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11/17/2017

Digestive System
Diseases

Ch 22

Food Infection Food Intoxication


m/o’s grow in
intestine
some invasive
fever common

Food Infection Food Intoxication


ingest toxins already
made by m/o
often sudden onset
of symptoms

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Common Symptoms

diarrhea & vomiting


dysentery – diarrhea with blood/mucus

each fig
= 5 cases

Staphylococcal Food Poisoning

S. aureus (nasal, skin)


hands
food (not refrigerated)
bacteria grow & prod. toxins

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Staphylococcal Food Poisoning

“temperature abuse”
– keep hot foods hot and cold foods cold!

Staphylococcal Food Poisoning

toxin – heat stable

Staphylococcal Food Poisoning

(symptoms:
– within 1-6 hrs.
– vomit, cramp, diarrhea
– recovery within 24 hours)

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Salmonellosis

Salmonella sp.
intestines of humans/animals
– (pet reptiles ~ 90% +)

Salmonellosis

poultry, eggs etc.


grow in intestines: 12-36 hrs.
can invade to blood/lymph
(systemic)

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Salmonellosis

(symptoms: fever, nausea, cramps,


diarrhea)
lasts few days/week
– but shed m/o ~6 months

Salmonellosis

treatment: rehydration

Salmonellosis

notifiable disease
~50,000 cases annually
(est. <1 million actual)
~100 deaths/yr
(infants & elderly – septicemia)

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Salmonellosis

prevention:
– stop contamination
– pasteurize eggs or cook well

Great Britain - vaccinates hens

*(newest info: problem due to lack of normal flora in chicks raised in incubators
rather than with their moms)

E. coli

normal flora & lab strains -


nonpathogenic

E. coli

pathogenic strains:
1. enterotoxigenic strain
– enterotoxin
– “traveler’s diarrhea”

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E. coli

pathogenic strains:
2. enteroinvasive strain
– invade intestine
inflam., fever, dysentery possible

E. coli

pathogenic strains:
3. enterohemorrhagic strains
ex. E.coli strain 0157:H7

a.k.a. STEC – Shiga-toxin producing E. coli

E. coli

pathogenic strains:
3. enterohemorrhagic strains
ex. E.coli type 0157:H7
~1% beef (cattle show no illness)
– actually more seen in sprouts

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E. coli

ex. E.coli type 0157:H7


toxins hemorrhagic colitis

• mostly self-limiting
• complication: HUS (hemolytic uremic
syndrome)

E. coli

ex. E.coli type 0157:H7


HUS blood in urine kidney failure

young children 5-10% infected get HUS


mort. rate 5%
200-500 deaths/year

Viral Gastroenteritis

1. Rotavirus
– most common (3 million cases/yr)
– (rota = “wheel”)

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Viral Gastroenteritis

1. Rotavirus
– >90% infected by age 3
• rare in adults = immune

Viral Gastroenteritis

1. Rotavirus
– (2-3 day incubation, low fever, diarrhea,
vomiting, lasts ~ 1 week)
– rehydration therapy (< 100 deaths in U.S.)

Viral Gastroenteritis

1. Rotavirus
Vaccine
– since 2006
– previously: 55,000 to 70,000 hospitalized
and 20-60 deaths in US
– still ~450,000 deaths worldwide

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Viral Gastroenteritis

2. Noroviruses
(old name: Norwalk-like viruses)
(illness aka: “winter vomiting disease”)
– local epidemics (cruise ships, daycare,
nursing homes etc)

Viral Gastroenteritis

2. Noroviruses
– by school-age most have been infected
(but not common in infants)
– poor immunity (few years)

Viral Gastroenteritis

2. Noroviruses
– (1-2 day inc., nausea, cramps, diarrhea)
– shed virus in stool for 10-14 days
– hardy in environment

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