Age Most of the morbidity and mortality from enteric pathogens involves children | Chapter 122. Acute Infectious Diarrheal Diseases and Bacterial Food Poisoning Part 7 Age Most of the morbidity and mortality from enteric pathogens involves children 5 years of age. Breast-fed infants are protected from contaminated food and water and derive some protection from maternal antibodies but their risk of infection rises dramatically when they begin to eat solid foods. Infants and younger children are more likely than adults to develop rotavirus disease while older children and adults are more commonly infected with norovirus. Other organisms with higher attack rates among children than among adults include enterotoxigenic enteropathogenic and enterohemorrhagic E. coli C. jejuni and G. lamblia. In children the incidence of Salmonella infections is highest among those 1 year of age while the attack rate for Shigella infections is greatest among those 6 months to 4 years of age. Bacterial Food Poisoning If the history and the stool examination indicate a noninflammatory etiology of diarrhea and there is evidence of a common-source outbreak questions concerning the ingestion of specific foods and the time of onset of the diarrhea after a meal can provide clues to the bacterial cause of the illness. Potential causes of bacterial food poisoning are shown in Table 122-4. Table 122-4 Bacterial Food Poisoning Incubation Period Organism Symptoms Common Food Sources 1-6 H Staphylococcus aureus Nausea vomiting diarrhea Ham poultry potato or egg salad mayonnaise cream pastries Bacillus cereus Nausea vomiting diarrhea Fried rice 8-16 H Clostridium perfringens Abdominal cramps diarrhea vomiting rare Beef poultry legumes gravies B. cereus Abdominal cramps diarrhea vomiting rare Meats vegetables dried beans cereals 16 H Vibrio cholerae Watery diarrhea Shellfish Enterotoxigenic Escherichia coli Watery diarrhea Salads cheese meats water Enterohemorrhagic E. coli Bloody diarrhea Ground beef roast beef salami raw milk raw vegetables apple .
