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==Overview==
==Overview==
The risk factors of Acute diarrhea may be assessed based on the [[epidemiologic]] associations and the patient exposure histories. Risk factors may be classified based on travel history, epidemics, outbreaks, food history, animal contact, hospitalization and immunosupression. The 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea lists the risk factors of diarrhea along with their causative pathogens.
The [[risk factors]] of acute diarrhea may be assessed based on the [[epidemiologic]] associations and the patient exposure histories. [[Risk factors]] may be classified based on travel history, [[Epidemic|epidemics]], [[Outbreak|outbreaks]], food history, animal contact, [[Hospital|hospitalization]] and [[immunosupression]]. The 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea lists the [[risk factors]] of diarrhea along with their causative [[Pathogen|pathogens]].


==Risk factors==  
==Risk factors==  
According to the '''2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea''', conditions associated with causative pathogens of diarrhea include the following:<ref name="pmid29083755">{{cite journal |vauthors=Dunn N, Gossman WG |title= |journal= |volume= |issue= |pages= |year= |pmid=29083755 |doi= |url=}}</ref>
According to the '''2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea''', common [[risk factors]] along with causative [[Pathogen|pathogens]] of diarrhea include the following:<ref name="pmid29083755">{{cite journal |vauthors=Dunn N, Gossman WG |title= |journal= |volume= |issue= |pages= |year= |pmid=29083755 |doi= |url=}}</ref>
{{Family tree/start}}
{{familytree |boxstyle=text-align: left; | | | | | | B01 | | | |B01='''Contamination''': <br> •Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events  <br> •Consumption of unpasteurized milk or dairy products <br> •Waterborne <br> •Animal exposure <br> •Consumption of raw or undercooked meat or poultry}}
{{Family tree | | | | | | |!| | | | | }}
{{Family tree | | | | | | |!| | | | | }}
{{familytree |boxstyle=text-align: left; | A01 |-|-| A02 |-|-|-| A03 | |A01= '''Exposure''': <br> •Child care facilities <br>•Long term care facilities <br>•[[Hospitalisation]] <br>•International travel| A02= '''RISK FACTORS FOR ACUTE DIARRHEA'''| A03='''Host factors''': <br>•[[Immunocompromised]] hosts <br>•Certain sexual practices <br>•Age group <br>•[[Hemochromatosis]] or [[hemoglobinopathy]]}} 


==== Exposure or condition ====
{{Family tree | | | | | | |!| | | | | }}
*Age group
{{Family tree | | | | | | |!| | | | | }}
**Birth- 3 months: Nontyphoidal Salmonella
{{familytree |boxstyle=text-align: left; | | | | | | B01 | | | |B01= '''Side effects of pharmacotherapy''': <br>•[[Antimicrobial]] therapy <br>•Drug side effects}}
**6–18 months: Rotavirus
{{Family tree/end}}
**1–7 years: Shigella
**Young adults: Campylobacter
**Adults >50 years with a history of atherosclerosis: Nontyphoidal Salmonella


*Immunocompromised individuals
==== Contamination ====
**Nontyphoidal Salmonella, Yersinia,  Shigella, Cryptosporidium, Campylobacter
*Hemochromatosis or hemoglobinopathy
**Salmonella, Y. enterocolitica
*AIDS, immunosuppressive therapies, homosexual men, transplant recipients
**Cytomegalovirus, Mycobacterium avium–intercellulare complex, Cryptosporidium, Cyclospora, Cystoisospora, Microsporidia, HIV
 
*Drug side effects<ref name="pmid16319813">{{cite journal |vauthors= |title=Severe Clostridium difficile-associated disease in populations previously at low risk--four states, 2005 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=54 |issue=47 |pages=1201–5 |year=2005 |pmid=16319813 |doi= |url=}}</ref>
**Broad spectrum antibiotics,  Immunosuppressants, Anti fungals
*Anal-genital, oral-anal, or digital-anal contact
**Shigella, Giardia lamblia, Campylobacter, E. histolytica, Cryptosporidium and sexually transmitted infections, Salmonella,
 
==== Foodborne ====
*Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events<ref name="pmid9282385">{{cite journal |vauthors=Todd EC |title=Epidemiology of foodborne diseases: a worldwide review |journal=World Health Stat Q |volume=50 |issue=1-2 |pages=30–50 |year=1997 |pmid=9282385 |doi= |url=}}</ref>
*Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events<ref name="pmid9282385">{{cite journal |vauthors=Todd EC |title=Epidemiology of foodborne diseases: a worldwide review |journal=World Health Stat Q |volume=50 |issue=1-2 |pages=30–50 |year=1997 |pmid=9282385 |doi= |url=}}</ref>
**Shigella, Vibrio cholerae, Bacillus cereus, Staphylococcus aureus, nontyphoidal Salmonella, Clostridium perfringens,Campylobacter spp, ETEC, Listeria, Norovirus, Rotavirus, Cryptosporidium, Cyclospora cayetanensis
**[[Shigella]], [[Vibrio cholerae]], [[Bacillus cereus]], [[Staphylococcus aureus]], [[Salmonella|nontyphoidal Salmonella]], [[Clostridium perfringens]], [[Campylobacter]], [[ETEC]], [[Listeria monocytogenes|Listeria]], [[Norovirus]], [[Rotavirus]], [[Cryptosporidium]], [[Cyclospora cayetanensis]]
*Consumption of unpasteurized milk or dairy products<ref name="pmid23804024">{{cite journal |vauthors=Gould LH, Walsh KA, Vieira AR, Herman K, Williams IT, Hall AJ, Cole D |title=Surveillance for foodborne disease outbreaks - United States, 1998-2008 |journal=MMWR Surveill Summ |volume=62 |issue=2 |pages=1–34 |year=2013 |pmid=23804024 |doi= |url=}}</ref>  
*Consumption of unpasteurized milk or dairy products<ref name="pmid23804024">{{cite journal |vauthors=Gould LH, Walsh KA, Vieira AR, Herman K, Williams IT, Hall AJ, Cole D |title=Surveillance for foodborne disease outbreaks - United States, 1998-2008 |journal=MMWR Surveill Summ |volume=62 |issue=2 |pages=1–34 |year=2013 |pmid=23804024 |doi= |url=}}</ref>  
**Salmonella, Campylobacter, Brucella (goat milk cheese), Coxiella burnetii, Yersinia enterocolitica, S. aureus toxin, Cryptosporidium, Listeria, Mycobacterium bovis  
**[[Salmonella]], [[Campylobacter]], [[Brucella]] (goat milk cheese), [[Coxiella burnetii]], [[Yersinia enterocolitica]], [[Staphylococcus aureus infections|S. aureus toxin]], [[Cryptosporidium]], [[Listeria monocytogenes|Listeria]], [[Mycobacterium bovis]]
*Consumption of raw or undercooked meat or poultry<ref name="pmid29379258">{{cite journal |vauthors=Somboonwit C, Menezes LJ, Holt DA, Sinnott JT, Shapshak P |title=Current views and challenges on clinical cholera |journal=Bioinformation |volume=13 |issue=12 |pages=405–409 |year=2017 |pmid=29379258 |pmc=5767916 |doi=10.6026/97320630013405 |url=}}</ref>
*Consumption of raw or undercooked meat or poultry<ref name="pmid29379258">{{cite journal |vauthors=Somboonwit C, Menezes LJ, Holt DA, Sinnott JT, Shapshak P |title=Current views and challenges on clinical cholera |journal=Bioinformation |volume=13 |issue=12 |pages=405–409 |year=2017 |pmid=29379258 |pmc=5767916 |doi=10.6026/97320630013405 |url=}}</ref>
**C. perfringens (beef, poultry), EHEC (ground beef), Salmonella (poultry), Calcivirus (oysters), Campylobacter (poultry), Vibrio (oysters),Yersinia (pork, chitterlings), S. aureus (poultry), and Trichinella spp (pork, wild game meat)
**[[Clostridium perfringens|C. perfringens]] (beef, poultry), [[EHEC]] (ground beef), [[Salmonella]] (poultry), Calcivirus (oysters), [[Campylobacter]] (poultry), [[Vibrio]] (oysters),[[Yersinia]] (pork, chitterlings), [[Staphylococcus aureus|S. aureus]] (poultry), and [[Trichinella]] (pork, wild game meat)
*Consumption of fruits or unpasteurized fruit juices, vegetables, leafy greens, and sprouts
*Consumption of fruits or unpasteurized fruit juices, vegetables, leafy greens, and sprouts
**Hepatitis A,  Listeria monocytogenes, Nontyphoidal Salmonella, Cyclospora, Cryptosporidium, Norovirus
**[[Hepatitis A]],  [[Listeria monocytogenes]], [[Salmonella|Nontyphoidal Salmonella]], [[Cyclospora cayetanensis|Cyclospora]], [[Cryptosporidium]], [[Norovirus]]
*Consumption of undercooked eggs  
*Consumption of undercooked eggs  
**Salmonella, Shigella (egg salad)
**[[Salmonella]], [[Shigella]] (egg salad)
*Consumption of raw shellfish
*Consumption of raw shellfish
**Hepatitis A, Vibrio species, Plesiomonas norovirus
**[[Hepatitis A]], [[Vibrio]] species, [[Plesiomonas shigelloides|Plesiomonas]], [[Norovirus]]


==== Contact or exposure ====
*Swimming in or drinking untreated fresh water<ref name="pmid26111239">{{cite journal |vauthors=Guzman-Herrador B, Carlander A, Ethelberg S, Freiesleben de Blasio B, Kuusi M, Lund V, Löfdahl M, MacDonald E, Nichols G, Schönning C, Sudre B, Trönnberg L, Vold L, Semenza JC, Nygård K |title=Waterborne outbreaks in the Nordic countries, 1998 to 2012 |journal=Euro Surveill. |volume=20 |issue=24 |pages= |year=2015 |pmid=26111239 |doi= |url=}}</ref>
*Swimming in or drinking untreated fresh water<ref name="pmid26111239">{{cite journal |vauthors=Guzman-Herrador B, Carlander A, Ethelberg S, Freiesleben de Blasio B, Kuusi M, Lund V, Löfdahl M, MacDonald E, Nichols G, Schönning C, Sudre B, Trönnberg L, Vold L, Semenza JC, Nygård K |title=Waterborne outbreaks in the Nordic countries, 1998 to 2012 |journal=Euro Surveill. |volume=20 |issue=24 |pages= |year=2015 |pmid=26111239 |doi= |url=}}</ref>
**Giardia, Campylobacter, Cryptosporidium, Salmonella, Shigella, Plesiomonas shigelloides, Aeromonas
**[[Giardia lamblia|Giardia]], [[Campylobacter]], [[Cryptosporidium]], [[Salmonella]], [[Shigella]], [[Plesiomonas shigelloides]], [[Aeromonas]]
*Swimming in recreational water facility with treated water<ref name="pmid26111239" /><ref name="pmid28214721">{{cite journal |vauthors=Efstratiou A, Ongerth JE, Karanis P |title=Waterborne transmission of protozoan parasites: Review of worldwide outbreaks - An update 2011-2016 |journal=Water Res. |volume=114 |issue= |pages=14–22 |year=2017 |pmid=28214721 |doi=10.1016/j.watres.2017.01.036 |url=}}</ref>   
*Swimming in recreational water facility with treated water<ref name="pmid26111239" /><ref name="pmid28214721">{{cite journal |vauthors=Efstratiou A, Ongerth JE, Karanis P |title=Waterborne transmission of protozoan parasites: Review of worldwide outbreaks - An update 2011-2016 |journal=Water Res. |volume=114 |issue= |pages=14–22 |year=2017 |pmid=28214721 |doi=10.1016/j.watres.2017.01.036 |url=}}</ref>   
**Cryptosporidium  
**[[Cryptosporidium]]
*Healthcare, long-term care, prison exposure, or employment
**Norovirus, Clostridium difficile, Shigella, Cryptosporidium, Giardia, Rotavirus
*Day care
**Rotavirus, Cryptosporidium, Giardia, Shigella, STEC, Noro virus, Calci virus, Campylobacter
*Recent antimicrobial therapy and hospitalization<ref name="pmid16319813" />
**C. difficile, multidrug-resistant Salmonella, Rotavirus
*Travel to endemic areas, poor sanitation and crowding<ref name="pmid25928418">{{cite journal |vauthors=Heather CS |title=Travellers' diarrhoea |journal=BMJ Clin Evid |volume=2015 |issue= |pages= |year=2015 |pmid=25928418 |pmc=4415508 |doi= |url=}}</ref>
**Escherichia coli (enteroaggregative, enterotoxigenic, enteroinvasive), Shigella, Typhi and nontyphoidal Salmonella, Campylobacter, Vibrio cholerae, Aeromonas, Plesiomonas, Rotavirus, Noro virus (Cruise ship diarrhea), enteric Adenovirus, Entamoeba histolytica, Cryptosporidium, Blastocystis, Giardia, Cyclospora, Cystoisospora
 
*Exposure to house pets with diarrhea
*Exposure to house pets with diarrhea
**Campylobacter, Yersinia
**[[Campylobacter]], [[Yersinia]]
*Exposure to pig feces in certain parts of the world
*Exposure to pig feces in certain parts of the world
**Balantidium coli
**[[Balantidium coli]]
*Contact with young poultry or reptiles
*Contact with young poultry or reptiles
**Nontyphoidal Salmonella
**[[Salmonella|Nontyphoidal Salmonella]]
*Visiting a farm or petting zoo
*Visiting a farm or petting zoo
**Cryptosporidium, Campylobacter
**[[Cryptosporidium]], [[Campylobacter]]
 
==== Host factors ====
*Age group
**Birth- 3 months: [[Salmonella|Nontyphoidal Salmonella]]
**6–18 months: [[Rotavirus]]
**1–7 years: [[Shigella]]
**Young adults: [[Campylobacter]]
**Adults >50 years with a history of [[atherosclerosis]]: [[Salmonella|Nontyphoidal Salmonella]]
 
*[[Immunocompromised|Immunocompromised individuals]]
**[[Salmonella|Nontyphoidal Salmonella]], [[Yersinia]], [[Shigella]], [[Cryptosporidium]], [[Campylobacter]]
*[[Hemochromatosis]] or [[hemoglobinopathy]]
**[[Salmonella]], [[Yersinia Enterocolitica Infection|Y. enterocolitica]]
*[[HIV AIDS|AIDS]], [[Immunosuppression|immunosuppressive therapies]], [[homosexual men]], [[Transplant|transplant recipients]]
**[[Cytomegalovirus]], [[Mycobacterium avium intracellulare|Mycobacterium avium–intercellulare complex]], [[Cryptosporidium]], [[Cyclospora cayetanensis|Cyclospora]], [[Cystoisospora belli|Cystoisospora]], [[Microsporidia]], [[Human Immunodeficiency Virus (HIV)|HIV]]
 
==== Side effects of pharmacotherapy ====
*Drug side effects<ref name="pmid16319813">{{cite journal |vauthors= |title=Severe Clostridium difficile-associated disease in populations previously at low risk--four states, 2005 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=54 |issue=47 |pages=1201–5 |year=2005 |pmid=16319813 |doi= |url=}}</ref>
**[[Antibiotic|Broad spectrum antibiotics]]
**[[Immunosuppressive drug|Immunosuppressants]]
**[[Antifungal drug|Antifungals]]
 
*Recent [[Antimicrobial|antimicrobial therapy]] and [[Hospital|hospitalization]]<ref name="pmid16319813" />
**[[Clostridium difficile infection|C. difficile]]
**Multidrug-resistant [[Salmonella]]
**[[Rotavirus]]
 
==== Exposure ====
*[[Anal]]-[[Sex organ|genital]], oral-anal, or digital-anal contact
**[[Shigella]], [[Giardia lamblia]], [[Campylobacter]], [[Entamoeba histolytica|E. histolytica]], [[Cryptosporidium]] and [[Sexually transmitted disease|sexually transmitted infections]], [[Salmonella]]
*Healthcare, long-term care, prison exposure, or employment
**[[Norovirus]], [[Clostridium difficile]], [[Shigella]], [[Cryptosporidium]], [[Giardia lamblia|Giardia]], [[Rotavirus]]
*Day care
**[[Rotavirus]], [[Cryptosporidium]], [[Giardia lamblia|Giardia]], [[Shigella]], [[Norovirus]], Calcivirus, [[Campylobacter]]
*Travel to endemic areas, poor [[sanitation]] and crowding<ref name="pmid25928418">{{cite journal |vauthors=Heather CS |title=Travellers' diarrhoea |journal=BMJ Clin Evid |volume=2015 |issue= |pages= |year=2015 |pmid=25928418 |pmc=4415508 |doi= |url=}}</ref>
**[[Escherichia coli]] ([[EAEC|enteroaggregative]], [[Enterotoxigenic Escherichia coli|enterotoxigenic]], [[Enteroinvasive Escherichia coli infection|enteroinvasive]]), [[Shigella]], [[Salmonella|Typhi and nontyphoidal Salmonella]], [[Campylobacter]], [[Vibrio cholerae]], [[Aeromonas]], [[Plesiomonas shigelloides|Plesiomonas]], [[Rotavirus]], [[Norovirus]] (Cruise ship diarrhea), [[Adenoviridae|enteric Adenovirus]], [[Entamoeba histolytica]], [[Cryptosporidium]], [[Blastocystis]], [[Giardia lamblia|Giardia]], [[Cyclospora cayetanensis|Cyclospora]], [[Cystoisospora belli|Cystoisospora]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 20:16, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2] Sudarshana Datta, MD [3]

Overview

The risk factors of acute diarrhea may be assessed based on the epidemiologic associations and the patient exposure histories. Risk factors may be classified based on travel history, epidemics, outbreaks, food history, animal contact, hospitalization and immunosupression. The 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea lists the risk factors of diarrhea along with their causative pathogens.

Risk factors

According to the 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea, common risk factors along with causative pathogens of diarrhea include the following:[1]

 
 
 
 
 
Contamination:
•Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events
•Consumption of unpasteurized milk or dairy products
•Waterborne
•Animal exposure
•Consumption of raw or undercooked meat or poultry
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exposure:
•Child care facilities
•Long term care facilities
•Hospitalisation
•International travel
 
 
RISK FACTORS FOR ACUTE DIARRHEA
 
 
 
Host factors:
•Immunocompromised hosts
•Certain sexual practices
•Age group
•Hemochromatosis or hemoglobinopathy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Side effects of pharmacotherapy:
•Antimicrobial therapy
•Drug side effects
 
 
 

Contamination

Host factors

Side effects of pharmacotherapy

Exposure

References

  1. ↑ Dunn N, Gossman WG. PMID 29083755. Missing or empty |title= (help)
  2. ↑ Todd EC (1997). "Epidemiology of foodborne diseases: a worldwide review". World Health Stat Q. 50 (1–2): 30–50. PMID 9282385.
  3. ↑ Gould LH, Walsh KA, Vieira AR, Herman K, Williams IT, Hall AJ, Cole D (2013). "Surveillance for foodborne disease outbreaks - United States, 1998-2008". MMWR Surveill Summ. 62 (2): 1–34. PMID 23804024.
  4. ↑ Somboonwit C, Menezes LJ, Holt DA, Sinnott JT, Shapshak P (2017). "Current views and challenges on clinical cholera". Bioinformation. 13 (12): 405–409. doi:10.6026/97320630013405. PMC 5767916. PMID 29379258.
  5. ↑ 5.0 5.1 Guzman-Herrador B, Carlander A, Ethelberg S, Freiesleben de Blasio B, Kuusi M, Lund V, Löfdahl M, MacDonald E, Nichols G, Schönning C, Sudre B, Trönnberg L, Vold L, Semenza JC, Nygård K (2015). "Waterborne outbreaks in the Nordic countries, 1998 to 2012". Euro Surveill. 20 (24). PMID 26111239.
  6. ↑ Efstratiou A, Ongerth JE, Karanis P (2017). "Waterborne transmission of protozoan parasites: Review of worldwide outbreaks - An update 2011-2016". Water Res. 114: 14–22. doi:10.1016/j.watres.2017.01.036. PMID 28214721.
  7. ↑ 7.0 7.1 "Severe Clostridium difficile-associated disease in populations previously at low risk--four states, 2005". MMWR Morb. Mortal. Wkly. Rep. 54 (47): 1201–5. 2005. PMID 16319813.
  8. ↑ Heather CS (2015). "Travellers' diarrhoea". BMJ Clin Evid. 2015. PMC 4415508. PMID 25928418.
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