Infectious Diarrhea

Introduction

Diarrhea is a subject matter that most of us will be familiar with at some point in our life. Most of these episodes are self limited. Especially most viral diarrhea which are common in school age children are self limiting and subside in 72 hours.

Diarrhea is uncomfortable and when on a trip and in the outdoors it becomes a very uncomfortable problem. It can be incapacitating and is rarely fatal. Fatalities with infectious diarrhea have to do with comorbidity, dehydration and cardiac arrythymias for the most part.

Infectious diarrhea is caused by food, beverage or waterborne pathogens which are either viruses, bacteria or protozoa parasites. These can cause watery diarrhea, cramping and severe abdominal pain. Foul smelling stool is also common.

Prevention

Prevention is the first step in limiting one’s exposure to any infectious agent.

1. Sound food preparation and how you handle the food is important.
2. Make sure you have portable water and if not you MUST have 3ays to disinfect it. Please go to disinfection category on our home page.
3. Good personal hygiene, brush your teeth, hand sanitization.
4. If you are traveling outside the U.S. be advised on travelers diarrhea and try to drink only bottled water. Eat hot food, peel your fruit and avoid ice.
5. Loperamide is a very good inhibitor of diarrhea however any diarrhea that lasts longer than three days should be assessed by a health care provider.
6. Depending on where you are traveling to some health care providers will prescribe you medication just in case you come down with symptoms. I have on a handful of occasions.
7. If medical help is not readily available then all efforts should be made to keep the person hydrated
8. I try to cary some anti-emetic in my kit as well as anti-diarrheal. At least I can abate the symptoms prior to getting to a clinic.

Cryptosporidium Parvum

Cryptosporidium is a protozoa that also causes infectious diarrhea. It is commonly found in contaminated water. It is characterized by severe watery diarrhea that can be accompanied by low grade fever. In general it is self limiting. And if left untreated usually only last about three days. Outbreaks are common in day care centers.

Symptoms: cramping, nausea, nausea and diarrhea, rare that diarrhea is bloody.

Cryptosporidium is spread  by oral contact with contaminated objects or drinking polluted water and eating unwashed vegetables. It also can be contracted by swimming and inadvertently swallowing water.

Myth you cannot get Cryptosporidium from chlorinated water.

Boiling does kill Crypto.

Campylobacter Jejuni

Campylobacter is an infectious bacteria causes severe diarrhea and severe bloody stool. Bloody diarrhea is seen with this bacteria and E-Coli. Unlike Crypto and Giardia Campylobacter also presents as nausea and emesis. The main culprit with this bacteria is eating poultry and eggs but it can be found in other meats.  Unpasteurized milk is also a common source. When camping and bringing these food sources please wash them thoroughly and cook them thoroughly. Even if you like your meat rare in a camping situation when far away from treatment it is beneficial to eat your steak well done.

Giardia Lambia

Giardia is thought to be in about 80% of North Americas water source. It has been labeled Beaver Fever however it can come from many sources of wild animals who defecate in streams. Elk, deer, bison, moose, voles and even birds. Patient presents with malodorous diarrhea which can be explosive and watery. It is usually self limiting however treatment is excellent and it can resolve quickly. It should be noted there are some resistant strains to our commonly used antibiotic and I have used an alternative in the last ten years.