Acute diarrhea risk factors
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2] Sudarshana Datta, MD [3]
Overview
The risk factors of acute diarrhea may be assessed based on the epidemiologic associations and the patient exposure histories. Risk factors may be classified based on travel history, epidemics, outbreaks, food history, animal contact, hospitalization and immunosupression. The 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea lists the risk factors of diarrhea along with their causative pathogens.
Risk factors
According to the 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea, common risk factors along with causative pathogens of diarrhea include the following:[1]
| Contamination: •Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events •Consumption of unpasteurized milk or dairy products •Waterborne •Animal exposure •Consumption of raw or undercooked meat or poultry | |||||||||||||||||||||||||||||
| Exposure: •Child care facilities •Long term care facilities •Hospitalisation •International travel | RISK FACTORS FOR ACUTE DIARRHEA | Host factors: •Immunocompromised hosts •Certain sexual practices •Age group •Hemochromatosis or hemoglobinopathy | |||||||||||||||||||||||||||
| Side effects of pharmacotherapy: •Antimicrobial therapy •Drug side effects | |||||||||||||||||||||||||||||
Contamination
- Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events[2]
- Consumption of unpasteurized milk or dairy products[3]
- Salmonella, Campylobacter, Brucella (goat milk cheese), Coxiella burnetii, Yersinia enterocolitica, S. aureus toxin, Cryptosporidium, Listeria, Mycobacterium bovis
- Consumption of raw or undercooked meat or poultry[4]
- C. perfringens (beef, poultry), EHEC (ground beef), Salmonella (poultry), Calcivirus (oysters), Campylobacter (poultry), Vibrio (oysters),Yersinia (pork, chitterlings), S. aureus (poultry), and Trichinella (pork, wild game meat)
- Consumption of fruits or unpasteurized fruit juices, vegetables, leafy greens, and sprouts
- Consumption of undercooked eggs
- Salmonella, Shigella (egg salad)
- Consumption of raw shellfish
- Hepatitis A, Vibrio species, Plesiomonas, Norovirus
- Swimming in or drinking untreated fresh water[5]
- Swimming in recreational water facility with treated water[5][6]
- Exposure to house pets with diarrhea
- Exposure to pig feces in certain parts of the world
- Contact with young poultry or reptiles
- Visiting a farm or petting zoo
Host factors
- Age group
- Birth- 3 months: Nontyphoidal Salmonella
- 6–18 months: Rotavirus
- 1–7 years: Shigella
- Young adults: Campylobacter
- Adults >50 years with a history of atherosclerosis: Nontyphoidal Salmonella
- Immunocompromised individuals
- Hemochromatosis or hemoglobinopathy
- AIDS, immunosuppressive therapies, homosexual men, transplant recipients
Side effects of pharmacotherapy
- Drug side effects[7]
- Recent antimicrobial therapy and hospitalization[7]
- C. difficile
- Multidrug-resistant Salmonella
- Rotavirus
Exposure
- Anal–genital, oral-anal, or digital-anal contact
- Healthcare, long-term care, prison exposure, or employment
- Day care
- Rotavirus, Cryptosporidium, Giardia, Shigella, Norovirus, Calcivirus, Campylobacter
- Travel to endemic areas, poor sanitation and crowding[8]
- Escherichia coli (enteroaggregative, enterotoxigenic, enteroinvasive), Shigella, Typhi and nontyphoidal Salmonella, Campylobacter, Vibrio cholerae, Aeromonas, Plesiomonas, Rotavirus, Norovirus (Cruise ship diarrhea), enteric Adenovirus, Entamoeba histolytica, Cryptosporidium, Blastocystis, Giardia, Cyclospora, Cystoisospora
References
- ↑ Dunn N, Gossman WG. PMID 29083755. Missing or empty
|title=(help) - ↑ Todd EC (1997). “Epidemiology of foodborne diseases: a worldwide review”. World Health Stat Q. 50 (1–2): 30–50. PMID 9282385.
- ↑ Gould LH, Walsh KA, Vieira AR, Herman K, Williams IT, Hall AJ, Cole D (2013). “Surveillance for foodborne disease outbreaks – United States, 1998-2008”. MMWR Surveill Summ. 62 (2): 1–34. PMID 23804024.
- ↑ Somboonwit C, Menezes LJ, Holt DA, Sinnott JT, Shapshak P (2017). “Current views and challenges on clinical cholera”. Bioinformation. 13 (12): 405–409. doi:10.6026/97320630013405. PMC 5767916. PMID 29379258.
- ↑ 5.0 5.1 Guzman-Herrador B, Carlander A, Ethelberg S, Freiesleben de Blasio B, Kuusi M, Lund V, Löfdahl M, MacDonald E, Nichols G, Schönning C, Sudre B, Trönnberg L, Vold L, Semenza JC, Nygård K (2015). “Waterborne outbreaks in the Nordic countries, 1998 to 2012”. Euro Surveill. 20 (24). PMID 26111239.
- ↑ Efstratiou A, Ongerth JE, Karanis P (2017). “Waterborne transmission of protozoan parasites: Review of worldwide outbreaks – An update 2011-2016”. Water Res. 114: 14–22. doi:10.1016/j.watres.2017.01.036. PMID 28214721.
- ↑ 7.0 7.1 “Severe Clostridium difficile-associated disease in populations previously at low risk–four states, 2005”. MMWR Morb. Mortal. Wkly. Rep. 54 (47): 1201–5. 2005. PMID 16319813.
- ↑ Heather CS (2015). “Travellers’ diarrhoea”. BMJ Clin Evid. 2015. PMC 4415508. PMID 25928418.
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