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INFECTIOUS DIARRHEA

Overview:

Infectious diarrhea is caused by ingestion of bacteria such as Campylobacter, Salmonella, Shigella, C. Difficile or E. Coli. Fire fighters may acquire the infection following contact with an infected person.

Mode of Transmission: Infectious diarrhea is transmitted through contact with infected stool. Bacteria are spread through eating contaminated food or water or direct contact with infected stool. Bacteria can spread from person to person if someone does not wash their hands after a bowel movement and then touches other objects or someone else’s hands.

 

Examples of Transmission:

  • Eating meat or poultry contaminated with bacteria during processing of the food or preparation of the food

  • Drinking contaminated water

  • Consuming foods that have been unrefrigerated for too long (dairy products or mayonnaise containing foods such as coleslaw or potato salad)

People with C. difficile infections carry the bacteria in their intestines. The bacteria produce a spore, which is shed in the feces of an infected person. The bacteria can be passed from person to person through direct contact, environmental contamination (bedding, commodes, bedpans, sinks, anal thermometers, handrails, etc) and can be carried on the hands of health care workers as they move from patient to patient. The spore can survive in the environment for up to 70 days. They prefer to live in dry, dusty areas.

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High Risk Sources 

  • Raw fish or oysters

  • Undercooked meats or eggs

  • Unwashed fruits or vegetables

  • Unpasteurized milk

  • A pet iguana or other lizards, turtles, or snakes (reptiles are carriers of salmonella)

  • Travel to countries without proper water or food sanitation

 

Prevention:

Careful hand washing. Do not eat or drink contaminated food or water.  Cook meats well, especially ground meats, which are more likely to be contaminated.

Precautions: Contact

 

Signs and Symptoms:

  • Sudden and severe diarrhea

  • Bloody diarrhea

  • Fever

  • Gas

  • Stomach cramping

  • Nausea and/or Vomiting

  • Muscle pain

  • Severe E. coli may reduce the amount of urine, make bloody urine or easy bruising

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The Time for Symptoms to Develop and Resolve:

  • E. coli: Symptoms 1 – 3 days after infection; recovery is in 1 – 2 days

  • Campylobacter: Symptoms 2 - 4 days after exposure; lasts about a week

  • Salmonella Symptoms in 8 - 48 hours and lasts 2 – 5 days

  • Shigella: Symptoms in 1 - 7 days and lasts 2 – 7 days

 

Complications:

Depending on the bacteria, complications include dehydration, anemia, kidney failure, and meningitis. Rarely, Campylobacter infection is linked to Guillain-Barre syndrome, which is a form of paralysis.

 

Immediately Following Exposure: 

  • Skin exposure (non-intact), immediately go to the sink and thoroughly wash the skin with water and soap for at least 15 minutes.

  • Skin wound, immediately go to the sink and thoroughly wash the wound with soap and water and pat dry.

  • Splash to eye(s), nose or mouth, immediately flush the area with running water for at least 15 minutes.

  • Splash affecting garments, spray with 10% bleach for minor spills and splashes. For large spills, remove garments that may have become soiled or contaminated and place them in a red plastic bag.

 

General Post Exposure Treatment:

Treatment is directed at making the patient feel better and avoid dehydration. Antibiotics are typically not used as these infections usually resolve without them. Antibiotics may be used for more severe infections such as those that spread outside the gastrointestinal tract and severe Shigella infections. Antidiarrheal medication may prolong the infection by slowing the transit of the bacteria through the intestine. 

 

Paperwork Required: (If Needed)

  1. The City “Report of Employee Injury” form

  2. Medical Service Order- RM -67 (when medical care is required)

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