Gastroenteritis%20-%20viral Signs and Symptoms

• Acute gastroenteritis is a diarrheal disease of rapid onset, with increased stool frequency, loose stool consistency with or without fever, vomiting or abdominal pain, and with the diarrhea lasting for ≤14 days
• Viruses are one of the common causes of acute gastroenteritis

• Rotavirus, norovirus/"Norwalk-like" virus, sapovirus, enteric adenovirus serotypes 40 and 41, astrovirus, calicivirus and enterovirus are the established viral agents causing gastroenteritis
• Rotavirus is the most common pathogen causing moderate to severe diarrhea in patients 3-24 months old
• Patients <3 months old are protected by maternal rotavirus antibodies that are passed transplacentally and possibly by breastfeeding
• Other viral agents causing acute gastroenteritis infrequently and presenting with extraintestinal manifestations include severe acute respiratory syndrome (SARS)-coronavirus, influenza virus type B, coxsackievirus, echovirus and poliovirus

• Globally causes approximately 25 million outpatient consults among children <5 years of age
• Transmission is through fecal-oral route, through contaminated water, ingestion of inadequately cooked contaminated shellfish, close person-to-person contact and respiratory droplets

Clinical Features

• Incubation period may vary from 12-72 hours depending on the causative agent 
• Asymptomatic infection is common and asymptomatic excretion after illness may last for several weeks
• Infection varies from mild watery diarrhea of limited duration to severe diarrhea with fever and vomiting that can result in dehydration
  • Disease severity depends on the patient’s immune system, presence of comorbidities, viral load and virulence of the viral agent 
• Extraintestinal site involvement (respiratory tract, liver, kidney, lymph nodes and central nervous system) is common in immunocompromised patients
• Dehydration and electrolyte imbalances are the main complications
  • Other complications may include irritant diaper dermatitis, hypoglycemia, hyperuricemia, renal tubular damage, liver function impairment and seizures 

Typical Symptoms 

• Watery bloodless diarrhea (in severe cases, 10-20 bowel movements daily)
• Fever (low-grade)
• Nausea and vomiting
• Abdominal cramps
• Malaise
• Symptoms may persist for 3-8 days