GASTROENTERITIS

What is gastroenteritis?

Gastroenteritis is an infection of the intestines caused by bacteria, viruses and other microbes. It can range from a mild stomach upset for a day or two with some mild diarrhoea, to severe vomiting and diarrhoea for several days or longer.

Symptoms

• The main symptom is diarrhoea, often with vomiting.
• Cramps in the abdomen. Pains may ease for a while each time some diarrhoea is passed.
• High temperatures (fever) and headaches are common.
• If vomiting occurs, it typically lasts a day or so. Diarrhoea often lasts for several days or more after the vomiting stops. Loose stools (motions or faeces) can persist for a week or so before a normal pattern returns. Sometimes the symptoms last longer.

Causes

• A virus is a common cause. Viruses are easily spread from one person to another by close contact, or when an infected person prepares food for others.
• Sometimes it is caused from infected food (food poisoning). There are many types of bacteria that can cause food poisoning.
• Water contaminated by bacteria or other 'bugs' is a common cause.

Prevention

• Good hygiene helps to prevent gastroenteritis. Always wash your hands, and teach children to wash theirs:
• After going to the toilet (and after changing nappies).
• Before touching food.
• After playing with pets (healthy animals can carry certain harmful bacteria).
• Between handling raw meat and food ready to be eaten. (There may be some bacteria on raw meat.)

For Children

• Regularly clean the toilets they use. Also, wipe the flush handle and toilet seat with disinfectant (such as household bleach) after each time they use the toilet.
• Wash hands after going to the toilet. Don't share towels and flannels.
• Do not let them help to prepare food for others.
• They should stay off school, nursery, etc until symptoms have gone.

Treatment

• Symptoms often settle within a week or so as the immune system usually clears the infection. The following are commonly advised until symptoms ease.
• Avoid dehydration (low body fluid). Even patient vomits or feels sick, give frequent sips of some fluid. Ideally, give water and also give some fruit juice as this contains sugar. However, any drink is better than none.
• Rehydration drinks may be advised by a doctor or nurse. You can give these instead of, or in addition to, normal drinks. Rehydration drinks provide a perfect balance of water, salt, and sugar. They do not stop or reduce diarrhoea, but are the best drinks to prevent or treat dehydration. (Do not use home made salt drinks as the quantity of salt has to be exact.).
• Eat normally. Do not starve patient with gastroenteritis. But if patient  does not want to eat, that is fine. Drinks are the most important and food can wait until appetite returns. Offer food now and then. Soups and food high in carbohydrate such as bread, pasta, rice and potatoes are best.
• Breast fed babies should continue to breast feed if they will take it. This is in addition to extra rehydration drinks which may be advised. Bottle fed babies should be fed with their normal full strength feeds if they will take it. Again, this is in addition to extra rehydration drinks which may be advised.
• You should not give medicines to stop diarrhoea to young children.
• If symptoms are severe, or persist, contact a doctor/hospital.

Complications

• Complications are uncommon. See a doctor if any of the following develop, or if any other symptoms occur that you are concerned about.
• Dehydration. Symptoms include: passing little urine, a dry mouth and tongue, drowsiness.
• Blood in the diarrhoea.
• Vomiting for more than 1 day, or diarrhoea which does not start to settle after 3-4 days.
• Pains which are getting worse.
• Drowsiness or confusion.
• Hospitalisation is sometimes needed if symptoms are severe, or if complications develop.

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DENGUE

What is dengue fever?

Dengue fever is a flu-like illness spread by the bite of an infected mosquito. Dengue hemorrhagic fever is a severe, often fatal, complication of dengue fever.

Causes

Dengue and dengue hemorrhagic fever are caused by any of the dengue family of viruses. Infection with one virus does not protect a person against infection with another.

Spread

Dengue is spread by the bite of an Aedes mosquito. The mosquito transmits the disease by biting an infected person and then biting someone else.

The mosquitoes that transmit dengue live among humans and breed in discarded tires, flower pots, old oil drums, and water storage containers close to human dwellings. Unlike the mosquitoes that cause malaria, dengue mosquitoes bite during the day.

Symptoms

• Dengue fever usually starts suddenly with a high fever, rash, severe headache, pain behind the eyes, and muscle and joint pain. The severity of the joint pain has given dengue the name 'breakbone fever.' Nausea, vomiting, and loss of appetite are common. A rash usually appears 3 to 4 days after the start of the fever. The illness can last up to 10 days, but complete recovery can take as long as a month. Older children and adults are usually sicker than young children.
• Most dengue infections result in relatively mild illness, but some can progress to dengue hemorrhagic fever. With dengue hemorrhagic fever, the blood vessels start to leak and cause bleeding from the nose, mouth, and gums. Bruising can be a sign of bleeding inside the body. Without prompt treatment, the blood vessels can collapse, causing shock (dengue shock syndrome). Dengue hemorrhagic fever is fatal in about 5 percent of cases, mostly among children and young adults.
• The time between the bite of a mosquito carrying dengue virus and the start of symptoms averages 4 to 6 days, with a range of 3 to 14 days. An infected person cannot spread the infection to other persons but can be a source of dengue virus for mosquitoes for about 6 days.

Diagnoses

Dengue is diagnosed by a blood test.

Treatment

There is no specific treatment for dengue. Persons with dengue fever should rest and drink plenty of fluids. They should be kept away from mosquitoes for the protection of others. Dengue hemorrhagic fever is treated by replacing lost fluids. Some patients need transfusions to control bleeding.

Prevention

There is no vaccine to prevent dengue.

• Use mosquito repellents on skin and clothing.
• Use mosquito nets in sleeping areas.

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LEPTOSPIROSIS

What is leptospirosis?

Leptospirosis is a bacterial disease associated with wild and domestic animals.

Spread

Leptospirosis is spread mainly by the urine of infected animals and is generally not transmitted from person to person.

Symptoms

The symptoms are fever, headache, chills, vomiting, jaundice, anemia and sometimes rash. People with leptospirosis are usually quite ill and are often hospitalized.

The incubation period is usually 10 days with a range of four to 19 days.

Diagnoses

The disease is diagnosed using specific blood tests.

Treatment

The antibiotics of choice are penicillin, streptomycin, tetracycline and erythromycin. Kidney dialysis may be necessary in some cases.

Prevention

Disease prevention consists of good sanitation. The use of boots and gloves in hazardous places, and rodent control can also minimize the risk of spread.

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CHOLERA

What is cholera

Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a copious, painless, watery diarrhoea that can quickly lead to severe dehydration and death if treatment is not promptly given. Vomiting also occurs in most patients

Treatment

Cholera is a treatable disease. The prompt administration of oral rehydration salts to replace lost fluids nearly always results in cure. In especially severe cases, intravenous administration of fluids may be required. Left untreated, however, cholera can kill quickly following the onset of symptoms.

Spread

Cholera is usually transmitted through faecally contaminated water or food.

Prevention and control

Children as well as adults can get infected. Among those infected, about 20 percent develop acute watery diarrhoea, of which 10-20 percent develop severe watery diarrhoea with vomiting. The mainstay of treatment is rehydration and up to 80 percent of cholera cases can be treated successfully using only oral rehydration salts. Prompt and appropriate medical management of cases can significantly decrease mortality.

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Caution: Do not self-medicate. This article is only intended to educate. If anyone has symptoms indicated in the article please contact a doctor

Compiled by S N Mishra