Diarrhea

Diarrhea is the passage of loose or watery stools at least 3 times in a 24-hour period. Acute diarrhea may be caused by different viruses, bacteria, and parasites. Rotavirus and Norwalk-like virus are the most common agents, causing up to 50% of acute diarrhea cases during the high-incidence seasons. Increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea.

Children in day care, nursing home resi-dents, food handlers, and recently hospitalized patients are at high risk of infectious diarrheal illness. Pregnant women have a 12-fold increased risk of listeriosis, which is primarily contracted by consuming cold meats, soft cheeses, and raw milk.

In a disaster scenario a child with diarrhea may present with three potentially severe or very severe clinical conditions:
(1) acute watery diarrhea (including cholera), which lasts several hours or days, and can cause dehydration
(2) acute bloody diar-rhea or dysentery, which may cause intes-tinal damage, sepsis, malnutrition and dehydration, and
(3) persistent diarrhea (diarrhea that lasts more than 14 days). Most diarrheal germs are spread from the stool of one person to the mouth of another.

These germs are usually spread through contaminated water, food, or objects. Water, food, and objects become contaminated with stool in many ways:
◊ People and animals defecate in or near water sources that people drink.
◊ Contaminated water is used to irrigate crops.
◊ Food preparers do not wash their hands before cooking.
◊ People with contaminated hands touch objects, such as doorknobs, tools, or cooking utensils.

Diarrheal illness accounts for 2.5 million deaths per year worldwide. In the United States, an estimated 48 mil-lion foodborne diarrheal illnesses occur annually, resulting in more than 128,000 hospitalizations and 3,000 deaths.
Diarrhea