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Diarrhea Viruses

Viral Gastroenteritis
• Viruses probably cause up to 3/4 of all
infective diarrhoeas.
• The second most common viral illness after
upper respiratory tract infection.
• In developing countries, a major killer of
undernourished infants.
• Rotaviruses cause of half a million deaths
per year.
• Only some gut-associated viruses cause
Gastroenteritis Viruses

• Rotaviruses
• Adenoviruses
• Astroviruses
• Calciviruses

• Naked ds RNA viruses, 80 nm in diameter.

• 50-80% of all cases of viral gastroenteritis.
• Responsible for occasional outbreaks.
• Severe symptoms in neonates and young children.
And elderly
• Symptomatic infections again common in people
over 60.
• Up to 30% mortality rate in malnourished children,
responsible for up to half a million deaths per year.
Rotavirus Pathogenesis

• Outbreaks occur primarily in winter months in

temperate zones and year around in the tropics
• Spread by oral-fecal route
• I.P. 2-3 days
• Rotaviruses replicate in the epithelial cells in the tips
of the microvilli of the small intestine
• The microvilli are stunted and absorption is reduced
Global Distribution of
Rotavirus Gastroenteritis
Enteric Adenoviruses

•Naked DNA viruses, 75 nm in


•Types 40 and 41are associated

with gastroenteritis.
Enteric Adenoviruses
• Cause occasional outbreaks in young children and

• Possibly the second most common viral cause of

gastroenteritis (7-15% of all endemic cases).

• Similar disease to rotaviruses

• Most people have antibodies against enteric

adenoviruses by the age of 3.

• Diagnosed by electron microscopy or by the

detection of adenovirus antigens in faeces by
ELISA or other assays.

• 30 nm in diametr
• Seen in stools from young
children up to 7 Y
• 7 serotypes
• Shed in large quantities in
• Are minimally pathogenic

• 27-38 nm
• Five groups
• Norwalk-like viruses
• Sapporo viruses
• Hepatitis E virus
• Marine calcivirus
• Rabbit haemorrhagic disease
• Relatively common cause of
gastroenteritis in Southeast
• Outbreaks can be endemic or
epidemic and a peak in winter
Diagnosis of Calicivirus Infection

• Specific diagnosis of calicivirus infection usually is

not possible.

• In epidemics, save stool and emesis specimens for


• Enzyme immunoassays for serum antibody and

stool antigen

Norwalk-like Viruses
Norwalk-like Viruses

• Small RNA viruses, 35 nm in diameter.

• Associated with epidemic outbreaks of gastroenteritis in adults

• Due to consumption of shellfish and other contaminated foods.

• Aerosol spread possible as well as faecal-oral spread.

• Also named "winter vomiting disease", with vomiting being the

prominent symptom, diarrhoea usually mild.

• Antibodies acquired later in life, in the US, only 50% of adults

are seropositive by the age of 50.

• Diagnosis is made by electron microscopy and by PCR.

Treatment & Prevention

• Rehydration
• Patient Education
• Vaccination: in developmental stages
• Rotavirus vaccine is available ( under trial,
approved in Latin America)