Gastroenteritis is a term used for inflammation or infection of the digestive tract.
Causes of gastroenteritis
There are many causes of gastroenteritis. The commonest causes are infectious organisms such as certain bacteria, viruses and parasites. Examples include:
Bacteria - Salmonella,Campylobacter
Viruses - Norovirus, Rotavirus
Parasites - Giardia, Cryptosporidium
A less common cause of bacterial diarrhoeal illness is Clostridium difficile which causes gastrointestinal illness associated with the administration of antibiotics.
Mode of transmission
In general, people acquire gastrointestinal illness by:
direct person to person transmission
airborne spread through aerosolised vomit
consumption of contaminated food or water
contact with contaminated environmental surfaces or fomites (objects).
While it can be difficult initially to determine if gastrointestinal disease is foodborne or due to person-to-person spread without laboratory confirmation of the pathogen, there are features of bacterial infections that typically differ from features of viral infection.
Bacterial gastroenteritis is often foodborne and typically causes symptoms of diarrhoea (that may contain blood, mucus or pus), abdominal cramping and vomiting. Fever may be present.
Viral gastroenteritis is often spread person-to-person and is less likely to cause fever or bloody diarrhoea. It is frequently of short duration (from 24 to 48 hours). Viral gastroenteritis outbreaks in facilities (for example aged care or hospitals) can occur.
In Australia, outbreaks of gastroenteritis in settings such as aged care facilities are common. The majority of these outbreaks are viral (frequently caused by norovirus) and are usually due to person-to-person transmission.
Symptoms of gastroenteritis
Common symptoms include diarrhoea, vomiting, nausea and abdominal cramps. Sometimes these symptoms may be accompanied by fever, headache and overall weakness.
Who is at risk?
Although most cases of gastroenteritis are self-limiting, people most at risk of developing complications and who are more likely to require hospitalisation due to gastroenteritis include:
immunocompromised people and
Faecal (or if unavailable, vomitus) testing is recommended to identify the cause. Testing may be by one or more of the following:
nucleic acid testing (PCR).
Varies depending on the pathogen but may range from a few hours to several days.
There is no specific treatment for most forms of infective gastroenteritis. It is generally a self-limiting illness. In infants and elderly persons, the most common complication is dehydration so maintaining good fluid intake is important.
For most types of gastroenteritis, exclude from child care, preschool, school and work until there has been no diarrhoea for 24 hours. If working in a commercial food setting, the exclusion period is 48 hours.
Careful attention to standard precautions and personal hygiene is important in the prevention of gastroenteritis. Key actions for staff and residents include:
careful attention to hand hygiene before and after patient/resident care
wash hands after using the toilet, and before preparing or eating food
clean and disinfect surfaces used for food preparation
This practical guide to the management of gastroenteritis has been developed to assist all residential environments such as aged care facilities, hospitals, hostels, rehabilitation facilities and cruise ships to manage outbreaks of viral and/or bacterial gastroenteritis.
While this practical guide to management of gastroenteritis is aimed at residential facilities, the principles are applicable to all settings (e.g. schools, child care centres and pre-schools) and should guide decision making in all circumstances.
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