Epidemiology of acute gastrointestinal infections in children

The source of infection is patients and carriers. Patients are contagious from the onset of the disease, the maximum contagiousness occurs at the height of the disease, as the condition of the patients improves, stool contraction decreases, the contagiousness decreases, but it can persist for a long time. It has been proven that bacterial excretion often remains after recovery and is usually supported by pathological changes in the intestine. The end of the infectious period is determined only bacteriologically . The smallest role in the spread of infection is played by patients with erased atypical forms in which the diagnosis is not established; staying in groups, they infect others. Children play a large role in the spread of intestinal infections, as they often suffer from erased forms, they may still lack hygiene skills, as a result of which they easily infect the environment. Newborn babies are often infected by mothers. Carriers of intestinal infections are relatively rare, but they are also involved in the spread of infection). In salmonellosis, the source of infection can be not only humans, but also animals (livestock, cats, mice, rats). A powerful reservoir of infection are birds, especially waterfowl (ducks, geese). Salmonella are found in them not only in organs, as in animals, but also in eggs (on the shell, in the contents of the egg), carriage is long. Transmission ways. All intestinal infections are fecal-oral: pathogens are excreted from the body with feces (can be in vomit) and enter the body through the mouth. These infections are called dirty hands disease: patients, carriers, or caregivers infect their hands, transfer the infection with their hands to surrounding objects (linen, dishes, door handles, toys, etc.), from where the infection is brought directly into the mouth by hands. or through food scheme 2, 3). Staphylococcal intestinal infection is also characterized by infection with sputum from patients with damage to the pharynx, respiratory tract or separable from skin lesions. Staphylococcus can be infected with surrounding objects, air, dust, etc. Carriage of staphylococci is widespread especially among staff of departments where patients with purulent diseases are located. Mothers with diseases of the genital tract can infect the baby during childbirth, mothers with nipple lesions – during feeding. In addition, autoinfection is possible, i.e., the development of an inflammatory process in the intestine caused by staphylococcus, which previously existed in other pathological foci. Intestinal infections are highly contagious . In children’s groups, in hospitals, with crowding, with violations of the sanitary-anti-epidemic regime, with a delay in isolation of patients or carriers, large foci of diseases can occur. Foodborne infection is possible for all intestinal infections; food workers, food workers, maintenance staff infect food, food with dirty hands; flies may have some significance. With dysentery, foodborne infection is most often associated with infected dairy products (milk, cottage cheese, sour cream), and with coli infections, with milk mixtures. Staphylococci reproduce especially well in creams used in the manufacture of cakes and cakes. Foodborne infection in infants can occur through mothers milk. In these cases, staphylococcus in breast milk is determined in high concentrations. With salmonellosis, infection most often occurs after eating foods prepared from meat products, eggs, egg powder. The foodborne infection route is dangerous because it can cause large outbreaks and severe illnesses to quickly occur. Due to the multiplication in products, a massive dose of the pathogen along with the toxin can enter the body, and diseases in these cases often proceed as a type of toxicoinfection . There are water outbreaks associated with infection of drinking water, water sources. The epidemiological patterns of intestinal disorders caused by viruses are not well understood. It is known that both patients and carriers are sources of infection. Many viruses ( enteroviruses , adenoviruses, etc.) can be excreted for a long time with feces. The susceptibility of children to intestinal infections is very high. It increases with a decrease in reactivity, with various diseases, rickets, eating disorders, hypovitaminosis, etc. The incidence is directly related to social factors. Poor sanitation of homes, child care facilities, crowding, poor sanitation, and lack of medical care contribute to the spread of intestinal infections. Among all patients with dysentery, salmonellosis, up to 60-80% of cases occur in children; coli infection due to EPI category I and staphylococcal intestinal infection are diseases that affect mainly children. The ratio of different etiological forms of intestinal infections in children is not constant, it changes significantly over time, in different geographical locations and depends on many factors. Among intestinal diseases, dysentery predominates, but the distribution of etiological forms by age has differences. Dysentery can occur at any age, but susceptibility to it increases by the end of the first year of life and reaches a maximum at the age of I-3 years (E.M. Novgorodskaya, L.V. Hazanson ). Salmonellosis mainly affects children up to 2-3 years old (from 50 to 85%). Coli infection (EPI category I) is most often observed in the first half of the life of children (starting from the first month), by the year its frequency decreases, and after 1 – 2 years it becomes a rarity. Among the cases, 55% were children under the age of 6 months , 30% from 6 months to I year, and 15-16% from I year to 2 years. (E.M. Novgorod). Approximately the same ratios are observed with staphylococcal diarrhea, excluding foodborne infections that occur at all ages. The incidence of intestinal forms of staphylococcal infection is often not sufficiently taken into account: in infancy, among all intestinal infections, it can reach 30% or more. Acute intestinal infections can occur throughout the year, seasonality is typical for dysentery, salmonella, to a lesser extent for coli infection. Seasonality is manifested by an increase in incidence in the second half of summer and autumn. Among the causes of seasonality indicate a change in the reactivity of children in the summer, a decrease in the bactericidal effect of gastric juice, the use of a large number of berries, fruits, vegetables, which in turn creates great opportunities for infection. In all seasons, in acute gastrointestinal infections, the contact-household route of infection prevails. Along with this, it should be borne in mind that outbreaks of food and water origin occupy a large place in morbidity.

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