Infectious Diarrheal Diseases Research Articles

The impact of antibiotics on the gut microbiota of children recovering from watery diarrhoea

Infectious diarrhoeal diseases remain a substantial health burden in young children in low- and middle-income countries. The disease and its variable treatment options significantly alter the gut microbiome, which may affect clinical outcomes and overall gut health. Antibiotics are often prescribed, but their impact on the gut microbiome during recovery is unclear. Here, we used 16S rRNA sequencing to investigate changes in the gut microbiota in Vietnamese children with acute watery diarrhoea, and highlight the impact of antibiotic treatment on these changes. Our analyses identified that, regardless of treatment, recovery was characterised by reductions in Streptococcus and Rothia species and expansion of Bacteroides/Phocaeicola, Lachnospiraceae and Ruminococcacae taxa. Antibiotic treatment significantly delayed the temporal increases in alpha- and beta-diversity within patients, resulting in distinctive patterns of taxonomic change. These changes included a pronounced, transient overabundance of Enterococcus species and depletion of Bifidobacterium pseudocatenulatum. Our findings demonstrate that antibiotic treatment slows gut microbiota recovery in children following watery diarrhoea.

Norovirus in children under 2 years of age: an epidemiological study in Panama during the COVID-19 pandemic.

Norovirus infection is a common cause of acute gastroenteritis (AGE). Surveillance activities are important to aid investigation into effective norovirus control strategies, including vaccination. Here, we report ancillary findings related to the incidence, prevalence, and etiology of AGE caused by norovirus in Panama after adjustment of study methodology to comply with national coronavirus disease 2019 (COVID-19) mandates. In January 2020, children aged <2 years began enrolling into an epidemiological study in Panama to estimate the burden of norovirus in preparation for evaluating upcoming prevention strategies. This included an observational, longitudinal, community-based AGE surveillance study and a hospital-based AGE surveillance study. For the longitudinal study, healthy children aged 5-18 months were enrolled from January 6 through March 23, 2020, with a follow-up of approximately 6 months. The last participant was contacted on September 23, 2020. For the hospital-based study, starting on January 21, 2020, children aged <2 years who were admitted to the Hospital del Niño Dr. José Renán Esquivel in Panama City due to AGE were evaluated. The last sample was collected on September 29, 2020. Collected stool samples were tested for norovirus as well as astrovirus, sapovirus, and various enteropathogens. Unfortunately, this study was disrupted by the subsequent implementation of disease transmission control procedures for the COVID-19 pandemic, and the study methodology was revised to comply with COVID-19 mandates. In the longitudinal surveillance cohort [N = 400 (Chiriquí, n = 239; Panama, n = 161)], a total of 185 AGE episodes were documented (Chiriquí, n = 85; Panama, n = 100) resulting in an overall AGE incidence of 11.6 (95% CI: 9.99-13.4) episodes per 100 child-months. The norovirus-related AGE incidence was 0.3 (95% CI: 0.10-0.73) episodes per 100 child-months (5/185 AGE episodes) and the prevalence of norovirus was 4.6% (13/282 stool samples collected). In the hospital-based surveillance cohort, at least one pathogen was detected in 50% of samples (44/88 stool samples collected) and norovirus prevalence was 6.8% (6/88 stool samples collected). This report demonstrates how the occurrence of the COVID-19 pandemic hindered the conduct of clinical trials. However, this also created unique research opportunities to investigate the potential impact of pandemic control measures on the etiology of infectious diarrheal disease.

Citrobacter rodentium possesses a functional type II secretion system necessary for successful host infection

ABSTRACT Infectious diarrheal diseases are the third leading cause of mortality in young children, many of which are driven by Gram-negative bacterial pathogens. To establish successful host infections these pathogens employ a plethora of virulence factors necessary to compete with the resident microbiota, and evade and subvert the host defenses. The type II secretion system (T2SS) is one such conserved molecular machine that allows for the delivery of effector proteins into the extracellular milieu. To explore the role of the T2SS during natural host infection, we used Citrobacter rodentium, a murine enteric pathogen, as a model of human intestinal disease caused by pathogenic Escherichia coli such as Enteropathogenic and Enterohemorrhagic E. coli (EPEC and EHEC). In this study, we determined that the C. rodentium genome encodes one T2SS and 22 potential T2SS-secreted protein effectors, as predicted via sequence homology. We demonstrated that this system was functional in vitro, identifying a role in intestinal mucin degradation allowing for its utilization as a carbon source, and promoting C. rodentium attachment to a mucus-producing colon cell line. During host infection, loss of the T2SS or associated effectors led to a significant colonization defect and lack of systemic spread. In mice susceptible to lethal infection, T2SS-deficient C. rodentium was strongly attenuated, resulting in reduced morbidity and mortality in infected hosts. Together these data highlight the important role of the T2SS and its effector repertoire during C. rodentium pathogenesis, aiding in successful host mucosal colonization.

Predictive modeling for infectious diarrheal disease in pediatric populations: A systematic review.

Diarrhea is still a significant global public health problem. There are currently no systematic evaluation of the modeling areas and approaches to predict diarrheal illness outcomes. This paper reviews existing research efforts in predictive modeling of infectious diarrheal illness in pediatric populations. We conducted a systematic review via a PubMed search for the period 1990-2021. A comprehensive search query was developed through an iterative process and literature on predictive modeling of diarrhea was retrieved. The following filters were applied to the search results: human subjects, English language, and children (birth to 18 years). We carried out a narrative synthesis of the included publications. Our literature search returned 2671 articles. After manual evaluation, 38 of these articles were included in this review. The most common research topic among the studies were disease forecasts 14 (36.8%), vaccine-related predictions 9 (23.7%), and disease/pathogen detection 5 (13.2%). Majority of these studies were published between 2011 and 2020, 28 (73.7%). The most common technique used in the modeling was machine learning 12 (31.6%) with various algorithms used for the prediction tasks. With change in the landscape of diarrheal etiology after rotavirus vaccine introduction, many open areas (disease forecasts, disease detection, and strain dynamics) remain for pathogen-specific predictive models among etiological agents that have emerged as important. Additionally, the outcomes of diarrheal illness remain under researched. We also observed lack of consistency in the reporting of results of prediction models despite the available guidelines highlighting the need for common data standards and adherence to guidelines on reporting of predictive models for biomedical research. Our review identified knowledge gaps and opportunities in predictive modeling for diarrheal illness, and limitations in existing attempts whilst advancing some precursory thoughts on how to address them, aiming to invigorate future research efforts in this sphere.

Identification of potent anti-Cryptosporidium new drug leads by screening traditional Chinese medicines.

Cryptosporidium spp. are gastrointestinal opportunistic protozoan parasites that infect humans, domestic animals, and wild animals all over the world. Cryptosporidiosis is the second leading infectious diarrheal disease in infants less than 5 years old. Cryptosporidiosis is a common zoonotic disease associated with diarrhea in infants and immunocompromised individuals. Consequently, cryptosporidiosis is considered a serious economic, veterinary, and medical concern. The treatment options for cryptosporidiosis are limited. To address this problem, we screened a natural product library containing 87 compounds of Traditional Chinese Medicines for anti-Cryptosporidium compounds that could serve as novel drug leads and therapeutic targets against C. parvum. To examine the anti-Cryptosporidium activity and half-maximal inhibitory doses (EC50) of these compounds, we performed in vitro assays (Cryptosporidium growth inhibition assay and host cell viability assay) and in vivo experiments in mice. In these assays, the C. parvum HNJ-1 strain was used. Four of the 87 compounds (alisol-A, alisol-B, atropine sulfate, and bufotalin) showed strong anti-Cryptosporidium activity in vitro (EC50 values = 122.9±6.7, 79.58±13.8, 253.5±30.3, and 63.43±18.7 nM, respectively), and minimum host cell cytotoxicity (cell survival > 95%). Furthermore, atropine sulfate (200 mg/kg) and bufotalin (0.1 mg/kg) also showed in vivo inhibitory effects. Our findings demonstrate that atropine sulfate and bufotalin are effective against C. parvum infection both in vitro and in vivo. These compounds may, therefore, represent promising novel anti-Cryptosporidium drug leads for future medications against cryptosporidiosis.

Structural elucidation of the O-antigen polysaccharide from Escherichia coli O125ac and biosynthetic aspects thereof.

Enteropathogenic Escherichia coli O125, the cause of infectious diarrheal disease, is comprised of two serogroups, viz., O125ab and O125ac, which display the aggregative adherence pattern with epithelial cells. Herein, the structure of the O-antigen polysaccharide from E. coli O125ac:H6 has been elucidated. Sugar analysis revealed the presence of fucose, mannose, galactose and N-acetyl-galactosamine as major components. Unassigned 1H and 13C NMR data from one- and two-dimensional NMR experiments of the O125ac O-antigen in conjunction with sugar components were used as input to the CASPER program, which can determine polysaccharide structure in a fully automated way, and resulted in the following branched pentasaccharide structure of the repeating unit: →4)[β-d-Galp-(1→3)]-β-d-GalpNAc-(1→2)-α-d-Manp-(1→3)-α-l-Fucp-(1→3)-α-d-GalpNAc-(1→, where the side chain is denoted by square brackets. The proposed O-antigen structure was confirmed by 1H and 13C NMR chemical shift assignments and determination of interresidue connectivities. Based on this structure, that of the O125ab O-antigen, which consists of hexasaccharide repeating units with an additional glucosyl group, was possible to establish in a semi-automated fashion by CASPER. The putative existence of gnu and gne in the gene clusters of the O125 serogroups is manifested by N-acetyl-d-galactosamine residues as the initial sugar residue of the biological repeating unit as well as within the repeating unit. The close similarity between O-antigen structures is consistent with the presence of two subgroups in the E. coli O125 serogroup.

Evidence of Community-Wide Spread of Multi-Drug Resistant Escherichia coli in Young Children in Lusaka and Ndola Districts, Zambia.

Increased antimicrobial resistance (AMR) has been reported for pathogenic and commensal Escherichia coli (E. coli), hampering the treatment, and increasing the burden of infectious diarrhoeal diseases in children in developing countries. This study focused on exploring the occurrence, patterns, and possible drivers of AMR E. coli isolated from children under-five years in Zambia. A hospital-based cross-sectional study was conducted in the Lusaka and Ndola districts. Rectal swabs were collected from 565 and 455 diarrhoeic and healthy children, respectively, from which 1020 E. coli were cultured and subjected to antibiotic susceptibility testing. Nearly all E. coli (96.9%) were resistant to at least one antimicrobial agent tested. Further, 700 isolates were Multi-Drug Resistant, 136 were possibly Extensively-Drug Resistant and nine were Pan-Drug-Resistant. Forty percent of the isolates were imipenem-resistant, mostly from healthy children. A questionnaire survey documented a complex pattern of associations between and within the subgroups of the levels of MDR and socio-demographic characteristics, antibiotic stewardship, and guardians’ knowledge of AMR. This study has revealed the severity of AMR in children and the need for a community-specific-risk-based approach to implementing measures to curb the problem.

A 2-Phase Survey to Assess a Facility's Readiness for Pediatric Essential Emergency and Critical Care in Resource-Limited Settings: A Literature Review and Survey Development.

Infectious diseases, including pneumonia, malaria, and diarrheal diseases, are the leading causes of death in children younger than 5 years worldwide. The vast majority of these deaths occur in resource-limited settings where there is significant variation in the availability and type of human, physical, and infrastructural resources. The ability to identity gaps in healthcare systems that may hinder their ability to deliver care is an important step to determining specific interventions for quality improvement. Our study objective was to develop a comprehensive, digital, open-access health facility survey to assess facility readiness to provide pediatric critical care in resource-limited settings (eg, low- and lower middle-income countries). A literature review of existing facility assessment tools and global guidelines was conducted to generate a database of survey questions. These were then mapped to one of the following 8 domains: hospital statistics, services offered, operational flow, facility infrastructure, staff and training, medicines and equipment, diagnostic capacity, and quality of clinical care. A 2-phase survey was developed and an iterative review process of the survey was undertaken with 12 experts based in low- and middle-income countries. This was built into the REDCap Mobile Application for electronic data capture. The literature review process yielded 7 facility assessment tools and 7 global guidelines for inclusion. After the iterative review process, the final survey consisted of 11 sections with 457 unique questions in the first phase, "environmental scan," focusing on the infrastructure, availability, and functionality of resources, and 3 sections with 131 unique questions in the second phase, "observation scan," focusing on the level of clinical competency. A comprehensive 2-phase survey was created to evaluate facility readiness for pediatric critical care. Results will assist hospital administrators and policymakers to determine priority areas for quality improvement, enabling them to implement a Plan-Do-Study-Act cycle to improve care for the critically ill child.

Exploring the Association Between Infectious Diarrheal Diseases and Sea Surface Temperatures - Coastal Areas of China, 2009-2018.

What is already known about this topic?Coastal areas of China have a higher reported incidence of other infectious diarrheal diseases (OIDD; excluding cholera, dysentery, typhoid, and paratyphoid) than inland areas of China.What is added by this report?The incidence of OIDD in high latitude coastal provincial-level administrative divisions (PLADs) near Bohai Sea was positively correlated with sea surface temperatures (SSTs), while in coastal PLADs near the South China Sea was negatively correlated.What are the implications for public health practice?The marine environmental risk factors acquired by remote sensing provide a new way for diseases surveillance and early warning. SSTs can be employed as predictor of OIDD in some coastal areas in China.

Development of a Self-Adjuvanting, Cross-Protective, Stable Intranasal Recombinant Vaccine for Shigellosis.

With the acquirement of antibiotic resistance, Shigella has resulted in multiple epidemics of shigellosis, an infectious diarrheal disease, causing thousands of deaths per year. Unfortunately, there are no licensed vaccines, primarily due to low or serotype-specific immunogenicity. Thus, conserved subunit vaccines utilizing recombinant invasion plasmid antigens (Ipa) have been explored as cross-protective vaccine candidates. However, achieving cross-protection against Shigella dysenteriae 1, which caused multiple pandemics/epidemics in the recent past, has been difficult. Therefore, a rational approach to improve cross-protection in the preparation for a possible pandemic should involve conserved proteins from S. dysenteriae 1 (Sd1). IpaC is one such conserved immunogenic protein that is less explored as an independent vaccine due to its instability/aggregation. Therefore, to improve cross-protection and potential immunogenicity and to be prepared for a future epidemic/pandemic, herein, we stabilized recombinant Sd1 IpaC, expressed without its chaperone, using a previously reported stabilizing detergent (LDAO) in a modified protocol and assessed its vaccine potential without an adjuvant. The protein assembled into heterogeneous complex spherical structures in the presence of LDAO and showed improved stability at storage temperatures of -80, -20, 4, 25, and 37 °C while providing enhanced yield and concentration. The protein could also be stably lyophilized and reconstituted, increasing the convenience of transportation and storage. Upon intranasal administration in BALB/c mice, the stabilized-IpaC-immunized groups generated significant antibody response and were not only protected against a high intraperitoneal dose of homologous S. dysenteriae 1 but also showed 100% survival against heterologous Shigella flexneri 2a without an adjuvant, while the control animals showed visible diarrhea (bloody-Sd1 challenge), lethargy, and weight loss with 0% survival. Overall, this work demonstrates that stabilized IpaC can be explored as a minimalist, self-adjuvanting, cross-protective, intranasal, single-antigen Shigella vaccine.

Infectious Diarrhea, as a Valid Medical and Public, Worldwide Health Problematic

Acute diarrhea of infec­tious etiology, referred to gastroenteri­tis and is associated with clinical signs and symptoms including: nausea, vomiting, abdomi­nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur­gency disorders [10]. Diarrheal illness is a problem worldwide, with substantial regional variation in the prevalence of specific pathogens [8]. In fact, Infectious diarrheal diseases, are the second leading cause of morbidity and mortality worldwide and can cause real public health problems. Such diarrhea was studied as a medical disorder, in a 3 year period, 2017-2020, in Transylvania region from Romania. It was found 3577 number of cases, almost during July to August. The case incidence for the disease arrived at 65%, in the entire summer season. The data were transmitted by 12 district Sanitary Polices, to the Public Health Center. This all were mostly diagnosed by the territorial family doctors and more than 50% , have need some days of hospitalization, because of several disease disorders. For this disorders it was used a specific adequate fluid and electrolyte replacement as key of the treatment, to managing diarrheal illnesses. Even so, 3 children under 5 year’s age died, because of severe complications. Organic failed was estimate to be the cause of their deaths. Clinical and epidemiological evaluation defined the severity and type of this illnesses. The detected infectious etiology for the acute diarrhea, where determined in authorized Microbiology laboratories, and there were identified: Shigella spp, Salmonella spp, Campylobacter spp, Yersinia spp, Rotavirus, Giardia. Most number of cases appeared in children in 63%, followed by elderly or adult people in 17% each, all data as quantified number of determined infectious diarrheas. Acute diarrheal illness had to be considered a major public health issue, against which control efforts are needed. Public health surveillance of infectious acute diarrhea, includes obligatory strategies of infection control. Good hygiene, hand washing, safe food preparation, and access to clean water are key factors in preventing diarrheal illness

Diarrheal pathogens trigger rapid evolution of the guanylate cyclase-C signaling axis in bats

The pathogenesis of infectious diarrheal diseases is largely attributed to enterotoxins that cause dehydration by disrupting intestinal water absorption. We investigated patterns of genetic variation in mammalian guanylate cyclase-C (GC-C), an intestinal receptor targeted by bacterially encoded heat-stable enterotoxins (STa), to determine how host species adapt in response to diarrheal infections. Our phylogenetic and functional analysis of GC-C supports long-standing evolutionary conflict with diarrheal bacteria in primates and bats, with highly variable susceptibility to STa across species. In bats, we further show that GC-C diversification has sparked compensatory mutations in the endogenous uroguanylin ligand, suggesting an unusual scenario of pathogen-driven evolution of an entire signaling axis. Together, these findings suggest that conflicts with diarrheal pathogens have had far-reaching impacts on the evolution of mammalian gut physiology.

Study of Infectious Diarrheas, in Transylvania – Romania

“Diarrhea” is an alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Acute diarrhea of infec¬tious etiology, often referred to as gastroenteri¬tis and is typically associated with clinical signs and symptoms including: nausea, vomiting, abdomi¬nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur¬gency. Infectious diarrheal diseases are the second leading cause of morbidity and mortality worldwide. It is the diarrhea we have also found out during a large 3 yeas study 2017-2020 in Transylvania – Romania. 3577 number of cases were transmitted during this time by the 12 territory sanitary polices, to the Epidemiology Department from the Public Health Center Cluj. These were mostly diagnosed by the territorial family doctors in the region and more then 20%, have need hospitalization, for several days, because of the mentioned disease disorders 3 children died during this time, because of severe complications. The detected infectious microbial etiology, were determined in authorized laboratories, in which it was identified: Shigella spp, Salmonella spp Campylobacter spp, and Yersinia spp. or Rotavirus Giardia, and Fungi species. Most number of cases appeared in children, followed by elderly or adult people, as quantified number of determination.

Infectious Diarrhea, a Public Health Problem in Population

Infec­tious etiology in acute diarrhea, referred several gastrointestinal diseases, Most are gastroenteri­tis associated with clinical signs and symptoms including: nausea, vomiting, abdomi­nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur­gency disorders. Diarrheal illness is a large worldwide public health problem, with substantial regional variation, in the prevalence of medical signs by being caused by specific pathogens. Infectious diarrheal diseases, are the second leading cause of morbidity and mortality worldwide and can cause real public health concerns. Such diarrhea was studied as a medical disorder, in a 3 years period, 2017 to 2020, in Transylvania a large region in Romania. It was found there, 3577 number of diarrheal diseases cases, appeared almost during July to August. The case incidence for the disease arrived at 65%, in the entire summer season. The cases data were transmitted by 12 district Sanitary Polices, to the Public Health Center Cluj. Cases were almost diagnosed by the family doctors of the region, in more then 50%. Few of this have need some days of hospitalization, because of several disease disorders, in which case it was used a specific adequate fluid and electrolyte replacement as key of the treatment, for managing diarrheal illnesses. Even so, 3 children under 5 years age died, because of severe complications. It was remarked so, organic failed who was estimate to be the cause of their deaths. Clinical and epidemiological evaluations were done and even defined the severity and type of this mentioned illnesses. The detected infectious etiology for the acute diarrheas, where determined in authorized Microbiology laboratories, where were identified: Shigella spp, Salmonella spp, Campylobacter spp, Yersinia spp, Rotavirus, Giardia. Most number of cases appeared in children, being suggestive in 63%, followed by elderly or adult people in 17% each. Acute diarrheal illness had to be considered a major public health issue, against which some determined control efforts are needed. Public health surveillance of infectious acute diarrhea, includes obligatory done strategies for a correct infection control.

Infectious Diarrhea, a Public Health Problem in Population

Infec­tious etiology in acute diarrhea, referred several gastrointestinal diseases, Most are gastroenteri­tis associated with clinical signs and symptoms including: nausea, vomiting, abdomi­nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur­gency disorders. Diarrheal illness is a large worldwide public health problem, with substantial regional variation, in the prevalence of medical signs by being caused by specific pathogens. Infectious diarrheal diseases, are the second leading cause of morbidity and mortality worldwide and can cause real public health concerns. Such diarrhea was studied as a medical disorder, in a 3 years period, 2017 to 2020, in Transylvania a large region in Romania. It was found there, 3577 number of diarrheal diseases cases, appeared almost during July to August. The case incidence for the disease arrived at 65%, in the entire summer season. The cases data were transmitted by 12 district Sanitary Polices, to the Public Health Center Cluj. Cases were almost diagnosed by the family doctors of the region, in more then 50%. Few of this have need some days of hospitalization, because of several disease disorders, in which case it was used a specific adequate fluid and electrolyte replacement as key of the treatment, for managing diarrheal illnesses. Even so, 3 children under 5 years age died, because of severe complications. It was remarked so, organic failed who was estimate to be the cause of their deaths. Clinical and epidemiological evaluations were done and even defined the severity and type of this mentioned illnesses. The detected infectious etiology for the acute diarrheas, where determined in authorized Microbiology laboratories, where were identified: Shigella spp, Salmonella spp, Campylobacter spp, Yersinia spp, Rotavirus, Giardia. Most number of cases appeared in children, being suggestive in 63%, followed by elderly or adult people in 17% each. Acute diarrheal illness had to be considered a major public health issue, against which some determined control efforts are needed. Public health surveillance of infectious acute diarrhea, includes obligatory done strategies for a correct infection control.

Study of infectious diarrheas, in Transylvania-Romania

“Diarrhea” is an alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Acute diarrhea of infec­tious etiology, often referred to as gastroenteri­tis and is typically associated with clinical signs and symptoms including: nausea, vomiting, abdomi­nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur­gency. Infectious diarrheal diseases are the second leading cause of morbidity and mortality worldwide. It is the diarrhea we have also found out, during a large 3 yeas study 2017-2020 in Transylvania – Romania. 3577 number of cases were transmitted during this time by the 12 territory sanitary polices, to the Epidemiology Department from the Public Health Center Cluj. These were mostly diagnosed by the territorial family doctors in the region and more then 20%, have need hospitalization, for several days, because of the mentioned disease disorders 3 children died during this time, because of severe complications. The detected infectious microbial etiology, were determined in authorized laboratories, in which it was identified: Shigella spp, Salmonella spp Campylobacter spp, and Yersinia spp or Rotavirus Giardia, and Fungi species. Most number of cases appeared in children, followed by elderly or adult people, as quantified number of determination. In light of these data, acute diarrheal illness had to be considered a major public health issue against which control efforts are needed. Public health surveillance and response in the field of infectious acute diarrhea include obligatory strategies of infection control.

Infectious Diarrhea, As Public Health Problem, In Romania

Diarrhea had to be understood from medical point of view, as an alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Acute diarrhea of infec¬tious etiology, referred to gastroenteri¬tis and is associated with clinical signs and symptoms including: nausea, vomiting, abdomi¬nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur-gency disorders. In fact, Infectious diarrheal diseases, are the second leading cause of morbidity and mortality worldwide and can cause real public health problems. Such diarrhea was studied as a medical disorder, in a 3 year period, 2017-2020, in Transylvania region from Romania. We have found out 3577 number of cases, data which were transmitted by 12 district Sanitary Polices, to the Public Health Center. This all were mostly diagnosed by the territorial family doctors and more than 50%, have need hospitalization, for several days, because of several disease disorders. The detected infectious etiology, were determined in authorized laboratories, by identified: Shigella spp, Salmonella spp, Campylobacter spp, Yersinia spp, Rotavirus, Giardia. Most number of cases appeared in children, followed by elderly or adult people, as quantified number of determined infectious diarrheas. Acute diarrheal illness had to be considered a major public health issue, against which control efforts are needed. Public health surveillance of infectious acute diarrhea, include obligatory strategies of infection control.

Infectious diarrhea, as public health problem, in Romania

From medical point of view, “Diarrhea” is an alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Acute diarrhea of infec­tious etiology, often referred to as gastroenteri­tis and is typically associated with clinical signs and symptoms including: nausea, vomiting, abdomi­nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur­gency. Infectious diarrheal diseases are the second leading cause of morbidity and mortality worldwide. It is the diarrhea we have also found out, during a large 3 yeas study 2017-2020 in Transylvania – Romania. 3577 number of cases were transmitted during this time, to our Public Health Center, by 12 district Sanitary Polices. These were mostly diagnosed by the territorial family doctors and more than 50%, have need hospitalization, for several days because of the mentioned disease disorders. The detected infectious etiology, were determined in authorized laboratories in which it was identified: Shigella, Salmonella, Campylobacter, and Yersinia, Rotavirus, Giardia. Most number of cases appeared in children, followed by elderly or adult people, as quantified number of determination. In light of these data, acute diarrheal illness had to be considered a major public health issue against which control efforts are needed. Public health surveillance and response in the field of infectious acute diarrhea include obligatory strategies of infection control.

Infectious Diarrhea, as Public Health Problem, in Romania

From medical point of view, “Diarrhea” is an alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Acute diarrhea of infec¬tious etiology, often referred to as gastroenteri¬tis and is typically associated with clinical signs and symptoms including: nausea, vomiting, abdomi¬nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur¬gency. Infectious diarrheal diseases are the second leading cause of morbidity and mortality worldwide. It is the diarrhea we have also found out, during a large 3 yeas study 2017-2020 in Transylvania – Romania. 3577 number of cases were transmitted during this time, to our Public Health Center, by 12 district Sanitary Polices. These were mostly diagnosed by the territorial family doctors and more then 50%, have need hospitalization, for several days because of the mentioned disease disorders. The detected infectious etiology, were determined in authorized laboratories in which it was identified: Shigella, Salmonella, Campylobacter, and Yersinia, Rotavirus, Giardia. Most number of cases appeared in children, followed by elderly or adult people, as quantified number of determination. In light of these data, acute diarrheal illness had to be considered a major public health issue against which control efforts are needed. Public health surveillance and response in the field of infectious acute diarrhea include obligatory strategies of infection control.

Study of Infectious Diarrheas, In Transylvania – Romania

“Diarrhea” is an alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Acute diarrhea of infec¬tious etiology, often referred to as gastroenteri¬tis and is typically associated with clinical signs and symptoms including: nausea, vomiting, abdomi¬nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur¬gency. Infectious diarrheal diseases are the second leading cause of morbidity and mortality worldwide. It is the diarrhea we have also found out, during a large 3 yeas study 2017-2020 in Transylvania – Romania. 3577 number of cases were transmitted during this time by the 12 territory sanitary polices, to the Epidemiology Department from the Public Health Center Cluj. These were mostly diagnosed by the territorial family doctors in the region and more than 20%, have need hospitalization, for several days, because of the mentioned disease disorders 3 children died during this time, because of severe complications. The detected infectious microbial etiology, were determined in authorized laboratories, in which it was identified: Shigella spp, Salmonella spp Campylobacter spp, and Yersinia spp. or Rotavirus Giardia, and Fungi species. Most number of cases appeared in children, followed by elderly or adult people, as quantified number of determination. In light of these data, acute diarrheal illness had to be considered a major public health issue against which control efforts are needed. Public health surveillance and response in the field of infectious acute diarrhea include obligatory strategies of infection control.