There gastroenteritis it is an intestinal disorder that manifests specific clinical symptoms, which can begin in a similar way due to different etiological agents.
Causes
Symptoms
For further information: Gastroenteritis Symptoms
Gastroenteritis is intestinal distress that causes AT LEAST three diarrheal discharges (unformed and liquid stools), or in any case an increase in daily bowel movements compared to the common habits of the subject; it is associated with this food vomiting (another indicator symptom of infectious gastroenteritis).
Gastroenteritis can ALSO manifest atypical symptoms; in particular, in the most severe forms, gastroenteritis is responsible for very serious systemic compromises; it is the case to mention the syndrome hemolytic-uremic (E. Coli VTEC), the syndrome of Guillain-Bané (campylobacteriosis) and the severe malnutrition with developmental and growth disorders.
Classification
Gastroenteritis can be classified according to the DURATION of symptoms:
- ACUTE gastroenteritis generally resolves within a few days, and in any case NEVER beyond two weeks.
- PERSISTENT gastroenteritis has a slower course and does not go away for 14 days
- CHRONIC gastroenteritis, as the name suggests, manifests symptoms for over 30 days.
Infectious gastroenteritis
There are many pathogens potentially responsible for infectious gastroenteritis; an extremely important part of these diseases is caused by zoonoses, which pass from animals to foods and lead to food poisoning of man.
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, Microsporidia, Giardia, Cyclospora cajetanensis and Entamoeba histolyca.
Gastroenteritis in Europe
In developed countries, infectious gastroenteritis from food poisoning has a very low mortality, but a particularly high morbidity (this means that the disease is very frequent but rarely fatal); more serious consequences are highlighted in the medium and long term, especially in the case of contamination by E. Coli VTEC And Campylobacter.
NB. In Europe, the cases of zoonoses linked to Salmonella are gradually decreasing.
Table referring to the notification rate per 100,000 inhabitants of the main etiological agents in Europe in 2010
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 from M. bovis
0,03
Sources: European Food Safety Authority - EFSA; European Center for Disease Prevention and Control - ECDC.
Distribution of acute gastroenteritis in Italy
Starting from the 90s, the incidence rate of gastroenteritis has been estimated in Italy thanks to the sources of investigation SIMI and ISTAT; rather than dwell on dispersive and not very productive exposures, below we will illustrate the image of the standardized NATIONAL distribution for 100,000 people : Non-Typhoid Salmonellosis (SNT), Non-Salmonella Infectious Diarrhea (DINS) and Food Toxic Infection Outbreaks (FTA).
Sources: Department of Veterinary Public Health and Food Safety; Higher Institute of Health, Rome.
Infectious disease and gastroenteritis surveillance system in Italy
In Italy, the surveillance of infectious gastroenteritis is carried out through the Information System of Infectious Diseases, which establishes the OBLIGATION of notification for a list of infectious diseases divided into IV classes, plus a V class which also includes zoonoses of predominantly veterinary interest.
Reference table per the notification classes of infectious diseases in Italy
Sources: Istituto Superiore di Sanità - Surveillance and diagnostics of acute gastroenteritis in Italy
Diffusion in the world
Infectious gastroenteritis hits hard the most disadvantaged populations (third world) to the point of being represented the second cause of morbidity and mortality on the globe.
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 the Rotavirus.
On the contrary, in developing countries, gastroenteritis has an "INCIDENCE of more than 10 episodes / person / year in the very young and only 1/10 of these have the possibility to consult a doctor; only 7% of these affected subjects 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 per year and, while in underdeveloped countries most of it concerns children, in industrialized areas (as well as being less frequent) mortality from gastroenteritis concerns especially the elderly aged> 70 years.
