Infectious diseases of the digestive system
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Infectious Diseases of the Digestive System. GI Tract. U.S. Foodborne-Disease Outbreaks. Typhoid Mary. Human carrier (and reservoir) of Salmonella typhi. Typhoid Fever and Salmonellosis. Salmonella enterica serovars. Infect domestic animals Eggs and contaminated meat

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Typhoid mary
Typhoid Mary

  • Human carrier (and reservoir) of Salmonella typhi



Salmonella enterica serovars
Salmonella enterica serovars

  • Infect domestic animals

  • Eggs and contaminated meat

  • One of the most prevalent causes of food-borne illnesses

  • Transmission dose as few as 10 organisms

  • Attachment is key virulence factor


Salmonella enterica serovars1
Salmonella enterica serovars.

  • Gram negative bacillus

  • Classification based on serology and phage susceptibility assays


Salmonellosis
Salmonellosis

  • 40,000 cases annually in US

  • Invades intestinal epithelial cells

  • Nausea, cramps, diarrhea

  • Recovery in a few days but may shed organism for 6 months


Campylobacter jejuni
Campylobacter jejuni

  • Small curved Gram negative rod

  • Lives in large intestine of birds and mammals

  • Fecal contamination of water and foods


Campylobacteriosis
Campylobacteriosis

  • Leading bacterial cause of human gastroenteritis in the world

  • 2.4 million U.S. cases/year

  • Undercooked poultry, shellfish, unpasteurized dairy products, contaminated water

  • Waterybloody diarrhea

  • Treated with antibiotics


Rotavirus
Rotavirus

  • virus

  • Primary cause of diarrhea morbidity and mortality

  • 1 million cases per year; 70,000 hospitalizations

  • Fecal-oral transmission

  • Most serious in infants 6-24 months


Hepatitis
Hepatitis

  • Inflammation of the liver

  • Multiple viruses


Hepatitis a virus
Hepatitis A Virus

  • “Infectious” hepatitis

  • Small RNA virus

  • Transmitted by fecal-oral route

  • New effective vaccine




Hepatitis b virus
Hepatitis B Virus

  • “Serum” hepatitis

  • Enveloped DNA virus

  • Can result in chronic infection and liver cancer

  • Recombinant vaccine


Hepatitis c virus
Hepatitis C Virus

  • “Serum” hepatitis

  • More likely than HBV to become chronic

  • Also causes liver cancer

  • No vaccine


Hepatitis c
Hepatitis C

  • Treated with Interferon alpha and ribavirin

  • No cure but slows liver damage


Giardia lamblia
Giardia lamblia

  • Protozoan

  • Cysts survive in environment

    • Insensitive to chlorine

  • Contaminated water source of infection


Giardiasis
Giardiasis

  • Shed by wild animals into water supply as well as by infected humans

  • G. lamblia attaches to human intestinal wall

  • Diarrhea lasting for weeks

  • Treated with anti-parasitic drugs


Helminthes

HELMINTHES

Flat worms and Round worms



Flat worms
FLAT WORMS

Phylum Platyhelminthes = Flat worms

Class Cestoda = Tape worms

Scolex contained in egg

holdfast structure with hooks and suckers

Proglottids major body of tapeworm

contains both ovaries and testes = hermaphroditic

Eggs can penetrate intestine of host and form hydatid cysts in tissues


FIGURE 13-57Taenia solium scolex (X64). The Taenia solium scolex has two rings of hooks and four suckers.


Hookworms
Hookworms

  • Ancylostoma duodenali and Necator americanus Old world and new world hookworms differ only in their geographic location.

    Human phase of this worm begins with a filaform larvae penetrating the skin, enters circulation, carried to the lungs, coughed up and swallowed, develops to adulthood in small intestine. Adult worms lay between 10,000 and 20,000 eggs per day. Daily blood loss 0.2ml/adult/day. Microcytic hypochromic anemia develops.


Biblical worm
Biblical worm

  • Trichinella spiralis etiological agent of trichinosis. Infectious larva is present in the striated muscle of carnivorous and omnivorous mammals. Swine most common organism to transmit to humans. Encysted larvae live for many years. Polar bears and walruses are accounting for new human infestations in our Alaskan artic regions.


FIGURE 13-68Trichinella spiralis larva in skeletal muscle (W.M., X260). The spiral juvenile and its nurse cell are visible in this preparation.


Pin worms or seat worms
Pin worms or Seat worms

  • Enterobius vermicularis most common helminthic infestation in America, 500 million cases annually globally second globally to Ascaris infestations.

    Eggs are ingested mainly fecal-oral.Egg laden dust can be inhaled. Autoinfection occurs frequently. “Scotch Tape Test” from perianal folds of diagnostic value.


Ascaris lumbricoides
Ascaris Lumbricoides

  • Large worms 25cm – 45cm in length. Most common helminth with over a billion infested a year. Prevalent in areas where sanitation is poor and human waste is used as fertilizer.

  • Ingested egg releases a larva that penetrates the duodenal wall and carried to the liver and the heart, enters the pulmonary system, enters the alveoli where they molt and mature. They are coughed up, swallowed and returned to the small intestine. Adults can be passed out into the feces.


Helminth transmission
Helminth Transmission

  • Intestine --> environment --> ingested

  • Examples: whipworm


Helminth transmission1
Helminth Transmission

  • Intestine --> environment --> skin penetration

  • Example: hookworms


Helminth transmission2
Helminth Transmission

  • Intestine --> environment --> food animal muscle --> ingested

  • Example: tapeworm


Helminth transmission3
Helminth Transmission

  • Various organs --> environment --> ingestion or penetration

  • Example: flukes


Treatment of inflammatory bowel disease with worms
Treatment of Inflammatory Bowel Disease with Worms?

  • Pig whipworm causes transient, non-invasive, non-infective human disease

  • Improved IBD symptoms


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