What are the common symptoms of norovirus infection. How is norovirus transmitted. What are the best ways to prevent and treat norovirus gastroenteritis. Who is most at risk for severe complications from norovirus.

Understanding Norovirus: The Leading Cause of Viral Gastroenteritis

Norovirus is the most common cause of viral gastroenteritis worldwide, affecting both children and adults. This highly contagious virus is responsible for millions of cases of what’s commonly known as “stomach flu” each year. Despite its nickname, norovirus is not related to influenza, which primarily affects the respiratory system.

Norovirus infections can spread rapidly through communities, especially in confined spaces like cruise ships, schools, and nursing homes. The virus is notorious for its ability to cause outbreaks in these settings, making it a significant public health concern.

What makes norovirus so contagious?

Several factors contribute to the high infectivity of norovirus:

• Low infectious dose – it takes very few virus particles to cause infection
• Environmental stability – the virus can survive on surfaces for extended periods
• Resistance to common disinfectants
• Ability to spread through multiple routes (fecal-oral, vomitus, contaminated food/water)
• Lack of long-lasting immunity after infection

Recognizing the Symptoms of Norovirus Infection

Norovirus infection typically manifests as acute gastroenteritis, with symptoms appearing 12 to 48 hours after exposure. The most common signs and symptoms include:

• Watery, non-bloody diarrhea
• Nausea and vomiting
• Stomach cramps and abdominal pain
• Low-grade fever
• Headache and body aches
• Fatigue

These symptoms usually last for 1 to 3 days in healthy individuals. However, the illness can be more severe and prolonged in young children, older adults, and people with compromised immune systems.

Can norovirus cause bloody diarrhea?

Typically, norovirus does not cause bloody diarrhea. If you experience bloody stools, it may indicate a more severe infection caused by bacteria like Salmonella or E. coli, or parasites such as Giardia. In such cases, immediate medical attention is necessary.

Transmission Routes: How Norovirus Spreads

Understanding how norovirus spreads is crucial for preventing outbreaks and protecting yourself from infection. The virus is primarily transmitted through:

1. Direct contact with an infected person
2. Consuming contaminated food or water
3. Touching contaminated surfaces and then touching your mouth
4. Inhaling airborne particles from vomit

Food handlers who are infected with norovirus can easily contaminate large quantities of food, leading to widespread outbreaks. Additionally, the virus can survive on surfaces for days or even weeks, making environmental contamination a significant concern.

How long is a person contagious with norovirus?

Infected individuals are most contagious while experiencing symptoms and during the first few days after recovery. However, it’s important to note that people can still shed the virus in their stool for up to two weeks after recovery, emphasizing the need for continued hygiene practices even after symptoms subside.

Treatment Approaches for Norovirus Gastroenteritis

There is no specific antiviral treatment for norovirus infection. Management primarily focuses on symptom relief and preventing complications, especially dehydration. The key elements of norovirus treatment include:

• Fluid replacement: Oral rehydration solutions are crucial to replace lost fluids and electrolytes
• Rest: Allowing the body time to fight the infection and recover
• Gradual reintroduction of food: Starting with bland, easily digestible foods as symptoms improve
• Over-the-counter medications: Antipyretics for fever and anti-diarrheal agents (used cautiously and avoided in young children)

In severe cases, especially for high-risk individuals, hospitalization may be necessary for intravenous fluid administration and close monitoring.

Are antibiotics effective against norovirus?

Antibiotics are not effective against norovirus or any viral gastroenteritis. These medications target bacteria and have no effect on viruses. Using antibiotics unnecessarily can lead to antibiotic resistance and disrupt the normal gut flora, potentially worsening symptoms.

Prevention Strategies: Protecting Yourself and Others

Given the high infectivity and lack of specific treatment for norovirus, prevention is paramount. Key strategies for preventing norovirus infection include:

1. Proper hand hygiene: Frequent handwashing with soap and water for at least 20 seconds
2. Safe food handling practices: Thoroughly washing fruits and vegetables, cooking seafood properly
3. Disinfecting contaminated surfaces: Using a chlorine bleach solution or other EPA-approved disinfectants
4. Avoiding food preparation when ill: Staying home from work or school when experiencing symptoms
5. Proper handling and washing of contaminated clothing and linens

It’s important to note that alcohol-based hand sanitizers are not as effective against norovirus as thorough handwashing with soap and water.

Is there a vaccine available for norovirus?

Currently, there is no approved vaccine for norovirus. However, researchers are actively working on developing vaccines that could provide protection against multiple strains of the virus. Some candidate vaccines have shown promise in clinical trials, but more research is needed before a norovirus vaccine becomes available for widespread use.

High-Risk Groups: Who’s Most Vulnerable to Severe Norovirus Infection?

While norovirus can affect anyone, certain groups are at higher risk for severe complications:

• Young children and infants
• Older adults, especially those in long-term care facilities
• People with weakened immune systems (e.g., those with HIV/AIDS, cancer patients undergoing chemotherapy)
• Individuals with chronic medical conditions
• Pregnant women

These high-risk groups are more susceptible to dehydration and other complications from norovirus infection. They may require closer monitoring and more aggressive treatment approaches.

How does norovirus affect young children differently?

Children, especially those under five years old, are particularly vulnerable to norovirus infection. They tend to experience more severe symptoms and are at higher risk of dehydration due to their smaller body size and faster metabolism. Additionally, children in daycare or school settings are more likely to be exposed to the virus and can easily spread it to family members at home.

Norovirus in Institutional Settings: A Unique Challenge

Norovirus outbreaks in institutional settings such as hospitals, nursing homes, schools, and cruise ships pose significant challenges. These environments often combine several risk factors that facilitate rapid spread of the virus:

• Close living quarters
• Shared dining facilities
• High-touch surfaces
• Vulnerable populations

Managing norovirus outbreaks in these settings requires a coordinated approach involving strict hygiene measures, isolation of infected individuals, and thorough environmental cleaning and disinfection.

What specific measures are taken to control norovirus outbreaks on cruise ships?

Cruise ships have developed comprehensive protocols to prevent and manage norovirus outbreaks, including:

• Enhanced cleaning and disinfection procedures
• Installation of hand sanitizer stations throughout the ship
• Passenger education on hygiene practices
• Isolation of symptomatic individuals
• Modifying food service practices to reduce contamination risks
• Reporting outbreaks to health authorities and conducting thorough investigations

The Economic Impact of Norovirus Infections

Norovirus infections have a significant economic impact globally. The costs associated with norovirus outbreaks include:

1. Healthcare expenses for treating infected individuals
2. Lost productivity due to illness-related absenteeism
3. Costs of implementing prevention and control measures
4. Economic losses in the food service and hospitality industries

In the United States alone, norovirus is estimated to cost billions of dollars annually in healthcare expenses and lost productivity. This underscores the importance of effective prevention strategies and ongoing research into treatment and vaccine development.

How do norovirus outbreaks impact the restaurant industry?

Norovirus outbreaks can have devastating effects on restaurants and food service establishments. Beyond the immediate costs of dealing with an outbreak, such businesses may face:

• Temporary closures for deep cleaning and disinfection
• Loss of customer trust and reputation damage
• Legal liabilities from affected customers
• Increased scrutiny from health inspectors
• Long-term revenue losses due to negative publicity

These impacts highlight the critical importance of stringent food safety practices and employee health policies in the food service industry.

Emerging Research and Future Directions in Norovirus Management

The field of norovirus research is rapidly evolving, with scientists working on several fronts to improve prevention, detection, and treatment of infections. Some promising areas of research include:

• Development of broad-spectrum antiviral drugs effective against norovirus
• Advancement of vaccine candidates targeting multiple norovirus strains
• Improved diagnostic tests for rapid and accurate detection of norovirus
• Studies on the long-term effects of norovirus infection and potential links to other health conditions
• Investigation of the role of the gut microbiome in norovirus susceptibility and recovery

These research efforts aim to reduce the global burden of norovirus infections and improve our ability to prevent and manage outbreaks effectively.

What role does genomic sequencing play in norovirus surveillance?

Genomic sequencing has become an invaluable tool in norovirus surveillance and outbreak investigation. It allows researchers and public health officials to:

• Identify and track specific norovirus strains
• Detect the emergence of new variants
• Link geographically distant outbreaks to common sources
• Monitor the evolution of the virus over time
• Inform the development of more effective vaccines and diagnostic tests

This technology has significantly enhanced our understanding of norovirus epidemiology and improved our ability to respond to outbreaks rapidly.

As research continues and our understanding of norovirus deepens, we can expect to see advancements in prevention strategies, treatment options, and outbreak management. However, the cornerstone of norovirus control remains vigilant hygiene practices and public health education. By staying informed and following recommended preventive measures, individuals and communities can significantly reduce the impact of this pervasive and challenging virus.

Viral gastroenteritis (stomach flu) – Symptoms & causes

Overview

Viral gastroenteritis is an intestinal infection that includes signs and symptoms such as watery diarrhea, stomach cramps, nausea or vomiting, and sometimes fever.

The most common way to develop viral gastroenteritis — often called stomach flu — is through contact with an infected person or by consuming contaminated food or water. If you’re otherwise healthy, you’ll likely recover without complications. But for infants, older adults and people with compromised immune systems, viral gastroenteritis can be deadly.

There’s no effective treatment for viral gastroenteritis, so prevention is key. Avoid food and water that may be contaminated and wash your hands thoroughly and often.

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Symptoms

Although it’s commonly called stomach flu, gastroenteritis isn’t the same as influenza. The flu (influenza) affects only your respiratory system — your nose, throat and lungs. Gastroenteritis, on the other hand, attacks your intestines, causing signs and symptoms such as:

• Watery, usually nonbloody diarrhea — bloody diarrhea usually means you have a different, more severe infection
• Nausea, vomiting or both
• Stomach cramps and pain
• Occasional muscle aches or headache
• Low-grade fever

Depending on the cause, viral gastroenteritis symptoms may appear within 1-3 days after you’re infected and can range from mild to severe. Symptoms usually last just a day or two, but occasionally they may last up to 14 days.

Because the symptoms are similar, it’s easy to confuse viral diarrhea with diarrhea caused by bacteria, such as Clostridioides difficile, salmonella and Escherichia coli, or parasites, such as giardia.

Viral gastroenteritis

The stomach, small intestine and large intestine (colon) are part of your digestive tract, which processes the foods you eat. Viral gastroenteritis is an inflammation of these organs caused by a virus.

When to see a doctor

If you’re an adult, call your health care provider if:

• You’re not able to keep liquids down for 24 hours
• You’ve been vomiting or having diarrhea for more than two days
• You’re vomiting blood
• You’re dehydrated — signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
• You notice blood in your bowel movements
• You have severe stomach pain
• You have a fever above 104 F (40 C)

For infants and children

See your child’s health care provider right away if your child:

• Has a fever of 102 F (38.9 C) or higher
• Seems tired or very irritable
• Is in a lot of discomfort or pain
• Has bloody diarrhea
• Seems dehydrated — watch for signs of dehydration in sick infants and children by comparing how much they drink and urinate with how much is normal for them, and watching for signs such as a dry mouth, thirst and crying without tears

If you have an infant, remember that while spitting up may be an everyday occurrence for your baby, vomiting is not. Babies vomit for a variety of reasons, many of which may require medical attention.

Call your baby’s doctor right away if your baby:

• Has vomiting that is frequent
• Hasn’t had a wet diaper in six hours
• Has bloody stools or severe diarrhea
• Has a sunken soft spot (fontanel) on the top of his or her head
• Has a dry mouth or cries without tears
• Is unusually sleepy, drowsy or unresponsive

Causes

You’re most likely to get viral gastroenteritis when you eat or drink contaminated food or water. You may also be likely to get gastroenteritis if you share utensils, towels or food with someone who has one of the viruses that cause the condition.

Many viruses can cause gastroenteritis, including:

• Noroviruses. Both children and adults are affected by noroviruses, the most common cause of foodborne illness worldwide. Norovirus infection can sweep through families and communities. It’s especially likely to spread among people in confined spaces.

  In most cases, you pick up the virus from contaminated food or water. But it can also spread between people who are in close contact or who share food. You can also get the virus by touching a surface that’s been contaminated with norovirus and then touching your mouth.

• Rotavirus. Worldwide, this is the most common cause of viral gastroenteritis in children, who are usually infected when they put their fingers or other objects contaminated with the virus into their mouths. It can also spread through contaminated food. The infection is most severe in infants and young children.

  Adults infected with rotavirus may not have symptoms, but can still spread the illness. This is of particular concern in institutional settings such as nursing homes because adults with the virus unknowingly can pass the virus to others. A vaccine against viral gastroenteritis is available in some countries, including the United States, and appears to be effective in preventing the infection.

Some shellfish, especially raw or undercooked oysters, also can make you sick. Contaminated drinking water is a cause of viral diarrhea. But in many cases the virus is passed when someone with a virus handles food you eat without washing his or her hands after using the toilet.

Risk factors

Gastroenteritis occurs all over the world and can affect people of all ages.

People who may be more susceptible to gastroenteritis include:

• Young children. Children in child care centers or elementary schools may be especially vulnerable because it takes time for a child’s immune system to mature.
• Older adults. Adult immune systems tend to become less efficient later in life. Older adults in nursing homes are vulnerable because their immune systems weaken. They also live in close contact with others who may pass along germs.
• Schoolchildren or dormitory residents. Anywhere that groups of people come together in close quarters can be an environment for an intestinal infection to get passed.
• Anyone with a weakened immune system. If your resistance to infection is low — for instance, if your immune system is compromised by HIV/AIDS, chemotherapy or another medical condition — you may be especially at risk.

Each gastrointestinal virus has a season when it’s most active. If you live in the Northern Hemisphere, for instance, you’re more likely to have rotavirus or norovirus infections in the winter and spring.

Complications

The main complication of viral gastroenteritis is dehydration — a severe loss of water and essential salts and minerals. If you’re healthy and drink enough to replace fluids you lose from vomiting and diarrhea, dehydration shouldn’t be a problem.

Infants, older adults and people with weakened immune systems may become severely dehydrated when they lose more fluids than they can replace. Hospitalization might be needed so that lost fluids can be replaced through an IV in their arms. Dehydration can rarely lead to death.

Prevention

The best way to prevent the spread of intestinal infections is to follow these precautions:

• Get your child vaccinated. A vaccine against gastroenteritis caused by the rotavirus is available in some countries, including the United States. Given to children in the first year of life, the vaccine appears to be effective in preventing severe symptoms of this illness.

• Wash your hands thoroughly. And make sure your children do, too. If your children are older, teach them to wash their hands, especially after using the toilet.

  Wash your hands after changing diapers and before preparing or eating food, too. It’s best to use warm water and soap and to rub hands well for at least 20 seconds. Wash around cuticles, beneath fingernails and in the creases of the hands. Then rinse thoroughly. Carry sanitizing wipes and hand sanitizer for times when soap and water aren’t available.

• Use separate personal items around your home. Avoid sharing eating utensils, drinking glasses and plates. Use separate towels in the bathroom.
• Prepare food safely. Wash all your fruits and vegetables before eating them. Clean kitchen surfaces before preparing food on them. Avoid preparing food if you’re sick.
• Keep your distance. Avoid close contact with anyone who has the virus, if possible.
• Disinfect hard surfaces. If someone in your home has viral gastroenteritis, disinfect hard surfaces, such as counters, faucets and doorknobs, with a mixture of 5-25 tablespoons (73 to 369 milliliters) of household bleach to 1 gallon (3.8 liters) of water.
• Avoid touching laundry that may have been exposed to a virus. If someone in your home has viral gastroenteritis, wear gloves while touching laundry. Wash clothing and bedding in hot water and dry them on the hottest setting. Wash your hands well after touching laundry.
• Check out your child care center. Make sure the center has separate rooms for changing diapers and preparing or serving food. The room with the diaper-changing table should have a sink as well as a sanitary way to dispose of diapers.

Take precautions when traveling

When you’re traveling in other countries, you can become sick from contaminated food or water. You may be able to reduce your risk by following these tips:

• Drink only well-sealed bottled or carbonated water.
• Avoid ice cubes because they may be made from contaminated water.
• Use bottled water to brush your teeth.
• Avoid raw food — including peeled fruits, raw vegetables and salads — that has been touched by human hands.
• Avoid undercooked meat and fish.

More Information

Viral gastroenteritis (stomach flu) – Symptoms & causes

Overview

Viral gastroenteritis is an intestinal infection that includes signs and symptoms such as watery diarrhea, stomach cramps, nausea or vomiting, and sometimes fever.

The most common way to develop viral gastroenteritis — often called stomach flu — is through contact with an infected person or by consuming contaminated food or water. If you’re otherwise healthy, you’ll likely recover without complications. But for infants, older adults and people with compromised immune systems, viral gastroenteritis can be deadly.

There’s no effective treatment for viral gastroenteritis, so prevention is key. Avoid food and water that may be contaminated and wash your hands thoroughly and often.

Products & Services

Symptoms

Although it’s commonly called stomach flu, gastroenteritis isn’t the same as influenza. The flu (influenza) affects only your respiratory system — your nose, throat and lungs. Gastroenteritis, on the other hand, attacks your intestines, causing signs and symptoms such as:

• Watery, usually nonbloody diarrhea — bloody diarrhea usually means you have a different, more severe infection
• Nausea, vomiting or both
• Stomach cramps and pain
• Occasional muscle aches or headache
• Low-grade fever

Depending on the cause, viral gastroenteritis symptoms may appear within 1-3 days after you’re infected and can range from mild to severe. Symptoms usually last just a day or two, but occasionally they may last up to 14 days.

Because the symptoms are similar, it’s easy to confuse viral diarrhea with diarrhea caused by bacteria, such as Clostridioides difficile, salmonella and Escherichia coli, or parasites, such as giardia.

Viral gastroenteritis

The stomach, small intestine and large intestine (colon) are part of your digestive tract, which processes the foods you eat. Viral gastroenteritis is an inflammation of these organs caused by a virus.

When to see a doctor

If you’re an adult, call your health care provider if:

• You’re not able to keep liquids down for 24 hours
• You’ve been vomiting or having diarrhea for more than two days
• You’re vomiting blood
• You’re dehydrated — signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
• You notice blood in your bowel movements
• You have severe stomach pain
• You have a fever above 104 F (40 C)

For infants and children

See your child’s health care provider right away if your child:

• Has a fever of 102 F (38. 9 C) or higher
• Seems tired or very irritable
• Is in a lot of discomfort or pain
• Has bloody diarrhea
• Seems dehydrated — watch for signs of dehydration in sick infants and children by comparing how much they drink and urinate with how much is normal for them, and watching for signs such as a dry mouth, thirst and crying without tears

If you have an infant, remember that while spitting up may be an everyday occurrence for your baby, vomiting is not. Babies vomit for a variety of reasons, many of which may require medical attention.

Call your baby’s doctor right away if your baby:

• Has vomiting that is frequent
• Hasn’t had a wet diaper in six hours
• Has bloody stools or severe diarrhea
• Has a sunken soft spot (fontanel) on the top of his or her head
• Has a dry mouth or cries without tears
• Is unusually sleepy, drowsy or unresponsive

Causes

You’re most likely to get viral gastroenteritis when you eat or drink contaminated food or water. You may also be likely to get gastroenteritis if you share utensils, towels or food with someone who has one of the viruses that cause the condition.

Many viruses can cause gastroenteritis, including:

• Noroviruses. Both children and adults are affected by noroviruses, the most common cause of foodborne illness worldwide. Norovirus infection can sweep through families and communities. It’s especially likely to spread among people in confined spaces.

  In most cases, you pick up the virus from contaminated food or water. But it can also spread between people who are in close contact or who share food. You can also get the virus by touching a surface that’s been contaminated with norovirus and then touching your mouth.

• Rotavirus. Worldwide, this is the most common cause of viral gastroenteritis in children, who are usually infected when they put their fingers or other objects contaminated with the virus into their mouths. It can also spread through contaminated food. The infection is most severe in infants and young children.

  Adults infected with rotavirus may not have symptoms, but can still spread the illness. This is of particular concern in institutional settings such as nursing homes because adults with the virus unknowingly can pass the virus to others. A vaccine against viral gastroenteritis is available in some countries, including the United States, and appears to be effective in preventing the infection.

Some shellfish, especially raw or undercooked oysters, also can make you sick. Contaminated drinking water is a cause of viral diarrhea. But in many cases the virus is passed when someone with a virus handles food you eat without washing his or her hands after using the toilet.

Risk factors

Gastroenteritis occurs all over the world and can affect people of all ages.

People who may be more susceptible to gastroenteritis include:

• Young children. Children in child care centers or elementary schools may be especially vulnerable because it takes time for a child’s immune system to mature.
• Older adults. Adult immune systems tend to become less efficient later in life. Older adults in nursing homes are vulnerable because their immune systems weaken. They also live in close contact with others who may pass along germs.
• Schoolchildren or dormitory residents. Anywhere that groups of people come together in close quarters can be an environment for an intestinal infection to get passed.
• Anyone with a weakened immune system. If your resistance to infection is low — for instance, if your immune system is compromised by HIV/AIDS, chemotherapy or another medical condition — you may be especially at risk.

Each gastrointestinal virus has a season when it’s most active. If you live in the Northern Hemisphere, for instance, you’re more likely to have rotavirus or norovirus infections in the winter and spring.

Complications

The main complication of viral gastroenteritis is dehydration — a severe loss of water and essential salts and minerals. If you’re healthy and drink enough to replace fluids you lose from vomiting and diarrhea, dehydration shouldn’t be a problem.

Infants, older adults and people with weakened immune systems may become severely dehydrated when they lose more fluids than they can replace. Hospitalization might be needed so that lost fluids can be replaced through an IV in their arms. Dehydration can rarely lead to death.

Prevention

The best way to prevent the spread of intestinal infections is to follow these precautions:

• Get your child vaccinated. A vaccine against gastroenteritis caused by the rotavirus is available in some countries, including the United States. Given to children in the first year of life, the vaccine appears to be effective in preventing severe symptoms of this illness.

• Wash your hands thoroughly. And make sure your children do, too. If your children are older, teach them to wash their hands, especially after using the toilet.

  Wash your hands after changing diapers and before preparing or eating food, too. It’s best to use warm water and soap and to rub hands well for at least 20 seconds. Wash around cuticles, beneath fingernails and in the creases of the hands. Then rinse thoroughly. Carry sanitizing wipes and hand sanitizer for times when soap and water aren’t available.

• Use separate personal items around your home. Avoid sharing eating utensils, drinking glasses and plates. Use separate towels in the bathroom.
• Prepare food safely. Wash all your fruits and vegetables before eating them. Clean kitchen surfaces before preparing food on them. Avoid preparing food if you’re sick.
• Keep your distance. Avoid close contact with anyone who has the virus, if possible.
• Disinfect hard surfaces. If someone in your home has viral gastroenteritis, disinfect hard surfaces, such as counters, faucets and doorknobs, with a mixture of 5-25 tablespoons (73 to 369 milliliters) of household bleach to 1 gallon (3. 8 liters) of water.
• Avoid touching laundry that may have been exposed to a virus. If someone in your home has viral gastroenteritis, wear gloves while touching laundry. Wash clothing and bedding in hot water and dry them on the hottest setting. Wash your hands well after touching laundry.
• Check out your child care center. Make sure the center has separate rooms for changing diapers and preparing or serving food. The room with the diaper-changing table should have a sink as well as a sanitary way to dispose of diapers.

Take precautions when traveling

When you’re traveling in other countries, you can become sick from contaminated food or water. You may be able to reduce your risk by following these tips:

• Drink only well-sealed bottled or carbonated water.
• Avoid ice cubes because they may be made from contaminated water.
• Use bottled water to brush your teeth.
• Avoid raw food — including peeled fruits, raw vegetables and salads — that has been touched by human hands.
• Avoid undercooked meat and fish.

More Information

Adenovirus infection – causes, symptoms, diagnosis and treatment

Lymphadenopathy

Conjunctivitis

SARS

Pharyngitis

Rhinitis

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May 19

Adenovirus infection: causes, symptoms, diagnosis and treatment.

Definition

Adenovirus infections include a group of acute viral diseases that affect the mucous membranes of the respiratory tract, eyes, intestines and lymphoid tissue. An increased risk of infection exists in children and young people: adenovirus is registered in 25-30% of young children from the total number of viral respiratory diseases.

Adenoviruses were first isolated in 1953 from human adenoids, hence the name. More than 50 serotypes of human adenoviruses are known, which are part of 7 subgroups (A, B1, B2, C, D, E, F). Virus particles contain DNA, have a diameter of 70 to 100 nm, they lack lipids and an envelope.

Adenoviruses are stable in the external environment: they remain at room temperature for 2 weeks, withstand low temperatures and drying. At the same time, the causative agent of adenovirus infection is inactivated under the influence of ultraviolet rays and chlorine-containing disinfectants.

Causes of adenovirus infection

The source of infection is sick people with an overt or latent form of the disease, as well as virus carriers. The most dangerous are patients in the acute period of the disease, when adenoviruses are found in high concentrations in nasopharyngeal swabs, scrapings from the affected conjunctiva, blood and feces. The mechanism of infection transmission is airborne, but the alimentary route of infection (fecal-oral mechanism) is also possible, through household items, pool water, medical supplies (contact mechanism). According to the epidemiological classification of infectious diseases, adenovirus infection is classified as an airborne and intestinal infection.

Adenovirus enters the body through the upper respiratory tract, the conjunctiva of the eyes or the intestines.

During the incubation period, the virus reproduces in epithelial cells and lymph nodes. After the death of the affected cells, viral particles are released and penetrate into the bloodstream, spread throughout the body, which can lead to inflammation of the bronchi, kidneys, liver, spleen, digestive tract, etc.

Disease classification

It is customary to distinguish three forms of adenovirus:

• mild – affects the upper respiratory tract and throat;
• moderate – manifested by lymphadenopathy (inflammation of the lymph nodes), hyperplasia of the lymphoid tissue;
• severe – caused by a secondary infection or generalization of the virus.

The clinical classification takes into account the localization of the process:

• pharyngoconjunctival fever;
• keratoconjunctivitis, conjunctivitis;
• acute respiratory disease;
• adenovirus pneumonia.

Symptoms of adenovirus infection

Adenovirus incubation period is 2 to 12 days (usually 5-7 days). Usually the disease begins acutely, but the various symptoms of the disease do not appear simultaneously, but sequentially. The first signs are more often a gradual increase in body temperature to 38-39 ° C (less often up to 40 ° C) by the 2-3rd day and catarrhal phenomena in the upper respiratory tract. There is a slight lethargy, general weakness, loss of appetite, a headache is possible, and muscle and joint pains are rare.

With pharyngoconjunctival fever , pharyngitis, rhinitis, conjunctivitis, general toxic syndrome (headache, weakness, aches, chills) are noted.

In case of keratoconjunctivitis, conjunctivitis the process begins acutely and is difficult. High temperature lasts up to 10 days. Peripheral lymph nodes are enlarged, especially cervical.

At picture of acute respiratory disease general toxic syndrome is observed: headache, weakness, aches, chills. Subfebrile temperature (within 37.1-38 ° C) lasts a long time.

Adenovirus pneumonia is characterized by undulating fever, worsening cough and symptoms of intoxication. There is shortness of breath, acrocyanosis (blue fingertips).

Adenovirus infection can occur in the intestinal form, which is accompanied by fever, paroxysmal abdominal pain, nausea and vomiting, and diarrhea.

Symptoms of adenovirus infection are similar to influenza. But there is a difference – damage to the eyes and conjunctiva. Patients complain of burning, pain, sensation of a foreign body in the eyes. The skin of the eyelids is moderately edematous, hyperemic, the eyes are half-open.

Conjunctivitis is the “calling card” of adenovirus infection.

Diagnosis of adenoviral infection

Clinically, adenoviral infection is diagnosed by the presence of conjunctivitis, pharyngitis, lesions of the lymph nodes against the background of fever. The blood picture in adenovirus infection is nonspecific and has no diagnostic value. Methods for rapid diagnosis of adenovirus infection are the immunofluorescence reaction: adenovirus, diarrheal syndrome and respiratory adenovirus (a method by which specific antibodies to adenovirus in blood serum are detected), as well as immune electron microscopy.

Adenovirus (Adenovirus), diarrheal syndrome, antigen test (Adenovirus. One step rapid immunochromotographic assay)

Adenovirus is the main cause of infectious gastroenteritis in newborns and young children, and they also occur in adults. …

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Serological diagnostics is used for retrospective interpretation of the etiology of SARS. Serological studies are widely used: RTGA (hemagglutination inhibition reaction) and RSK (compliment binding reaction).

Which doctors to contact

Diagnostics and treatment of adenovirus infection
pediatrician,
therapist or
general doctor.

Treatment of adenovirus infection

Most cases are treated at home. Bed rest, a complete and balanced diet, and plenty of fluids are prescribed.

Topical therapy for adenovirus infection includes the use of eye drops, application of antiviral ointments behind the eyelid, the introduction of antiviral ointments into the nasal passages, instillation of interferons into the nose, irrigation of the pharynx. Focusing on the symptom complex, expectorants, vasoconstrictors, multivitamins are prescribed.

Antibacterial therapy is necessary only in case of bacterial infection.

Children of early age with a severe form of adenovirus infection and complications are subject to hospitalization. Note that the infection is especially dangerous for children under 3 years old, therefore, in order to avoid complications, it is necessary to consult a doctor at the first symptoms of the disease.

Complications

Complications, as a rule, arise due to the addition of a bacterial infection:

• sinusitis; pneumonia;
• bowel dysfunction;
• damage to the heart, kidneys.

Prevention of adenovirus infection

Specific prevention (vaccination) has not yet been developed, therefore, non-specific measures are used to increase the body’s resistance to infectious diseases.

During periods of epidemic outbreaks, isolation of patients is indicated; carrying out current disinfection, ventilation and UVR of premises; prescribing interferon to persons at risk of infection.

Sources:

1. Shamsheva O.V. Influenza and SARS in children / O.V. Shamshev. – M.: GEOTAR-Media, 2018. – 112 p.
2. Yushchuk N.D. Infectious diseases: national guidelines / Ed. N.D. Yushchuk, Yu.Ya. Vengerov. – M.: GEOTAR-Media, 2015. – 1056 p.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Intestinal infections | H-Clinic

06/13/2022

Intestinal infections are a group of diseases that can be caused by viruses, bacteria, and parasites. They are often called gastroenteritis because both the stomach and intestines are affected.

They are ubiquitous and do not have seasonality (such as influenza or tick-borne infections), but the maximum number of cases is still recorded in the spring and summer, when hands begin to reach for fruits and vegetables from the beds, “and washing is not necessary – we have everything of our own, everything is clean!”

In fact, this is not the only way to get sick – you can also swim in a pond and take a sip of water from there .

.. but seriously, there are two main ways to get infected:

1. Eating contaminated food, drinking contaminated water
2. Contact with a sick person and objects contaminated with his secretions (this includes both non-compliance with the rules of hygiene, patient care, and oral sex, including rimming)

Intestinal infections are mainly manifested by symptoms such as:

• diarrhea (it is important to pay attention to the consistency, color of feces, the presence of pathological impurities, blood, mucus)

• nausea

• vomit

• discomfort/abdominal pain

• fever

• headache

Most of these infections go away on their own after symptomatic treatment. Symptomatic treatment is drugs for nausea if you feel sick, for pain in the abdomen if your stomach hurts, for headaches if your head hurts, etc. But some diseases pose a real threat, can lead to complications and even death.

The main thing to be afraid of is dehydration. Dehydration is especially dangerous for children and the elderly, as well as for people with chronic kidney and heart diseases. Therefore, it is important to constantly replenish the volume of fluid lost by the body during vomiting and diarrhea, with sweat during fever, and even with breathing, we lose water – and it needs to be replenished! For this, there are many special solutions (Regidron, Acesol, Hydrovit) that you can drink, but if a person cannot even take a sip (for example, he constantly vomits), then it is better to administer saline solutions intravenously – this is more reliable.

It is important to know when to seek medical attention.

• severe symptoms such as persistent vomiting and diarrhea

• diarrhea lasting more than 3 days

• high fever

• an admixture of blood and mucus in the stool

• signs of dehydration (severe thirst, decreased diuresis*, decreased blood pressure, loss of consciousness)

* diuresis is the volume of urine formed over a certain period of time, most often per day; it is also the ratio of fluid drunk and excreted in the urine

When it comes to children, you should always pay attention to:

• signs of dehydration (lack of urine, sunken eyes, dry mouth, pallor, cold extremities)

• persistent nausea/vomiting, severe abdominal pain

• lethargy, hypodynamia, delayed reaction

What are the most common causes of intestinal infections?

For parasites, you need to highlight a whole separate article, so today we will briefly go over viruses and bacteria – the main causative agents of gastroenteritis. So.

Viruses (rotavirus, norovirus, adenovirus)

You can become infected through food, contaminated water, household items contaminated with secretions of a sick person. As a rule, the disease has a “family” character – everyone gets sick in turn or at the same time. Usually, if most family members with similar symptoms are sick, a viral infection is suspected.

The symptoms for all of these viruses are similar: high body temperature, abdominal discomfort or pain, nausea, vomiting, and clear watery stools. True, with an adenoviral infection, high fever can persist for quite a long time, there may be a sore throat, lymph nodes may increase, a rash and conjunctivitis may appear. By and large, it doesn’t matter to know what kind of virus has now crippled your health, because the knowledge of this tactic does not change – symptomatic therapy + fluid replenishment. There are no antiviral drugs for the treatment of intestinal infections.

Replenishing lost fluid and electrolytes is the main goal of treating viral gastroenteritis. Insufficient rehydration leads to very serious consequences up to death, especially in young children. For example, rotavirus infection in young children causes several hundred thousand deaths each year due to dehydration. However, there is prevention – we will talk about it later.

Bacteria

– Campylobacter is one of the four leading causes of diarrheal disease worldwide. This bacterium is considered the world’s most common bacterial cause of intestinal infections in humans. Most cases are mild, but children, the elderly, and immunocompromised people are at risk for severe disease. It is transmitted through consumption of undercooked meat, poultry, or milk. The clinical picture is very similar to many acute intestinal infections, and diagnosis is only possible using laboratory stool tests such as PCR or culture. Antibacterial therapy is carried out only in the case of an invasive form of the disease or for the sanitation of asymptomatic excretory carriers.

– Escherichia coli is the leading cause of traveler’s diarrhea and the leading cause of diarrheal disease in developing countries, especially among children. Most strains of E. coli are harmless, but some strains can cause severe food poisoning, such as Shigatoxin producing E. coli (STEC). The main sources of STEC outbreaks are uncooked or undercooked minced meat products, raw milk, and vegetables contaminated with faeces. In most cases, the disease resolves on its own, but life-threatening conditions can develop.

* Traveler’s diarrhea is the most common travel-related illness. People who travel to places where there are pathogens other than those they are used to become infected, especially in regions where food/water contamination is more common. It is most often transmitted through food or water contaminated with faeces. Most cases are caused by bacteria, including E. coli, Salmonella, and Shigella.

– Salmonellosis is one of the most common intestinal infections. Infection occurs when eating food, usually raw meat, fish, seafood, eggs (including quail). Accompanied by high body temperature, headache, cramping abdominal pain, repeated watery stools with a characteristic dark green color, sometimes with nausea and vomiting. There is no salmonella in fresh chicken eggs, but in chicken manure, which is on the shell, there may be plenty of it. It can remain on the shell (therefore, it is necessary to wash chicken eggs before cooking), or it can penetrate inside (therefore, the heat treatment must be complete). The most dangerous type of salmonella is Salmonella Typhi, which causes typhoid fever. The infection affects the lymphatic system and digestive tract, spreads throughout the body with blood and lymph, causing severe intoxication. Symptoms include persistent fever, fatigue, headache, nausea, abdominal pain, and constipation or diarrhea. Some patients may develop a rash. Severe cases of the disease can lead to serious complications (such as intestinal perforation, intestinal bleeding, peritonitis) and even death. Antibacterial therapy is indispensable here, the main thing is to complete the course of treatment under the supervision of a doctor and be sure to pass control tests of feces for Salmonella typhi to confirm the cure.

– Shigellosis (or dysentery) is as common as salmonellosis. Unlike salmonellosis, to get sick with dysentery, you need a very small infectious dose (few bacteria). A sick person, his feces is the only source of the pathogen that can be transmitted through water, food, objects, or carried by flies. The nature of the stool with shigellosis is already different, most often with mucus, blood, or even pus. The pain in the abdomen has a cramping character, false urge to defecate, and the volume of stool is smaller and smaller each time. In moderate and severe cases, antibiotics are used.

– Yersinia , caused by Yersinia enterocolitica, is a relatively rare cause of diarrhea and abdominal pain. Infection most often occurs through the consumption of contaminated foods, vegetables, especially raw or undercooked pork products, as well as ice cream and milk. Mice are the most common carriers. Common symptoms are fever, abdominal pain, and diarrhea, which is often bloody, bothersome muscle and joint pain, and sometimes a rash. The danger of this disease is that a chronic form of the disease develops with joint damage, reactive arthritis, the appearance of erythema nodosum, chronic colitis, and the development of myocarditis. Antibacterial therapy is required.

In many cases, even with a bacterial infection, symptomatic treatment is sufficient. However, if there is a prolonged high temperature, the presence of mucus, pus or blood in the stool, inflammatory changes in the general blood test, an increase in the level of C-reactive protein, then it is necessary for the doctor to prescribe adequate antibiotic therapy.

But here it is important to know that every antibiotic intake carries the risk of developing antibiotic-associated colitis. The most common causative agent is the opportunistic bacterium Clostridium Difficile, which produces a large amount of toxins. It is characterized by a violation of the stool, the appearance of mucus in the feces, an increase in body temperature, and a general deterioration in the condition. The danger lies in the violation of protein absorption, leading to severe edema. The most dangerous, life-threatening condition is toxic dilatation (expansion) of the colon, requiring surgical intervention. It sounds strange, but colitis due to antibiotics is also treated with antibiotics, only with different ones. Treatment and recovery takes a long time and there are frequent relapses of the disease. Therefore, any appointment of antibiotic therapy should be made by a doctor strictly according to indications and taking into account many additional factors.

– Another Clostridium ( Clostridium Botulinum ) can cause botulism, a dangerous, potentially fatal disease that often masquerades as common intestinal infections. A person becomes infected with botulism when eating home canned products (mushrooms, fish, meat). Products canned under industrial conditions rarely become a source of infection. Wound botulism develops as a result of wound contamination (ingress of bacterial spores into the wound surface). Infant botulism develops when spores of the pathogen enter the gastrointestinal tract. This type of botulism is observed mainly in children of the first 6 months of life. If visual impairment begins: double vision, “fog” before the eyes, a feeling of a grid – this is a reason for urgent hospitalization, and the treatment of the disease itself is strictly in the hospital. The toxin causes paralysis. Paralysis begins in the muscles of the face and spreads to the limbs. If it reaches the respiratory muscles, respiratory failure can occur, which can be fatal.

– Bacterial food poisoning is one of the most common diagnoses. Symptoms are identical to viral gastroenteritis and are close even to bacterial infections. The only common difference is that the temperature is not as high, usually no higher than 38. 0°C. The reason is bacterial toxins in food. Often occurs when using expired products, improperly stored confectionery.

Intestinal infections can be prevented by taking care of what you eat and drink and by maintaining good hygiene.

• cook food thoroughly (there must be a good heat treatment, a separate cutting board for meat, and it must be washed thoroughly with soap)

• wash your hands regularly (after going to the toilet, before eating, after caring for a sick relative, after changing diapers, after cutting raw meat, etc.)

• when traveling to developing countries, use only bottled water, avoid ice and raw foods

• and, of course, we must try to avoid contact with patients with intestinal infections

And, as always, we cannot ignore the rubric “specific prophylaxis – vaccination”

• You can vaccinate against dysentery with the Shigellvac vaccine.