traveler's diarrhea
Introduction
Introduction to tourist diarrhea Giardiasis is a diarrhea, weight loss, and malabsorption disease caused by Giardialamblia. It is spread throughout the world, especially in warm and humid areas. The infection rate in the world is 1% to 30%. The infection rate of children is higher, reaching 50% to 70%. It is also widely distributed in China. Most of them are scattered, but in special cases, it is often caused by infections caused by infection with Giardiasis. Therefore, there are tourists. The name of diarrhea. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: fecal mouth spread Complications: anemia
Cause
Tourists' causes of diarrhea
Piriformis is a single-cell protozoa with simple developmental process, including trophozoites and cysts. Two trophozoites: 1 trophozoite: about 9.5 to 21 m × 5 to 15 m in size, shaped like a half-cut pear in the middle, with a rounded front end The tip of the tail is thin, the back is raised, the ventral surface is flat, and the suction cup is formed. The tight nucleus is adsorbed on the intestinal mucosa. There are two nucleus on the inner side, and the body has four pairs of flagella. The movement is flexible. 2 capsules: oval, about 8-12 m in size. ×710m, the mature capsule contains 4 cores at one end, and has a thick wall. It has strong protection ability in the external environment. The general disinfection measures are not easy to kill. The person with the capsule is the main source of infection, one with a capsule. Those who can discharge more than 900 million capsules a day and night, contaminate food and water sources through feces, cause transmission, and can be infected in all age groups. Children with hypoproteinemia and other immune dysfunction have more chances of being infected.
Prevention
Tourist diarrhea prevention
Strengthen health publicity and education, cultivate health habits, pay attention to diet management, strengthen stool management, and treat patients and carriers.
Complication
Tourist diarrhea complications Complications anemia
1. Anemia.
2. Growth retardation.
3. Water, electrolyte metabolism disorders.
Symptom
Tourists' diarrhea symptoms common symptoms abdominal pain diarrhea bloating bloating malabsorption syndrome anorexia
The incubation period after infection is about 12-15 days, some do not show symptoms. Most of the symptoms are mainly diarrhea and malabsorption. The typical symptoms in the acute phase are fulminant watery diarrhea, more odor, abdominal distension, abdominal pain, and belching. Vomiting, pus and blood can not be seen in the feces, but microscopic examination can find pus cells, red blood cells and trophozoites or cysts usually last 3 to 4 days, but some cases are unhealed, lasting for several months or repeated, so that absorption Obstacles, obviously thin.
Examine
Tourist diarrhea check
(1) In the acute phase of fecal examination, direct smear examination, easy to find trophozoites or cysts, if no pathogens can be found, it is best to send the test once every other day for 3 times, than for 3 consecutive days, the daily positive rate of detection is high. .
(2) Immunodiagnosis
1 enzyme-linked immunosorbent assay (ELISA): detection of Giardia disease with high sensitivity and strong specificity, IgG antibody positive rate of 71.1% ~ 98.9%, with fast, objective, easy to operate and so on.
2 Indirect hemagglutination (IHA) test: It is a widely used serological diagnosis method. It has high sensitivity, simple operation, fast operation, no complicated equipment and special reagents, and is a better method for diagnosing Giardia. The positive rate was 73.4%. The disadvantage is that the specificity and repeatability of the test are not satisfactory.
3 Indirect fluorescent antibody test (IFAT): The positive rate is higher than IHA, which is 66%-97%. The positive rate of IFAT in patients with symptoms is stronger than that in asymptomatic patients. It has strong specificity in the diagnosis of giardiasis and no false positives. reaction.
4 Convective immunoelectrophoresis (CIE) test: It is an effective method for detecting fecal antigen in patients with giardiasis. It has the advantages of fast, accurate and simple, and does not require special reagents for large instruments and equipment. Its specificity is strong, but its sensitivity. It is lower than the ELISA and IFAT methods.
Diagnosis
Diagnostic identification of tourists with diarrhea
The disease needs to be differentiated from diarrhea caused by other causes, such as bacterial diarrhea and amoebic bowel disease.
Intestinal amebiasis should not be ignored. Because of the lack of special clinical manifestations of amebiasis, the disease is slow onset, the symptoms of poisoning are mild, and it is easy to recurrent. The intestinal symptoms or dysentery-like diarrhea vary in severity. Disorder or dysentery-like diarrhea and the cause is not clear, or by sulfa drugs, antibiotic treatment has no effect on the disease
Fecal examination before diagnosis: (1) live trophozoite examination; (2) cyst inspection method.
