Viral Gastroenteritis MCB

GREGORY UNIVERSITY UTURU
COLLEGE OF MEDICAL AND HEALTH SCIENCES
DEPARTMENT OF MEDICINE AND SURGERY
LEVEL: 400 Level || BATCH C
LECTURER: DR IWU J.
COURSE: MEDICAL MICROBIOLOGY
DATE: February 15, 2023.
GROUP PRESENTATION
1. EFURHIEVWE DANIEL OGHENETEGA
170401000105
2. USEN-OBONG FAVOUR PETER
17040100111
TOPIC: VIRAL GASTROENTERITIS
OUTLINE
 Introduction
 Definition of Terms
 Virus
 Gastroenteritis
 Viral Gastroenteritis
 Epidemiology
 Pathophysiology
 Aetiology
 Clinical features
 Diagnosis
 Complications
 Prevention
 Conclusion
 References
INTRODUCTION:
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.
DEFINITION OF TERMS:
VIRUS: A virus is a submicroscopic infectious agent that replicates only inside

the living cells of an organism. Viruses infect all life forms, from animals and
plants to microorganisms, including bacteria and archaea.
GASTROENTERITIS: It is an inflammation of the stomach and intestines,

typically resulting from bacterial toxins or viral infection and causing vomiting
and diarrhea.
VIRAL GASTROENTERITIS: Viral gastroenteritis is an inflammation and

irritation of your intestines caused by one of a number of viruses, most
commonly norovirus or rotavirus. This illness is also known as the stomach flu.
EPIDEMIOLOGY
Acute diarrheal disease is generally self-limiting in industrialized nations but

can have significant morbidity for young and elderly patients. In
underdeveloped countries, viral diarrheal diseases are a significant cause of
death, especially in infants. According to the Centers for Disease Control, viral
gastroenteritis infections can account for over 200,000 deaths of children per
year worldwide. Isolated cases can occur, but viral gastroenteritis more
commonly occurs in outbreaks within close communities such as daycare
centers, nursing facilities, and cruise ships. In the United States and other
industrialized countries, the disease is most often self-limited and resolves in 1
to 3 days. However, in susceptible patients including young children, elderly
patients, and the immunocompromised, hospitalization can occur without proper
supportive care leading to increased morbidity and mortality. The most frequent
cause of diarrheal disease worldwide is acute viral gastroenteritis. Men and
women are affected equally. Norovirus is the most common viral cause. It is
responsible for 90% of epidemic diarrheal cases worldwide and approximately
50% of all viral gastroenteritis cases. It accounts for 19 to 21 million cases of
diarrheal illness annually in the United States alone. Norovirus causes 50% of
all food-borne diarrheal outbreaks. Prior to routine vaccination, rotavirus was
the most common cause of diarrheal illness in the pediatric population with
roughly 3.5 million cases per year in the United States. Nearly all children
possessed rotavirus antibodies by age three. Worldwide, rotavirus accounted for
440,000 deaths per year. However, since the implementation of vaccination in
2006, the number of cases seen annually in the United States has declined 50%
to 90% per year. As more countries adopt the standard practice of rotavirus
vaccination, the overall number of cases is expected to continue to decrease.
Other viral causes such as adenovirus, Sapovirus, and astrovirus account for 2%
to 9% of cases worldwide, with a higher bias for children than adults.
AETIOLOGY
Several different viruses including rotavirus, norovirus, adenovirus, and

astroviruses account for most cases of acute viral gastroenteritis. Most are
transmitted via the fecal-oral route, including contaminated food and water.
Transmission has also been shown to occur via fomites, vomitus, and possibly
airborne methods. Norovirus is more resistant to chlorine and ethanol
inactivation than other viruses.
Viruses (particularly rotavirus (in children) and norovirus (in adults)) and the
bacteria Escherichia coli and Campylobacter species are the primary causes of
gastroenteritis. There are, however, many other infectious agents that can cause
this syndrome including parasites and fungus. Non-infectious causes are seen on
occasion, but they are less likely than a viral or bacterial cause.
Risk of infection is higher in children due to their lack of immunity. Children

are also at higher risk because they are less likely to practice good hygiene
habits. Children living in areas without easy access to water and soap are
especially vulnerable.
Rotaviruses, noroviruses, adenoviruses, and astroviruses are known to cause
viral gastroenteritis.
Rotavirus is a double-stranded RNA virus named for the wheel-like appearance

of its viral capsid on an electron micrograph. Rotavirus infection is universal
among humans, and almost all children acquire antibodies by age 3. Rotavirus
infection usually presents with acute vomiting followed by several days of
diarrhea, crampy abdominal pain, anorexia, and low-grade fevers. Infants and
young children who develop severe dehydration are more likely to have an
infection from rotavirus than other viral gastroenteritis pathogens. Viral
shedding of infectious particles can occur in the stool for up to 10 days. Adults
are more likely to develop an asymptomatic infection with a rise in antibody
titer. Immunosuppressed individuals can experience more prolonged and severe
disease, with longer viral shedding. Rotavirus is the most common cause of
gastroenteritis in children, and produces similar rates in both the developed and
developing world. Viruses cause about 70% of episodes of infectious diarrhea in
the pediatric age group. Rotavirus is a less common cause in adults due to
acquired immunity. Generally speaking, viral gastroenteritis accounts for 21–
40% of the cases of infectious diarrhea in developed countries.
Norovirus is a single-stranded RNA member of the calicivirus family. It is the

most common cause of epidemic diarrheal illness, accounting for over 90% of
viral gastroenteritis outbreaks and approximately 50% of cases worldwide.
Norovirus can withstand freezing, heating, and common disinfectant products
containing alcohol or chlorine .
Norovirus is the leading cause of gastroenteritis among adults in America

accounting for about 90% of viral gastroenteritis outbreaks. These localized
epidemics typically occur when groups of people spend time proximate to each
other, such as on cruise ships, in hospitals, or in restaurants. Norovirus presents
most commonly with abdominal cramps and nausea followed by vomiting
and/or diarrhea. Onset can be abrupt. Symptoms also include myalgias, malaise,
and low-grade fevers up to 39 C. Diarrhea is non-bloody and can consist of
multiple bowel movements per day. The illness is self-limiting, and most
patients have recovered in 72 hours without sequelae [1]. Elderly individuals
and immunocompromised patients may have a more severe and prolonged
illness.
Norovirus infection causes histopathologic changes in the jejunum of blunted

villi with intact mucosa [15]. These changes occur quickly and usually resolve
by two weeks after the onset of illness. Fat and d-xylose absorption decrease as
does brush border enzyme activity leading to diarrhea [15]. Unlike rotavirus,
there does not seem to be enterotoxin production.People may remain infectious
even after their diarrhea has ended. Norovirus is the cause of about 10% of
cases in children.
PATHOPHYSIOLOGY
The clinical manifestations of viral gastroenteritis are due to the effects that the
viruses, along with specific cytotoxins, have on the enterocytes of the intestine.
The virus uses the enterocyte to replicate, leading to interference with brush
border enzyme production, which in turn leads to malabsorption and osmotic
diarrhea. Additionally, viral toxins lead to direct damage and cell lysis of
enterocytes and intestinal villa, causing a transudative loss of fluid into the
intestine. The loss of cell function can lead to electrolyte abnormalities which
are caused by the loss of transporter functionality. That can lead to acid-base
disturbances as well. The virus is then shed through feces, and occasionally in
the vomitus. Peak viral load within the stool is anywhere between 24 to 48
hours after symptomatology. Some studies show viral shedding lasting for
several weeks past symptomatology.
CLINICAL FEATURES:
Symptoms of viral gastroenteritis usually begin about 1 to 2 days after the virus
gets into the body.
Common symptoms include:
 Nausea
 Vomiting
 Watery diarrhea
Other possible symptoms are:
 Headache
 Fever
 Chills
 Stomachache
Signs of dehydration:
 Decreased urine output

 Dark-colored urine
 Dry skin
 Thirst
 Dizziness
Signs of dehydration in young children:
 Dry diapers (from a lack of urination)

 Lack of tears
 Dry mouth
 Drowsiness
Sunken fontanel (the soft spot on the top of an infant’s head)
DIAGNOSIS
Diagnosis of viral gastroenteritis is usually based on history and symptoms. It

rarely needs testing. However, if symptoms persists, a stool sample culture
maybe required to look for viruses, bacteria and parasites.
COMPLICATIONS
The main complication of gastroenteritis is dehydration. 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 system, May become severely dehydrated when they lose
more fluids than they can replace. So hospitalization maybe be required so that
lost fluids can be replaced through IV infusion. Dehydration rarely leads to
death.
PREVENTION
Vaccines are available to protect children from rotavirus. Healthcare providers
give shots to babies before the age of 6 months. Steps to help prevent viral
gastroenteritis:
1. Wash hands for 20 seconds with soap and water after going to the
bathroom, after changing a diaper and before touching any food.
2. Use alcohol based sanitizers
3. If someone in the house has gastroenteritis, wash all surfaces that might
be contaminated with a bleach based cleaner.
4. Avoid any food or water with warnings of contamination
TREATMENT
Specific treatment is usually not needed. In most cases, you simply need to
drink plenty of fluids and rest at home until the virus leaves your system. In rare
cases, you may need treatment for severe dehydration, with IV fluids. Helpful
home care tips includes:
1. Drink plenty of light fluids like water, ice chips, joint juice. Sports drinks
are high in sugar and they are not appropriate, if you are extremely dehydrated.
2. Avoid drinks that contain milk, caffeine and alcohol.
3. Once you feel hungry again, start with mild, easy to digest foods
4. Rehydrate children with oral rehydration solutions.
REFERENCES:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/
understanding-viral-gastroenteritis
https://www.mayoclinic.org/diseases-conditions/viral-gastroenteritis/
symptoms-causes/syc-20378847
https://en.m.wikipedia.org/wiki/Gastroenteritis
https://www.ncbi.nlm.nih.gov/books/NBK518995/

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GREGORY UNIVERSITY UTURU

COLLEGE OF MEDICAL AND HEALTH SCIENCES

DEPARTMENT OF MEDICINE AND SURGERY

LEVEL: 400 Level || BATCH C

COURSE: MEDICAL MICROBIOLOGY

DATE: February 15, 2023.

1. EFURHIEVWE DANIEL OGHENETEGA

2. USEN-OBONG FAVOUR PETER

Viral gastroenteritis is an intestinal infection that includes signs and symptoms

VIRUS: A virus is a submicroscopic infectious agent that replicates only inside

GASTROENTERITIS: It is an inflammation of the stomach and intestines,

VIRAL GASTROENTERITIS: Viral gastroenteritis is an inflammation and

Acute diarrheal disease is generally self-limiting in industrialized nations but

Several different viruses including rotavirus, norovirus, adenovirus, and

Risk of infection is higher in children due to their lack of immunity. Children

Rotavirus is a double-stranded RNA virus named for the wheel-like appearance

Norovirus is a single-stranded RNA member of the calicivirus family. It is the

Norovirus is the leading cause of gastroenteritis among adults in America

Norovirus infection causes histopathologic changes in the jejunum of blunted

Common symptoms include:

Other possible symptoms are:

 Decreased urine output

Signs of dehydration in young children:

 Dry diapers (from a lack of urination)

Sunken fontanel (the soft spot on the top of an infant’s head)

Diagnosis of viral gastroenteritis is usually based on history and symptoms. It

The main complication of gastroenteritis is dehydration. If you’re healthy and

2. Use alcohol based sanitizers

4. Avoid any food or water with warnings of contamination

2. Avoid drinks that contain milk, caffeine and alcohol.

4. Rehydrate children with oral rehydration solutions.

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