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Public Health Department Staff Presentation Epidemiology of Viral Gastroenteritis in Adults Bianca L. Tristan, PhD Student Walden University PUBH 8165-Environmental Health Instructor: Dr. Howard Rubin Summer, 2010
Introduction to Foodborne Illnesses • High morbidity & Mortality • Affects 76 million yearly • 325,000 hospitalizations • 5,000 deaths • $6 billion economic burden
Viral GastroenteritisRotavirus and Norovirus • High prevalence globally • 600,000 – 800,000 deaths/yearly • 21 million fromNorovirus in U.S. • 50% of all foodborne illness
Etiology • Four important viral agents • Norovirus • Rotavirus • Enteric Adenovirus • Astrovirus
Epidemiology Patterns • Two identifiable patterns • Endemic • Epidemic
Epidemiology Patterns • Endemic • Rotavirus Group A • Age 4-24 month old • Severe diarrhea • Dehydration
Transmission of Rotavirus • Transmitted fecal-oral route • Person - to - Person • Contaminated food & water • Contaminated commercial ice
Clinical Presentation • Vomiting • Watery diarrhea • Low grade fever • Abdominal pain
Clinical Presentation of the Norovirus • Nausea • Vomiting • Abdominal cramps • Fever • Headache
Diagnosis • Presentation • Transcriptase Polymerase Chain Reaction (RT – PCR) • Stool specimens within 48 to 72 hours • Direct and immune electron microscopy
Prevention • Frequent hand washing • Vaccination of infants • Adequate garbage and refuse disposal • Effective insect and rodent control
Surveillance • National Outbreak reporting system (NORS) • States report directly to the CDC • To the National Calicivirus Laboratory • Gastroenteritis & Respiratory Virus Laboratory Branch, Division for Immunization & Respiratory Disease
Surveillance • National Outbreak Reporting System • Calicinet – PulseNet Model-Public Health • Laboratories • Foodborne Gastroenteritis • Waterborne Gastroenteritis • Person – to – Person transmission
Education • Ten rules for safe food preparation & consumption • Follow Universal Precautions • Keep a free environment of rodents • Control insects and cockroaches
conclusion • Pathogens of Gastroenteritis • Rotavirus/Norovirus • Manifestations • Prevention
Conclusion • Evaluation • Severity of Illnesses • Exclusion
Conclusion • Resources • Recommendations • Laboratory tests may include
References: • California Endowment Health Journalism Fellowship (2010) Foodborne Illnesses: 76 million cases annually. USC, Reporting on Health, Los Angeles, CA Retrieved from http://www.reportingonhealth.org/resources/topics/foodborne-illness • Center for Disease Control and Prevention, Technical Factsheet, (2010) Norovirus: Center for Immunization and Respiratory Disease; Division of Viral Disease, Atlanta, GA. Retrieved from http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-factsheet.htm
References: • Blacklow, (2008) Epidemiology of viral gastroenteritis in adults, UpToDate Retrieved from http://www.uptodate.com/online/content/topic.do? • Matson, D. O. (2008) Epidemiology, Pathogenesis, clinical presentation and diagnosis of viral gastroenteritis in Children, UpToDate Retrieved from http://www.uptodate.com/online/content/topic.do?
References • Moeller, D. W. (2005) Environmental Health. (3rd Ed.) Cambridge, MA. Harvard University Press • World Who Organization, Fact sheet (2009) Diarrhoeal disease. Media Centre Retrieved from http://www.who.int/mediacentre/factsheets/fs330/ • en/index.html
References: • WHO (2009) Global use of Rotavirus Vaccine Recommended. Media Centre Retrieved From http://www.who.int/mediacentre/news/releases/200rotavirus_vaccine_2