tailieunhanh - Chapter 183. Viral Gastroenteritis

Acute infectious gastroenteritis is a common illness that affects persons of all ages worldwide. It is a leading cause of mortality among children in developing countries, accounting for an estimated 2 million deaths each year, and is responsible for up to 10–12% of all hospitalizations among children in industrialized countries, including the United States. Elderly persons, especially those with debilitating health conditions, are also at risk of severe complications and death from acute gastroenteritis. Among healthy young adults, acute gastroenteritis is rarely fatal but incurs substantial medical and social costs, including those of time lost from work. Several. | Chapter 183. Viral Gastroenteritis Introduction Acute infectious gastroenteritis is a common illness that affects persons of all ages worldwide. It is a leading cause of mortality among children in developing countries accounting for an estimated 2 million deaths each year and is responsible for up to 10-12 of all hospitalizations among children in industrialized countries including the United States. Elderly persons especially those with debilitating health conditions are also at risk of severe complications and death from acute gastroenteritis. Among healthy young adults acute gastroenteritis is rarely fatal but incurs substantial medical and social costs including those of time lost from work. Several enteric viruses have been recognized as important etiologic agents of acute infectious gastroenteritis Table 183-1 Fig. 183-1 . Illness caused by these viruses is characterized by the acute onset of vomiting and or diarrhea which may be accompanied by fever nausea abdominal cramps anorexia and malaise. As shown in Table 183-2 several features can help distinguish gastroenteritis caused by viruses from that caused by bacterial agents. However the distinction based on clinical and epidemiologic parameters alone is often difficult and laboratory tests may be required to confirm the diagnosis. Table 183-1 Viral Causes of Gastroenteritis among Humans Virus Family Genome Primary Age Group at Risk Clinical Severity Detection Assays Group A rotavirus Reoviridae Doublestrand segmented RNA Children 5 years EM EIA commercial PAGE RT-PCR Norovirus Caliciviridae Positivesense singlestrand RNA All ages EM EIA RT- PCR Sapovirus Caliciviridae Positivesense Children 5 years EM EIA RT- PCR singlestrand RNA Astrovirus Astroviridae Positive- Children EM EIA RT- sense 5 years PCR singlestrand RNA Adenovirus types 40 and 41 Adenoviridae Double- Children EM EIA strand 5 years commercial DNA PCR aEIA enzyme immunoassay EM electron microscopy PAGE polyacrylamide gel electrophoresis PCR .