Infectious Diarrhea Gigi H. Ross, PharmD Clinical Assistant Professor U of MN, CoP and Scientific Liaison, OrthoOrtho- McNeil
Epidemiology
l Common Foodborne Pathogens − Bacterial • Epidemiology • Evaluation/Management • Antibiotic Therapy − Parasitic − Viral l Traveler’s Diarrhea − Epidemiology − Management/Prevention
Risky Food Items
§ Estimated 2020- 45 million cases a year Ø
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1 in 4 Americans gets a foodfood- borne illness each year 300,000 patients are hospitalized 400 Americans die $6.5 billion in medical and other costs
§ Primarily affects the very young, the elderly, and the immunocompromised § Changes in demographics, food production/distribution, microbial adaptation, lack of public health resources are to blame
Campylobacter
l Pink Chicken l Pink Turkey l Pink Burgers l Pink Ground Pork l Raw Fresh Fish l Raw Shellfish
l Raw/unpasteurized Milk l Runny Eggs l Alfalfa Sprouts l Unpasteurized Apple juice/cider l Fresh Produce
l Ready Ready--to to--Eat meats
Campylobacteriosis l Most common cause of diarrhea in US − 1-6 million cases per year l Sources: raw poultry, meat, unpasteurized milk l Incubation period: 22-5 days l Symptoms: diarrhea, abdominal cramps, fever, bloody stools, vomiting l Duration: 22-10 days l Treatment: macrolides (DOC -C. jejuni), quinolones, carbapenem (DOC(DOC- C. fetus) l Sequelae: GuillainGuillain-Barre syndrome
Cases of Quinolone-Resistant C. jejuni Infection
Campylobacteriosis
in Minnesota Residents, 1996-1998*
l Travel outside the US continues to be associated with fluoroquinolonefluoroquinolone- resistant Campylobacter infections
History of Foreign Travel No History of Foreign Travel 12
Number of Cases
Unknown Travel History 10
l Most fluoroquinolonefluoroquinolone- resistant Campylobacter infections were domestically acquired.
8 6 4 2
J F M A MJ J
A S O N D J F M A M J J A S O N D J FM A M J J A S O N D
1996
1997 Month of Specimen Collection
1998
l Poultry is an important source of domestically acquired fluoroquinolonefluoroquinoloneresistant Campylobacter infections.
