Acute diarrhea risk factors
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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, conditions associated with causative pathogens of diarrhea include the following:[1]
Exposure or condition
- Age group
- Birth- 3 months: Nontyphoidal Salmonella
- 6–18 months: Rotavirus
- 1–7 years: Shigella
- Young adults: Campylobacter
- Adults >50 years with a history of atherosclerosis: Nontyphoidal Salmonella
- Immunocompromised individuals
- 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[2]
- 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[3]
- Shigella, Vibrio cholerae, Bacillus cereus, Staphylococcus aureus, nontyphoidal Salmonella, Clostridium perfringens,Campylobacter spp, ETEC, Listeria, Norovirus, Rotavirus, Cryptosporidium, Cyclospora cayetanensis
- Consumption of unpasteurized milk or dairy products[4]
- Salmonella, Campylobacter, Brucella (goat milk cheese), Coxiella burnetii, Yersinia enterocolitica, S. aureus toxin, Cryptosporidium, Listeria, Mycobacterium bovis
- Consumption of raw or undercooked meat or poultry[5]
- 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)
- Consumption of fruits or unpasteurized fruit juices, vegetables, leafy greens, and sprouts
- Hepatitis A, Listeria monocytogenes, Nontyphoidal Salmonella, Cyclospora, Cryptosporidium, Norovirus
- Consumption of undercooked eggs
- Salmonella, Shigella (egg salad)
- Consumption of raw shellfish
- Hepatitis A, Vibrio species, Plesiomonas norovirus
Contact or exposure
- Swimming in or drinking untreated fresh water[6]
- Giardia, Campylobacter, Cryptosporidium, Salmonella, Shigella, Plesiomonas shigelloides, Aeromonas
- Swimming in recreational water facility with treated water[6][7]
- 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[2]
- C. difficile, multidrug-resistant Salmonella, Rotavirus
- Travel to endemic areas, poor sanitation and crowding[8]
- 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
- Campylobacter, Yersinia
- Exposure to pig feces in certain parts of the world
- Balantidium coli
- Contact with young poultry or reptiles
- Nontyphoidal Salmonella
- Visiting a farm or petting zoo
- Cryptosporidium, Campylobacter
References
- ↑ Dunn N, Gossman WG. PMID 29083755. Missing or empty
|title=(help) - ↑ 2.0 2.1 "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.
- ↑ Todd EC (1997). "Epidemiology of foodborne diseases: a worldwide review". World Health Stat Q. 50 (1–2): 30–50. PMID 9282385.
- ↑ 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.
- ↑ 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.
- ↑ 6.0 6.1 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.
- ↑ 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.
- ↑ Heather CS (2015). "Travellers' diarrhoea". BMJ Clin Evid. 2015. PMC 4415508. PMID 25928418.