From the Guidelines
The most common cause of acute gastroenteritis is viral infection, particularly norovirus, as it exceeds Salmonella enterica subspecies as a cause of illness, accounting for 58% of cases, as reported in the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1.
Causes of Acute Gastroenteritis
The causes of acute gastroenteritis can be categorized into:
- Viral infections: norovirus and rotavirus are the most common causes, with norovirus being the leading cause of illness, and rotavirus being a significant cause, especially in children, as noted in the prevention of rotavirus disease guidelines 1.
- Bacterial infections: Salmonella, Campylobacter, and E. coli are significant contributors, often from undercooked meats or contaminated produce.
- Parasitic infections: Giardia can cause gastroenteritis, especially in areas with poor sanitation.
Treatment and Prevention
Treatment typically involves supportive care with fluid replacement to prevent dehydration, using oral rehydration solutions containing electrolytes, as recommended by the Centers for Disease Control and Prevention 1. Some key points to consider:
- Most cases resolve within 1-3 days without specific medication.
- Antibiotics are rarely needed unless bacterial infection is confirmed and severe.
- To prevent spread, practice good hand hygiene with soap and water, especially after using the bathroom and before handling food.
- Those affected should avoid preparing food for others and stay home from work or school until symptoms resolve.
Clinical Features and Outcomes
The inflammation of the stomach and intestines during gastroenteritis leads to the characteristic symptoms of:
- Diarrhea
- Vomiting
- Abdominal pain
- Sometimes fever It is essential to note that the burden of acute gastroenteritis has been reduced since the implementation of rotavirus vaccines, as reported in the 2017 IDSA guidelines 1.
From the Research
Common Causes of Acute Gastroenteritis
- Viral infections are a leading cause of acute gastroenteritis, with noroviruses and rotaviruses being the most common etiologic agents 2, 3, 4, 5, 6
- Bacterial causes, such as Shigella, Vibrio cholerae, Campylobacter, and Salmonella, can also cause acute gastroenteritis, although they are less common than viral causes 3
- The spectrum of causative agents differs in developed and developing countries, with rotaviruses being a major cause of childhood mortality in developing countries 2, 5
Viral Causes of Acute Gastroenteritis
- Noroviruses are the leading cause of foodborne disease outbreaks worldwide and can cause significant morbidity and mortality among children, the elderly, and the immunocompromised 4, 6
- Rotaviruses are a major cause of severe pediatric gastroenteritis, although the use of rotavirus vaccines has reduced their impact 2, 5
- Other viral causes of acute gastroenteritis include human caliciviruses, astroviruses, and enteric adenoviruses 2, 5
Epidemiology and Treatment
- Acute gastroenteritis can cause significant morbidity and mortality, particularly in vulnerable populations such as children, the elderly, and the immunocompromised 2, 3, 4, 5, 6
- Treatment of acute gastroenteritis typically involves oral or intravenous rehydration, with antimicrobial treatment reserved for specific bacterial causes 3
- Vaccines against rotaviruses and noroviruses are available or in development, and can help prevent acute gastroenteritis in vulnerable populations 5, 6