Table 6.6.
Most common syndromes
| Aetiological agents |
Clinical features |
Incubation period | Epidemiological features | Firstline treatment | ||
|---|---|---|---|---|---|---|
| Common | Others | |||||
| Rotavirus | Vomiting | Fever. Severe dehydration in some | 24-72 hours | Infants and young children particularly. Common world-wide in all socio-economic groups. Peak in winter in temperature climates | Oral rehydration therapy | |
| Acute watery diarrhoea | Enterotoxigenic E. coli | Nausea. Vomiting | Fever. Malaise. Severe dehydration | 6–72 hours | Infants and young children in developing countries. Travellers' diarrhoea | Oral rehydration therapy |
| Enteropathogenic E. coli | Nausea. Vomiting | Fever | 6–72 hours | Nursery outbreaks in developed countries. Children in developed countries. Uncertain in developing countries. | Oral rehydration therapy | |
| Non-typhoid Salmonellae | Nausea. Vomiting. Fever. Chills. Abdominal pain | Malaise | 8–36 hours | Children. Common world-wide. Food-borne outbreaks (animal products, e.g. chicken meat) Warmer seasons | Oral rehydration therapy | |
| Campylobacter | Abdominal pain. Malaise | Chills stools | 3–5 days | World-wide distribution. In developed countries may be transmitted by handling of animals | Oral rehydration therapy in severe cases | |
| Vibrio cholerae | Vomiting. Abdominal pain | Severe dehydration. Circulatory collapse ‘shock’ | 1–3 days | Children in endemic areas. Adults in newly affected areas. Not found in Latin America. | Oral rehydration therapy. Tetracycline | |
| Dysentery. Stool is soft and watery with blood and/or pus | Shigellae | Fever. Abdominal pain | Malaise. Vomiting. Urgency to defaecate. Painful spasm on defecation | 36–72 hours | Children. Poor hygiene. Malnutrition. Instititions. Warmer-seasons | Oral rehydration therapy Trimethoprimsulfamethoxazole |
| Prolonged diarrhoea (7–14 days) | Entamoeba histolytica | Abdominal discomfort | 2–6 weeks | All age groups. World-wide distribution | Metronidazole | |
| For at least 7 days stools have been more frequent or of softer consistency (with or without blood or pus) | Giardia lamblia | Abdominal distension. Flatulence | Anorexia. Nausea. Malabsorption. Frothy stools | 1–3 weeks | Young children. Some travellers. Poor hygiene. World-wide distribution | Metronidazole |