Summary

In this study session, you have learned that:

• Common faeco-orally transmitted diseases caused by bacteria and viruses include cholera, shigellosis (bacillary dysentery), viral diarrhoeal diseases (rotavirus infection is the most prevalent), and typhoid fever.
• Cholera is a bacterial disease, which manifests with painless, acute watery diarrhoea that resembles rice-water, and profuse vomiting.
• Shigellosis or bacillary dysentery is an acute diarrhoeal disease characterised by blood and mucus in the stool, with urgency and straining during defaecation.
• Viral diarrhoeal diseases are the commonest type of diarrhoeal disease, particularly in children. Their manifestation is mainly acute watery diarrhoea.
• The transmission of cholera bacteria and rotaviruses is mainly via contaminated water and food, whereas shigellosis is mainly spread via person-to-person contact.
• Cholera and shigellosis are prone to epidemics, because small numbers of bacteria can cause the illness, and bacteria continue to be shed for some time after the patient recovers.
• Epidemic control measures include swift case reporting, identification of contacts of the source patient, frequent thorough handwashing with soap and water, safe disposal of faeces, and disinfection or boiling of clothes, bedding and utensils used by the patient.
• You can treat most cases of children with acute water diarrhoea, without the need for laboratory diagnosis of the causative infectious agent. However, adults with severe diarrhoea and children with dysentery should be referred urgently after starting rehydration with oral rehydration salts (ORS).
• Typhoid fever is a febrile illness, characterised by high continuous fever, with constipation (rather than diarrhoea) in most adult patients. The disease is spread faeco-orally via infected water and contaminated food. If you suspect typhoid fever, you should refer the patient quickly.