Enfermedades parasitarias de origen alimentariomás frecuentes en España: incidenciay comparación con las de origen víricoy bacteriano / Food and waterborne parasitic diseases more frequent in Spain: incidence, prevention and comparison with virus and bacteria diseases

Las infecciones gastrointestinales son un problema clínico frecuente e infradiagnosticado. La población más susceptible son los niños y ancianos. El mecanisno de transmisión fundamentalmente es indirecto, a través de los alimentos y el agua. La transmisión directa (fecal-oral) es muy común para el caso de los virus. La vigilancia epidemiológica de estas infecciones se efectúa en nuestro país mediante el Sistema de Información Microbiológica (SIM) y los brotes epidémicos. En el presente artículo se revisa y se compara la incidencia y la prevención de las infecciones gastroinestinales entre los distintos microorganismos más frecuentes en España (AU)

An outbreak of viral gastroenteritis in a psychiatric hospital.

In September and October 1987, an outbreak of gastroenteritis due to small round structured viruses occurred in a large psychiatric hospital. A total of 149 people, 83 patients and 66 members of staff, were affected over a 26-day period. Most cases were associated with three psychogeriatric wards. The outbreak highlighted the special problems of infection control in long-stay psychiatric units and methods of overcoming these difficulties are discussed.

Outbreak of gastroenteritis in different areas of Pakistan.

Outbreak of acute gastroenteritis occurred during July to August, 1988 in districts of Mansehra, Swat and Muzaffarabad. Thirty cases, clinically diagnosed as cholera, were investigated. On examination, 22 (73.3%) cases were bacteriologically confirmed as cholera due to V. cholerae Eltor, ogawa. All strains were sensitive to chloramphenicol.

[Quality of potable water and incidence of gastroenteritis in 2 cities in the state of Sonora, Mexico]. / Calidad del agua potable e incidencia de gastroenteritis en dos ciudades del estado de Sonora, México.

Based on the fact that drinking-water is of great significance in the transmission of infectious diseases, the incidence of diarrheal disorders was examined in two cities similar in their demographic composition and in their use of health services, but not in the quality of the drinking-water supply. In Navojoa, a city with high incidence of diarrheal diseases (116/1000 pop. in 1985), high rates of drinking-water contamination with fecal coliforms were found (43% of water samples); on the contrary, in Ciudad Obregón, a city with lower rates of diarrheal diseases (49/1000 pop. in 1985), drinking-water contamination with fecal coliforms was also comparatively lower (only 6% of water samples). These data illustrate the need to promote the implementation of drinking-water treatment in those places with signs of fecal contamination and high incidence of diarrheal diseases. To this regard, the General Direction for Research and Technological Development of the Ministry of Health has promoted the development of a chlorination equipment, useful mainly in rural areas, where biological contamination is usually high. These and similar procedures for water treatment should be considered as effective means to decrease the incidence of diarrheal diseases.

An outbreak of acute infectious nonbacterial gastroenteritis in a high school in Maryland.

An outbreak of acute infectious nonbacterial gastroenteritis (AING) occurred in a high school in Maryland in 1984. Thirty-six percent of students surveyed met the case definition of gastroenteritis, as did 24 percent of school employees. Eating lunch in the cafeteria on January 30 was significantly associated with illness. After controlling for other food items consumed during the January 30 lunch, only the sandwiches were significantly associated with illness, but the source of the contamination was not identified. Four of 17 serum pairs from sick students and none of the 8 serum pairs from exposed controls (a nonsignificant difference) showed at least a 4-fold rise in antibody titre to Norwalk virus between acute- and convalescent-phase specimens. This outbreak of AING is believed to be the first to implicate epidemiologically sandwiches as vehicles of transmission. The outbreak highlights the need for investigators to look for a viral etiology in gastroenteritis outbreaks.

Routine cleaning and the elimination of Campylobacter pylori from endoscopic biopsy forceps.

The effect of routine cleaning in removing Campylobacter pylori from the biopsy forceps of endoscopes has been examined in a series of 50 patients. Campylobacter pylori was isolated from the biopsies of 15 of the patients, while one of the 50 biopsy forceps washings yielded the organism after routine cleaning. This study suggests that there is a small chance of transmitting C. pylori by endoscopic equipment if cleaning is the only method of decontamination adopted.

Role of infected food handler in hotel outbreak of Norwalk-like viral gastroenteritis: implications for control.

Investigation of an outbreak of viral (Norwalk-like) gastroenteritis amongst staff (40 cases), resident guests (over 70 cases), and persons attending functions (54 cases) at one hotel over 8 days suggested that the main vehicle of infection was cold foods prepared by a food handler during and after a mild gastrointestinal illness. He was excreting Norwalk-like virus particles 48 hours after the illness. In addition, ill kitchen staff vomited in the kitchen area and may have contaminated surfaces and stored foods. It is recommended that food handlers should be regarded as potentially infectious until at least 48 hours after clinical recovery from viral gastroenteritis. Stored foods that may have been contaminated should be immediately discarded and areas of the work place which may have been affected should be identified and decontaminated.

25- to 30-nm virus particle associated with a hospital outbreak of acute gastroenteritis with evidence for airborne transmission.

Between November 1 and 22, 1985, an outbreak of acute, nonbacterial gastroenteritis occurred in a 600-bed hospital in Toronto, Ontario, Canada. Illness in 635 of 2,379 (27%) staff was characterized by fatigue, nausea, diarrhea, and vomiting and had a median duration of 24-48 hours. The finding of virus-like particles measuring 25-30 nm in six stool specimens and low rates of seroresponse to Norwalk virus (3/39) and Snow Mountain agent (1/6) suggest that a Norwalk-like virus was responsible for the outbreak. The outbreak was of abrupt onset and high incidence, affecting 79 people in a single day. No common food or water exposure could be identified. The attack rate was greatest (69%) for staff who had worked in the Emergency Room. Of 100 patients and their companions who visited the Emergency Room on November 11-12 for unrelated problems, 33 (33%) developed gastroenteritis 24-48 hours after their visit, versus 0 of 18 who visited the Emergency Room on November 8 (p less than 0.001). An analysis of housekeepers who worked at least once during the period from November 9-13, which included those who became ill during the period of November 9-14, showed that the risk of becoming ill was four times greater for those who visited or walked through the Emergency Room than for those who did not (p = 0.028). These data are consistent with the possibility of the airborne spread of a virus.

Financial impact of transmissible gastroenteritis in pigs.

The financial impact of an epizootic of transmissible gastroenteritis in pigs was evaluated in a California sow herd through estimating growth, feed, and profit functions. Two groups of pigs were studied: pigs born before and surviving the epizootic (epizootic [E] pigs), and pigs born after the epizootic (postepizootic [PE] pigs). Short-term profits were maximized at 165 days for both groups of pigs, ranging from $47.14 for female E pigs to $60.32 for male PE pigs. Accordingly, it was concluded that pigs surviving or born shortly after a transmissible gastroenteritis epizootic are profitable to raise, if raised under management conditions similar to those in the study herd.

Risk factors for secondary transmission in households after a common-source outbreak of Norwalk gastroenteritis.

In November 1984, a foodborne outbreak of Norwalk gastroenteritis occurred in a K-12 public school in northern Vermont. The outbreak offered an opportunity to systematically study in detail secondary transmission rates in households. Eating salad at Tuesday's school-sponsored Thanksgiving Banquet was associated with illness among students and staff members (p less than 0.025). Seven of 11 serum pairs from ill persons showed a fourfold or greater rise in antibody titer to Norwalk virus compared with one of nine controls (p = 0.028). The study of secondary household transmission revealed that households with persons with primary illness were 5.5 times more likely to experience secondary illness than households with well school children or adults. As the number of individuals with primary illness in the household increased, the secondary illness rates increased. Pre-school children were twice as likely as adults to develop secondary illness.

Surveillance of food and waterborne diseases in Thailand, 1979-1984.

National surveillance of foodborne diseases in Thailand has revealed an increasing incidence of from 29/100,000 population in 1979 to 74/100,000 in 1984. A total of 158,482 cases and 241 deaths were reported during this 6 year period. In each year, foodborne diseases occurred regularly in April-June. The highest mean annual reported rates were from the North-eastern region, followed by the Central region and the Northern region. Because of inadequate investigations, only 7% (10,567) of the total cases had known specific aetiology. Of these 10,567 cases, the majority (7788, 73%) were caused by micro-organisms which included bacteria (46%), parasites (12%), and viruses (15%), the remaining (2779, 27%) were caused by poisonous plants (19%), animals (1%), and chemicals (7%). In recent years surveillance has increasingly served as a means to control the outbreak. However, due to many limitations, the surveillance data presented here probably do not represent an accurate picture of the whole problem. Two very important factors identified are under-reporting and inadequate case and outbreak investigations.

Caracterización de rotavirus asociados a gastroenteritis infantil humana / Characterization of rotavirus associated to human infant gastroenteritis

Se hace un estudio de los principales agentes virales asociados a cuadros diarreicos en niños venezolanos, a fin de caracterizarlos y establecer sus patrones epidemiológicos

Viral hepatitis and gastroenteritis transmitted by shellfish and water.

The epidemiology and clinical presentation of water-borne viral diseases, including shellfish-associated viral illnesses, are discussed in this article. Hepatitis A virus, Non A-Non B hepatitis and the agents of viral gastroenteritis, Norwalk agent, Snow Mountain agent, rotavirus, the small round viruses, caliciviruses, and astroviruses are included. The technical problems associated with evaluating the viral contamination of water or shellfish are noted.

Salmonella newport infections transmitted by fiberoptic colonoscopy.

During a 2-week period following the colonoscopy and biopsy of a patient with acute Salmonella newport gastroenteritis, S. newport was recovered from colonic aspirates or fecal specimens of eight of 28 patients from whom specimens were cultured during or after colonoscopy. Two of the eight persons from whom S. newport was isolated developed acute gastroenteritis, two had asymptomatic infections, and four had positive aspirates collected through a colonoscope but did not become infected. Although S. newport was never recovered from the four colonoscopes used during the outbreak, cultures of one of the colonic biopsy forceps grew S. newport. Contamination of the equipment most likely occurred during colonoscopy of the index patient. Inadequate disinfection of the equipment allowed the organism to survive and possibly to cross-contaminate other colonoscopes, and the organism was then transmitted to other patients by use of the contaminated colonoscopes or the contaminated biopsy forceps. Implemented control measures terminated the outbreak.