Gastroenteritis or Intestinal Infectious Disease (IID)

What is gastroenteritis?
Gastroenteritis is inflammation due to infection, of the intestinal tract. It generally produces diarrhoea that may be accompanied by vomiting and/or abdominal pain. Gastroenteritis that results from consumption of food contaminated with the pathogens below is known as food poisoning.

What causes gastroenteritis?
A range of different micro-organisms can cause gastroenteritis: bacteria such as Salmonella, Campylobacter and E. coli O157; viruses such as norovirus and rotavirus, and protozoa (more complex micro-organisms) such as Cryptosporidium and Giardia. The different pathogens produce a range of symptoms and can be spread in different ways. Below is a table listing a number of causes of gastroenteritis and the symptoms associated with them. Links are provided to more detailed information on selected pathogens.

Organism	Typical Signs and Symptoms	Incubation Period*	Duration of Illness
Bacteria
*Campylobacter*	Diarrhoea, abdominal pain, fever and vomiting, bloody diarrhoea in half of cases.	1-10 days (typically 2-5 days).	2-10 days
*Listeria monocytogenes*	Tends to be a mild ‘flu-like illness with fever, muscle aches and nausea and diarrhoea. In the elderly or immunocompromised (for example, due to cancer, diabetes or AIDS) it may be complicated by meningitis or septicaemia. If a pregnant woman contracts the infection, it can lead to miscarriage or still birth, or septicaemia or meningitis in the baby soon after delivery.	1 day to 3 months (typically about 3 weeks).	Variable
*Salmonella enterica* spp. (Non-typhoidal salmonellae)	Diarrhoea, fever, abdominal cramps, vomiting, occasionally muscle cramps and headache.	12-72 hours	3-7 days
Salmonella Typhi and Paratyphi (Typhoid and Paratyphoid; Enteric Fever)	Typhoid enteric fever is a severe illness with fever, headache, cough, constipation followed by diarrhoea, characteristic skin rash (rose spots), abdominal pain and confusion. Paratyphoid enteric fever is less severe. Paratyphoid can also produce a severe gastroenteritis with diarrhoea and vomiting.	1-3 weeks 1-10 days for paratyphoid gastroenteritis	Up to 3 months
Shigella spp.	A wide variety of illness depending on the particular species, ranging from mild diarrhoea to severe illness with pain, watery diarrhoea (often with blood or mucus), fever, and collapse.	12-96 hours (can be up to one week).	1-2 weeks
Verotoxigenic E. coli (VTEC) including O157	Can vary, from a mild illness with little or no symptoms, to moderate or severe bloody diarrhoea, with abdominal pain (haemorrhagic colitis). Vomiting and fever are uncommon.	1-8 days (typically 3-4 days).	5-10 days
*Vibrio cholerae* (Cholera)	Severe watery diarrhoea, occasional vomiting. Dehydration can be life threatening.	6-48 hours	1-3 weeks
**Yersinia enterocolitica and Y. pseudotuberculosis**	Generally diarrhoea with some vomiting. May be some bloody diarrhoea. Y. pseudotuberculosis can produce appendicitis-like symptoms.	2-11 days (typically 4-7 days).	1-3 weeks, usually self-limiting
Protozoa
Cryptosporidium	Diarrhoea (usually watery and with mucus), stomach cramps, upset stomach, slight fever.	1-28 days (typically 2-10 days).	Generally 2-4 weeks
*Giardia lamblia*	There may be no symptoms or diarrhoea, stomach cramps and flatulence and bloating.	7-10 days	Days to weeks
Viruses
Norovirus	Nausea, vomiting, abdominal cramping, diarrhoea, fever, myalgia, and some headache. Diarrhoea is more prevalent in adults and vomiting is more prevalent in children.	15-50 hours	4-70 hours
Rotavirus	Watery diarrhoea, vomiting with mild fever. Commonest between 6 months and 2 years.	1-3 days	About a week

* The Incubation Period is the time between being exposed to the pathogen (e.g. eating contaminated food) and the development of symptoms.

The best way to prevent gastroenteritis is to ensure that you regularly wash your hands with soap under warm running water and especially:

After using or cleaning the toilet
After attending to anyone with diarrhoea or vomiting
After touching anything contaminated by diarrhoea or vomiting
After handling contaminated clothing or bedding (including nappies)
After handling household and garden waste or rubbish
After touching or handling pets or other animals
On returning to the house having been working in the garden or on the farm
Before handling, preparing, serving, or consuming food or drink

If anyone in your house is suffering from vomiting or diarrhoea, the toilet and other areas should be cleaned and disinfected after use.

Any family member who is ill with diarrhoea or vomiting should use his or her own towels, flannel and should never prepare food for others until 48 hours after their diarrhoea and vomiting has subsided. In the same way, anyone who is ill with diarrhoea or vomiting should stay off work/school until they have been symptom free for 48 hours.

It is important to ensure that you minimise the risk of foodborne infection in the home; safefood have useful information on this subject.

When travelling on holidays, it is important to make sure you have checked with your GP or medical travel centre that you are up to date with any vaccinations. When on holiday, you should take extra travel precautions with your and your family’s health.

Further information can be found in our Infectious Intestinal (IID) and Zoonotic Disease Quarterly Reports.

Last updated: 2 July 2010

Gastroenteritis or Intestinal Infectious Disease (IID)

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