Gastroenteritis – colloquially called gastroenteritis – (synonyms: Intestinal catarrh; enterocolitis; enterorrhea; gastroenteritis; gastroenteritis; ileitis; ileocolitis; ileal inflammation; jejunitis; norovirus infections; salmonella; shigella; spastic enterocolitis; enterohemorrhagic colitis; ICD-10-GM A09: Other and unspecified gastroenteritis and colitis of infectious and unspecified origin) refers to an inflammatory disease of the stomach and small intestine, which is usually caused by an infection. If only the small intestine is affected, it is referred to as enteritis; if only the large intestine is affected, it is referred to as colitis. Acute gastroenteritis (AGE) is usually accompanied by acute diarrhea with symptoms lasting up to two weeks. This is most often caused by viruses, but bacteria, protozoa and helminths (worms) can also lead to infectious gastroenteritis. A special form of gastroenteritis is traveler’s diarrhea (traveler’s diarrhea; synonyms: turista, Montezuma’s revenge, Delhi belly). Traveler’s diarrhea is said to occur when the stool consistency changes during a trip or up to ten days after return and more than three bowel movements with mushy, liquid stools occur per day. It is usually a mild, self-limiting diarrhea that sits (does not progress) after 3-5 days.It is classically a fecal-oral infection caused largely by bacteria (about 80% of cases). Seasonal clustering of illnesses:Campylobacter enteritis occurs more frequently in the warm season (June to September). Gastroenteritis due to norovirus can occur at any time of year, but infections are clustered between October and March. It is the most common causative agent of nonbacterial gastroenteritis. Rotavirus infection occurs in clusters from February through April. Bacterial infections (e.g., Salmonella infections) are clustered during the summer months. The incubation period (time from infection to onset of disease) of Campylobacter enteritis is usually 2-5 days, but may be as long as ten days in isolated cases. The incubation period of EHEC infection (= enterohemorrhagic colitis) is about 2 to 10 days (on average: 3-4 days). The incubation period of norovirus infection is usually 6-50 hours. The incubation period of rotavirus infection is usually 1-3 days. The incubation period of Salmonella enteritis ranges from a few hours (12-72 hours) to three days, with a maximum of seven days. The incubation period of Shigella enteritis (shigellosis) is 2 to 7 days. The incubation period of yersiniosis averages 2-7 days (minimum: 1 day; maximum: 11 days). The duration of illness usually ranges from 1-2 days for norovirus infection to 3/4 weeks for Salmonella/Shigella infection. Frequency peak: Infectious diarrheal diseases in the sense of infectious enteritis (see below acute enteritis) occur in all age groups, especially frequently in infants and young children. In the elderly, diseases with Clostridium difficile (new name: Clostridioides difficile) are increasingly occurring (see under: pseudomembranous enterocolitis (Clostridium difficile-associated diarrhea or Clostridium difficile infection, CDI). The incidence (frequency of new cases) of Campylobacter enteritis is approximately 87 cases per 100,000 population per year (in Germany). The incidence of E. coli enteritis (excl. enterohemorrhagic E. coli, EHEC, or HUS (hemolytic uremic syndrome)) is approximately 14-37 illnesses per 100,000 population. The incidence of norovirus gastroenteritis is approximately 140 illnesses per 100,000 population. The incidence of Rota virus infection is approximately 67 illnesses per 100,000 population per year. The incidence of yersiniosis is approximately 4 illnesses per 100,000 population per year. Course and Prognosis: Characteristic of acute gastroenteritis is diarrhea (diarrhea), often accompanied by nausea and vomiting. Usually, acute diarrhea (diarrhea) resolves within 3-5 (-7) days (up to two weeks in rare cases). Vomiting should stop after 1-3 days, at the latest after three days.In infants, children and adolescents, if diarrhea or vomiting persists for longer than usual, or if other symptoms occur, further illnesses should be considered, such as other serious infections like pneumonia. Acute uncomplicated traveler’s diarrhea (90% of cases) is a mild, self-limiting diarrhea that stops progressing after 3-5 days. Note: Chronic diarrhea with symptom duration of more than 4 weeks must be considered to be due to inflammatory bowel disease (IBD), functional disorders, or other causes. For details on the course and prognosis of the diseases listed above, see the diseases of the same name. Vaccination: Vaccinations against Salmonella typhi, the causative agent of typhoid fever, and against Vibrio cholerae, the causative agent of cholera, exist for the prevention of traveler’s diarrhea. Gastroenteritis (gastrointestinal infection) is reportable if:
- A person is affected who performs an activity within the meaning of § 42 para 1,
- Two or more similar diseases occur, where an epidemic link is likely or suspected,
if this indicates a serious danger to the general public and pathogens are considered as the cause, which are not mentioned in § 7 (Act on the Prevention and Control of Infectious Diseases in Humans).
