Micropara FInals

Gastrointestinal communicable disease

· Infections that affect the stomach, intestines, and other parts of the digestive system

Gastrointestinal communicable disease

· Leading cause of morbidity and mortality, especially in developing countries

Viral Gastroenteritis (Viral Diarrhea)

· Inflammation of the stomach and intestines caused by a virus, leading to acute GI symptoms

enteric adenoviruses, astroviruses, caliciviruses (noroviruses), rotaviruses

Causative Agent of Viral Diarrhea (children)

norovirus, rotavirus

Causative Agent of Viral Diarrhea (adult and children)

· Fecal-oral route (contaminated food & water)

· Direct contact with infected individuals

· Fomites

MOT Viral Diarrhea

Signs and symptoms Viral Diarrhea

· Nausea, vomiting, diarrhea, abdominal pain, muscle pain, headache, malaise, and low- grade fever.

· ORS or IV fluid for severe dehydration

Medical Management Viral Diarrhea

Picornaviridae

Causative Agent HAV

Hepadnaviridae

Causative Agent HBV

Flaviviridae

Causative Agent HCV

· Unclassified (satellite virus)

Causative Agent HDV

Calciviridae

Causative Agent HEV

Flaviviridae

Causative Agent HGV

HAV and HEV

Fecal Oral MOT in Viral Hepatitis

HBV, HCV, HDV, HGV

Bloodborne MOT in Viral Hepatitis

Jaundice

Pathognomonic sign Viral hepatitis

Hepatitis A (HAV) S/Sx

· Abrupt onset

· Varies severely from a mild illness lasting 1-2 weeks to a severe

· Disease lasting several months

· No chronic infection

Hepatitis B (HBV) S/Sx

· Gradual onset

· Asymptomatic or symptomatic

· Severe or life-threatening

· May progress to cirrhosis or hepatocellular

Hepatitis C (HCV) S/Sx

· 50% to 80% develop chronic infection

· May progress to cirrhosis or hepatocellular

Hepatitis D (HDV) S/Sx

· Abrupt onset

· May progress to cirrhosis or severe

Hepatitis E (HEV) S/Sx

· Similar to HAV

· No chronic form

Hepatitis G (HGV) S/Sx

· Lead to chronic hepatitis

· Bile examination and Liver function test

Diagnostic Test Viral Hepatitis

· Isoprinosine (methiosprinol)

Regulated interferons and/or ribavirin (C, D, E)

Medical Management Viral Hepatitis

HAV and HBV

Vaccines Available in Hepatitis

Bacterial Gastritis

- Inflammation of the stomach lining caused by a bacterial infection

Helicobacter pylori (H. pylori)

Causative Agent Bacterial Gastritis

· Fecal-oral route

· Oral-oral route

· Contaminated food and water

MOT Bacterial Gastritis

stomach belching

pathognomonic sign Bacterial gastritis

Bacterial gastritis S/sx

· Upper abdominal discomfort or burning pain

· Nausea or vomiting

· Bloating, gas, or stomach belching

· Loss of appetite

· Black tarry stool

· Hematemesis

Proton pump inhibitors (PPI) and antibiotic medications

Medical Management Bacterial Gastritis

Leptospira interrogans (bacteria)

Causative Agent Leptospirosis

· Calf pain

Pathognomonic Sign Leptospirosis

Icterohaemorrhagiae

CA rats Leptospirosis

Canicola

CA dogs Leptospirosis

Batavale

CA bats Leptospirosis

Grippotyphosa

CA mice Leptospirosis

Inoculation into broken skin, ingestion of contaminated food and water with urine of animal

MOT Leptospirosis

7-13 days

Incubation Period Leptospirosis

urine (rodents, pet, farm animals)

Source of Infection Leptospirosis

Blood/urine culture

Diagnostic Test (1st week) Leptospirosis

Leptospira agglutination test

Diagnostic Test (2nd to 3rd week) Leptospirosis

Leptospirosis S/Sx (Septicemic Stage)

· High fever 4-7 days

· Calf and abdominal pain

Leptospirosis S/Sx (Anicteric stage)

Disorientation

Leptospirosis S/Sx (Icteric stage)

o Conjunctival suffusion

o Jaundice

o Acute renal failure

Leptospirosis S/Sx (Convalescence)

· Relapse may occur 4th to 5th week

Penicillin, tetracycline, or doxycycline

Medical Management Leptospirosis

Typhoid Fever

· Once inside the body, the bacteria enter the bloodstream and travel to various organs, especially the intestines, liver, and spleen, causing inflammation and damage

Salmonella typhosa

causative agent of typhoid fever

Contaminated food and water, fecal-oral

MOT Typhoid Fever

7-14 days

Incubation Period Typhoid Fever

Diagnostic test Typhoid Fever

· Widal's test

· Typhidot (confirmatory)

· Rectal swab

· Rose spots on trunk

Pathognomonic Sign Typhoid Fever

Typhoid Fever S/Sx (Prodromal)

Headache, fever, anorexia, lethargy, diarrhea, vomiting, abdominal pain

Typhoid Fever S/Sx (Fastigial)

Ladder-like curve of temperature

· Rose spots on trunk

Typhoid Fever S/Sx (Defervescence)

Fever gradually subsides, onset of complications (hemorrhage and peritonitis)

Chloramphenicol

Medical Management Typhoid Fever

Cholera

· This leads to dehydration, electrolyte imbalance, and shock if not promptly treated with fluids and electrolytes.

Vibrio cholerae (El Tor)

CA Cholera

Vehicle

MOT Cholera

Rice watery stool

Pathognomonic Sign Cholera

Cholera S/SX

Sign of severe dehydration, washer woman's hands

Rapid onset characterized by explosive or watery diarrhea or vomiting

· IVF; Plain lactated ringer's solution, PNSS

Medical Management Cholera (dehydration)

Tetracycline 500mg

Medical Management Cholera (antibiotic) (1st line)

Cotrimoxazole q 12

Medical Management Cholera (antibiotic) (2nd line)

· Chloramphenicol 500mg q 6hrs

· Oresol or 1 cup water, 4 tsp sugar

Medical Management Cholera (others)

Dukoral Vaccine

Vaccine Cholera

Dysentery

· Once the causative organism enters the digestive tract, it invades the intestinal lining, damaging the tissues. This leads to inflammation, ulcers, and bleeding

Vehicle, fecal-oral

MOT Dysentery

Diarrhea with tenesmus- straining

Pathognomonic Sign Dysentery

Shigella dysenteriae

CA Dysentery

Dysentery S/SX ·

High grade fever

· Colicky abdominal pain with tenderness

Medical Management Dysentery·

Oral Rehydration Solution (ORS)

· IV fluids for severe dehydration

· Antipyretics for fever (eg, paracetamol)

Schistosomiasis (Snail Fever) Bilharziasis

The parasite enters the skin, travels through the bloodstream, and settles into the blood vessels of the intestines or bladder, where it lays eggs.

Schistosoma japonicum

causative agent of schistosomiasis

Indirect (Skin pores)

MOT schistosomiasis

2 months

Incubation Period schistosomiasis

Diagnostic Test schistosomiasis

Direct stool exam (+) Schistosoma eggs

· COPT Cercum Ova Precipitin Test

· Confirmatory test

Kato Katz technique

S/SX schistosomiasis ·

Rash at site of inoculation: swimmer's itch

· Low grade fever, myalgia, cough

· Bloody, mucoid stool on and off for weeks

· Jaundice

· Enlargement of the abdomen

· Praziquantel (Biltricide): DOC

· Oxamniquine, S mansoni, S. haematobium

Medical Management schistosomiasis

Ascariasis Roundworm

Once swallowed the eggs hatch in the Intestines, and the larvae travel through the blood to the lungs.

Ascaris lumbricoides (round worm)

CA Ascariasis Roundworm

Vehicle -fecal oral

MOT Ascariasis Roundworm

Eating raw vegetables

Source Ascariasis Roundworm

Diagnostic Test Ascariasis Roundworm·

Direct Fecalysis

· Kato Techniques (Fertilized egg)

· Abdominal x-ray (Spaghetti, dot sign)

S/SX Ascariasis Roundworm

Pulmonary signs and symptoms like cough and fever, severe abdominal pain, Mentally and physically underdeveloped, Protruding abdomen, Lethargic

vomiting of worms

Pathognomonic Sign Ascariasis Roundworm

Mebendazole/albendazole 100mg BID for 3days

Medical Management Ascariasis Roundworm

Enterobiasis Oxyuriasis

The adult worms reside in the colon and rectum, and during the night, female worms migrate to the anal area to lay eggs, leading to intense perianal Itching

Enteroblus vermicularis (human pinworm or seatworm)

CA Enterobiasis Oxyuriasis

Vehicle-ingestion or inhalation of eggs

MOT Enterobiasis Oxyuriasis

Source Enterobiasis Oxyuriasis

Overcrowding and water supply is inadequate

eggs fingernails cutting

· Perianal itching

Pathognomonic Sign Enterobiasis Oxyuriasis

S/SX Enterobiasis Oxyuriasis ·

Disturbed sleep pattern

· nervousness

· Irritability

· Worms visible in the anal area or in stool (tiny, white, thread-like worms)

Scotch tape swab (perianal region done in the morning before both

Diagnostic Test Enterobiasis Oxyuriasis

Mebendazole 100 mg single dose repeated once at 2nd week for effectivity

Medical Management Enterobiasis Oxyuriasis

Ancylostoma duodenale

CA Ancylostomiasis (Hookworm) (Europe and Asia)

Hector Americanus

CA Ancylostomiasis (Hookworm) (America)

Direct contact (Skin)

MOT Ancylostomiasis (Hookworm)