small round viruses in 4. Enteroviruses were isolated in tissue culture from 24 stools. Rotaviruses were present in the Ahaggar but were associated with little acute enteric disease. The high frequency of coronaviruses both in gastroenteritis patients and in patients without disease was surprising. The prevalence of enteroviruses in this hyperarid zone was similar to or higher than that found in noticeably more human countries. Further systematic bacterial, viral and parasitic examinations are required to clarify the role of the above viruses in the aetiology of gastroenteritis in this region.

The relative importance of rotavirus and other pathogens in the etiology of gastroenteritis in Trinidadian children.

Over a 2-year period, 300 infants less than 3 years old with gastroenteritis admitted to hospitals in Trinidad were investigated for the presence of certain microorganisms in the feces, along with an equal number of age- and sex-matched controls. Rotavirus was detected in 23% of cases and 1% of controls; Salmonella in 7% of cases and in 1% of controls; Shigella in 4% of cases and in no controls and two serotypes of enteropathogenic E. coli in 7% of cases and in 2% of controls. Campylobacter fetus subspecies jejuni was cultured from 7 out of 60 cases and from 1 of 60 controls. Enterotoxigenic E. coli, most strains of enteropathogenic E. coli, cytopathic enteroviruses and adenoviruses and fecal parasites were not significantly associated with diarrhea. Rotaviruses were detected throughout the year but were more prevalent in the dry than in the rainy season. They were found less often in children younger than 6 months than in those aged 6 to 35 months and were present in 6 of the 20 children who died.

TRAVELERS' DIARRHEA AMONG UNITED STATES MARINES IN SOUTH KOREA

A battalion of United States Marines traveling to South Korea in the spring of 1976 was studied to determine the incidence and etiology of gastroenteritis. During the three weeks they visited South Korea, 21% of 694 marines developed diarrhea. Stool and serum specimens collected before, during, and after their stay were examined for evidence of infection with Salmonella, Shigella, and Vibrio species, enterotoxigenic and invasive Escherichia coli, reovirus-like agent (RVLA), and intestinal ova and parasites. Infections with these agents were uncommon; 91% of 44 closely studied cases of gastorenteritis were unexplained. Five per cent of 169 marines had serologic evidence of recent infection with RVLA, and 3% of 273 marines had serologic evidence of infection with heat-labile enterotoxin producing E. coli over an eight-week period. However, infections with these agents were not associated with most cases of diarrhea in South Korea. It is concluded that infectious agents previously thought responsible for travelers' diarrhea were not responsible for gastroenteritis among United States Marines arriving in a temperate climate.

THE ARTIFICIAL COOLING OF SICK-ROOMS IN SUMMER

The mortality of gastro-enteritis in infants, despite all scientific efforts devoted to its amelioration, is so appalling, that each summer, in addition to employing what is best in the old methods of treatment, we attempt to devise newer and better ways of combating this formidable disease. It was with this in view that during my summer service of 1913, an endeavor was made to attack this malady in a way entirely different from any previously undertaken. The etiology of gastro-enteritis has been and will be for years to come a much discussed subject. Without reiterating the well known conclusions of many pediatrists, based on theoretical considerations and practical observations, let us state that in our opinion also, gastro-enteritis is probably primarily a nutritional disorder, having as a secondary causal factor a bacteriologic basis. Both of these factors operate in winter as well as in summer. To account, then, for the