1. Infective diarrhoea By Remilekun Odetoyinbo GPST1

2. Causes Bacteria campylobacter salmonella e-coli Shigella Staph clotridium Cholera Viral Rota, Adeno, Noro virus Parasites like giardia, Worms hook worms,pin worms Others amoebic dysentery

3. Signs and symptoms Diarrhoea Abdominal pain Vomiting Fever Bloating Weight loss Malaise nausea

4. E coli. Commonest cause of travellers diarrhoea Main route is feacal to oral transmission. Can get it from contaminated vegetables, cheese Can be treated with amoxicillin or cephalosporin

5. Clostridium difficile. Most serious cause of antibiotic associated diarrhoea. Presentation is mainly after antibiotics with abdominal pain, bloating, loose foul smelling stools Can be treated with metronidazole or vancomycin if no response.

6. Viral causes Rota Virus Commonest cause of severe diarrhoea in infants and children. Incubation period of 2 days Symptoms start with vomiting followed by 4-8 days of watery stools More associated with dehydration than bacterial causes. Symptomatic management and rehydration is essential

7. Viral causes Noro virus affects all ages Common in semiclosed or closed communities. camps, hospital, dormitories Transmitted from person to person or from contaminated food and water Incubation period 1-2 days. Last for 24-60 hours. Symptoms are mainly forceful vomiting, diarrhoea, abdominal pain Handwashing is essential to reduce spread.

8. Gardia Lamblia. Protozoa parasite. Got from contaminated water or faecal –oral transmission. Causes villous atropy. Presents with weight loss, bloating steatorrhoea epigastric pain nausea and explosive diarrhoea Treat with metronidazole first line. Others tinidazole,nitazoxamide

9. QUIZ Most common cause of severe diarrhoea in infants and children The cause of 90% of non bacterial outbreaks of diarrhoea in the world. Antibiotic of choice for campylobacter Commonest cause of travellers diarrhoea. Antibiotic of choice for Clostridium difficille

10. A Rota virus B E-coli C Noro virus D Metronidazole E Erythromycin

11. True or false 1 Gardia lamblia is a protozoan 2 Dehydration is twice more likely to occur in diarrhoea of bacteria origin than with rota virus 3 Noro virus infection can follow breathing air near an episode of vomiting. 4 Alcohol gel is inadequate for infection control when in contact with noro virus patients