Gastroenteritis is an intestinal disorder that manifests a specific clinical symptomatology, which can start in a similar way due to different etiological agents.
Causes
Symptoms
To learn more: Symptoms Gastroenteritis
Gastroenteritis is an intestinal suffering that causes AT LEAST three diarrheal discharges (unformed and liquid stools), or at least an increase in daily evacuations compared to the common habits of the subject; this is associated with food vomiting (another symptom indicating infectious gastroenteritis).
Gastroenteritis may ALSO manifest atypical symptoms; in particular, in the most severe forms, gastroenteritis is responsible for very serious systemic impairments; it is worth mentioning the hemolytic-uremic syndrome (E. Coli VTEC), the Guillain-Bané syndrome (campylobacteriosis) and the severe malnutrition with developmental and growth disorders.
Classification
Gastroenteritis can be classified based on the duration of symptoms:
- ACUTE gastroenteritis generally resolves within a few days, and in any case NEVER past two weeks.
- PERSISTENT gastroenteritis has a slower course and does not disappear before 14 days
- CHRONIC gastroenteritis, as its name suggests, shows symptoms for over 30 days.
Infectious gastroenteritis
The pathogens potentially responsible for infectious gastroenteritis are many; an extremely relevant part of these diseases is caused by zoonoses, which pass from animals to food and result in human food poisoning .
The pathogens potentially responsible for gastroenteritis are: viruses, bacteria, protozoa, fungi and helminths; the main ones are:
- Among the viruses: Norovirus, Astrovirus, Rotavirsus and Adenovirus.
- Among the bacteria: Salmonella, Campylobacter spp., E. Coli (6 strains), Vibrio spp., Aeromonas spp., Yersinia, Bacillus cereus, Clostridium perfrigens, Staphylococcus aureus enterotoxicogen, Listeria monocytogenes and Shigella spp.
- Among the parasites: Cryptosporidium, Microsporidi, Giardia, Cyclospora cajetanensis and Entamoeba histolyca.
Gastroenteritis in Europe
In developed countries, infectious foodborne gastroenteritis has a very low mortality, but a particularly high morbidity (meaning that the pathology is very frequent but rarely fatal); there are more serious consequences in the medium and long term, especially in the event of contamination with E. Coli VTEC and Campylobacter .
NB . In Europe, cases of zoonoses related to Salmonella are gradually decreasing.
Table referring to the notification rate per 100, 000 inhabitants of the main etiological agents in Europe in 2010
| Disease | Notification rate per 100, 000 inhabitants |
Campylobacteriosis | 48, 60 |
Salmonellosis | 21, 50 |
yersiniosis | 1.58 |
VTEC | 0.83 |
Listeriosis | 0.35 |
Echinococcosis | 0.23 |
Brucellosis | 0.07 |
Trichinellosis | 0.05 |
Tuberculosis due to M. bovis | 0.03 |
Distribution of acute gastroenteritis in Italy
Since the 1990s, the incidence rate of gastroenteritis has been estimated in Italy thanks to the SIMI and ISTAT survey sources; rather than extending into dispersive and poorly producing exposures, below we will illustrate the image of the NATIONAL standardized distribution for 100, 000 people of: Non-Typhoid Salmonellosis (SNT), Infectious Diarrhea Not from Salmonella (DINS) and Focola di Food Toxination (FTA).
Sources : Department of Veterinary Public Health and Food Safety; Higher Health Institute, Rome.
Surveillance system for infectious diseases and gastroenteritis in Italy
In Italy, the surveillance of infectious gastroenteritis is carried out through the Information System of Infectious Diseases, which establishes the notification OBLIGATION for a list of infectious diseases divided into IV classes, plus a V class that also includes zoonoses of mainly veterinary interest.
Reference table for the notification classes of infectious diseases in Italy
Sources : National Institute of Health - Surveillance and diagnostics of acute gastroenteritis in Italy
Diffusion in the world
Infectious gastroenteritis severely affects the most disadvantaged populations (third world) to the point of representing the second cause of morbidity and mortality in the world.
Gastroenteritis is distributed with important geographical variations, essentially determined by the pathogenic prevalence (different in the various affected areas), and by the availability of preventive, clinical, diagnostic and therapeutic medical assistance.
In industrialized countries, gastroenteritis has an INCIDENCE of about 1.2-1.9 episodes / person / year, with greater frequency for very young subjects (<3 years, 2.5 episodes) and a seasonal peak in the winter months, attributable to the greater development of enteric viral etiological agents such as Norovirus and Rotavirus .
On the contrary, in developing countries, gastroenteritis has an INCIDENCE greater than 10 episodes / person / year in the very young and only 1/10 of these has the possibility to contact a doctor; only 7% of these subjects suffering from gastroenteritis can make use of a hospitalization.
To conclude, in the world gastroenteritis is associated with a mortality equal to or greater than 3, 000, 000 a year and, while in underdeveloped countries the majority concerns children, in industrialized areas (besides being less frequent) the mortality from gastroenteritis concerns especially elderly people> 70 years old.
