| Infective agent |
Incubation |
Characteristic |
Presentation |
Diagnosis |
Treatment |
|---|---|---|---|---|---|
| Norovirus (also known as Norwalk virus) |
12-48 hrs |
Common more in adults than children. Highly infectious from infected people, food, environment |
Acute-onset vomiting, watery diarrhoea, cramps, nausea lasting 1-3 days |
clinical, stool PCR, enzyme immunoassay |
Supportive as self-limiting |
| Rotavirus |
1-3 days |
Common more in children than adults (commonest cause of gastroenteritis in children 50%) |
Watery diarrhoea and vomiting for 3–8d, fever, abdominal pain |
clinical, stool PCR, enzyme immunoassay |
Supportive as self-limiting, Routine vaccination in UK |
| Enterotoxigenic E. Coli |
1-3 days |
Disease due to heat-stable or heat-labile toxin which stimulates Na+, Cl- and water efflux into gut lumen à secretory diarrhoea Major cause of traveller’s diarrhoea. |
Watery diarrhoea and vomiting for 3–8d, fever, abdominal pain |
Clinical, culture, PCR |
Supportive as self-limiting but antibiotics can have a role in shortening treatment duration |
| Clostridium perfringens (Strain Type A) |
8-12 hrs |
Spores survive cooking and germinate during unrefrigerated storage à produce enterotoxins β-toxin of C. perfringens strain type C can cause a necrotizing enteritis with fulminant disease |
sudden-onset diarrhoea, cramps, usually lasts <24h |
Clinical, PCR, ELISA |
Supportive |
| Cholera (vibrio cholera) |
12 hours to 5 days |
Found in faecally contaminated water Major cause of diarrhoea related mortality and morbidity worldwide Causes secretory diarrhoea |
Profuse (1L/h) diarrhoea (‘rice-water’ stool), vomiting, dehydration, metabolic acidosis, circulatory collapse, death |
Stool microscopy and culture |
Oral rehydration, Rigler’s lactate, normal saline, electrolytes, zinc in children |
| Salmonella gastroenteritis (typhoid fever) |
8-14 days |
Certain serotypes of S. enterica, primarily serotype Typhi (S. typhi) can cause more severe type of salmonella gastroenteritis called typhoid fever |
High fever, body aches, headache, nausea, lethargy, and a possible rash. Asymptomatic carrier possible (think of Typhoid Mary) |
Clinical examination and culture |
Ciprofloxacin |
| Bacillus cereus |
<6 hrs |
By eating questionable rice. Characterised by marked vomiting |
Diarrhoea and vomiting |
Stool microscopy and culture |
Supportive |
| Vibrio para haemolyticus |
16-72 hrs |
By eating questionable seafood |
|
Stool microscopy and culture |
Supportive. Antibiotic has a role |
| Botulism |
18-36 hrs |
By eating questionable canned food |
Diarrhoea, abdominal cramps, dry mouth, diplopia, progressive paralysis |
Serum/faecal C. Bolulinum toxin |
Manage in ITU with mechanical ventilation |