Bianca L. Tristan, PhD Student Walden University PUBH 8165-Environmental Health Instructor: Dr. Howard Rubin Summer, 2010 Public Health Department Staff Presentation Epidemiology of Viral Gastroenteritis in Adults

High morbidity & Mortality Affects 76 million yearly 325,000 hospitalizations 5,000 deaths $6 billion economic burden Introduction to Foodborne Illnesses

High prevalence globally 600,000 – 800,000 deaths/yearly 21 million from Norovirus in U.S. 50% of all foodborne illness Viral Gastroenteritis Rotavirus and Norovirus

Four important viral agents Norovirus Rotavirus Enteric Adenovirus Astrovirus Etiology

Two identifiable patterns –Endemic –Epidemic Epidemiology Patterns

Endemic Rotavirus Group A Age 4-24 month old Severe diarrhea Dehydration Epidemiology Patterns

Transmitted fecal-oral route Person - to - Person Contaminated food & water Contaminated commercial ice Transmission of Rotavirus

Vomiting Watery diarrhea Low grade fever Abdominal pain Clinical Presentation

 Nausea  Vomiting  Abdominal cramps  Fever  Headache Clinical Presentation of the Norovirus

Presentation Transcriptase Polymerase Chain Reaction (RT – PCR) Stool specimens within 48 to 72 hours Direct and immune electron microscopy Diagnosis

Frequent hand washing Vaccination of infants Adequate garbage and refuse disposal Effective insect and rodent control Prevention

National Outbreak reporting system (NORS) States report directly to the CDC To the National Calicivirus Laboratory Gastroenteritis & Respiratory Virus Laboratory Branch, Division for Immunization & Respiratory Disease Surveillance

National Outbreak Reporting System Calicinet – PulseNet Model-Public Health Laboratories –Foodborne Gastroenteritis –Waterborne Gastroenteritis –Person – to – Person transmission Surveillance

Ten rules for safe food preparation & consumption Follow Universal Precautions Keep a free environment of rodents Control insects and cockroaches Education

Pathogens of Gastroenteritis Rotavirus/Norovirus Manifestations Prevention conclusion

Evaluation Severity of Illnesses Exclusion Conclusion

Resources Recommendations Laboratory tests may include Conclusion

California Endowment Health Journalism Fellowship (2010) Foodborne Illnesses: 76 million cases annually. USC, Reporting on Health, Los Angeles, CA Retrieved from dborne-illness dborne-illness Center for Disease Control and Prevention, Technical Factsheet, (2010) Norovirus: Center for Immunization and Respiratory Disease; Division of Viral Disease, Atlanta, GA. Retrieved from factsheet.htm factsheet.htm References:

Blacklow, (2008) Epidemiology of viral gastroenteritis in adults, UpToDate Retrieved from Matson, D. O. (2008) Epidemiology, Pathogenesis, clinical presentation and diagnosis of viral gastroenteritis in Children, UpToDate Retrieved from References:

Moeller, D. W. (2005) Environmental Health. (3 rd Ed.) Cambridge, MA. Harvard University Press World Who Organization, Fact sheet (2009) Diarrhoeal disease. Media Centre Retrieved from en/index.html References

WHO (2009) Global use of Rotavirus Vaccine Recommended. Media Centre Retrieved From rotavirus_vaccine_2 References: