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Infectious intestinal diseases

Infectious intestinal diseases include several diseases with similar syndromes but different causal agents (viruses, bacteria, fungi or parasites). Most cases involve indigestion due to infection of the digestive system: nausea, vomiting, stomach pain, high body temperature, diarrhoea. Patients are easily exhausted and are exposed to dehydration due to the loss of body fluids. Less severe infections are accompanied with milder symptoms or no symptoms at all. The symptoms occur a few hours or a few days after infection, depending on the causal agent and the infective dose. The disease may last for several days, rarely longer. If untreated, the disease usually lasts from 3 to 5 days, in 10-15% of patients longer than a week and in 1-2% of patients longer than a month.

Infectious intestinal diseases are especially dangerous for elderly people, chronic patients, children and pregnant women. Infectious intestinal diseases include: hepatitis A, typhus and paratyphoid fever, cholera, poliomyelitis and others (rarely).

There are known cases of intoxication with some types of fish and shellfish, which contain biological agents or high amounts of the amino acid histidine.

Manner of infection

All infectious intestinal diseases have a common manner of transmission of the causal agents. They are consumed through food, water or dirty hands. The causal agent is excreted through the faeces of the patient.  The excretion of germs typically does not stop when the patient recovers, but continues for several weeks or months, which can be established only by microbiological analyses. Through the patient or germ carrier the causal agent returns into the environment and, in unhygienic conditions (not enough safe drinking water, inappropriate drinking water supply, inappropriate discharge of sewage, inappropriate hygienic regime in preparing food etc.), the infection may spread to healthy people.

Infectious intestinal diseases typically occur more frequently and spread more easily in post-disaster areas (wars, earthquakes, storms, floods, etc.). Damaged water installations disrupt the supply of drinking water and various causal agents may enter the water pipeline systems (also from the sewage system).

Some causal agents may also infect animals, which do not show signs of infections. The disease may be caused by consummation of inappropriately prepared contaminated meat or eggs. In most cases the causal agent are sensible to heat and can be exterminated with appropriate heat treatment (boiling or frying).

Treatment

 

The treatment of infectious intestinal diseases depends on the type of the causal agent and the severity of symptoms. It typically involves easing pain and only rarely treatment with antibiotics. In all cases it is very important that the loss of fluid and salt is replaced. Several types of salts are available on the market, which are dissolved in bottled water and are consumed in small amounts (ca. 1 dcl) several times a day. The patient should consume at least 2.5 litres of fluid a day, which satisfies the basic need for water and replaces all fluid loss resulting from the disease (diarrhoea, vomiting, sweating, etc.).

In case the symptoms are more severe, consultation with a doctor is imperative.


Prevention

 

In preventing the occurrence and spreading of infectious intestinal diseases the most important factor is to take into consideration the basic hygienic measures and carefully select food and drinks.

HAND WASHING:

  • Always wash your hands thoroughly with soap and clean water after using the bathroom and when leaving the sanitary facilities,
  • Always wash your hands with clean water and soap before eating,.
  • Wash your hands as frequently as possible, wherever there is warm water and soap and wipe them in clean paper towels. Where there is no available clean water, use wet hygienic or alcohol wipes.

FOOD:

  • Eat well cooked/boiled/fried freshly prepared food (not stale or warmed).
  • Eat fruit and vegetables only if it is heat-treated or if you peel, crush or cut it yourself with a clean knife and clean hands.
  • Do not eat “lukewarm” food, milk which was not boiled, or pastries at room temperature; eating raw fish and shellfish is also not advised.
  • Consider the rule: Do not eat, unless it is cooked, fried, boiled or peeled!

WATER and beverages:

  • Drink bottled water and beverages (originally sealed) with no added ice, or boiled water and beverages.
  • In hygienically inappropriate areas use bottled or boiled water also for teeth brushing.

 

Vaccination and chemoprophylaxis

 

Preventive use of antibiotics is not necessary and not advisable. Antimicrobial preventive drugs are appropriate for travellers who are susceptible to intestinal infections or when there is risk of difficulties in case of diarrhoea.

The only effective vaccination against numerous microbes which can cause intestinal difficulties is the hepatitis A vaccine. The typhoid fever vaccine, which is also available, is slightly less effective.

 

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Slovensko zdravniško društvo
Sekcija za preventivno medicino
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1000 Ljubljana

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