| Prevention for all organisms includes: washing hands with soap and water when exposed to stool or contaminated products, bleaching surfaces, and drinking treated water. Addtionally, people with diarrhea should not prepare food, swim, or use water parks. |
| Name of Infection // Type of Organism |
Transmission |
Symptoms // Complications |
Symptom Onset // Duration |
Treatment |
Risk and Exposure |
| Adenovirus F40/41 // Virus |
Person to person spread from infected stool |
Watery diarrhea, abdominal pain, fever // Dehydration, abdominal lymph node swelling |
3-10 days after exposure // 4-8 days |
Hydration, anti-nausea meds, NO antibiotics |
Children younger than 5 years of age, daycare centers |
| Astrovirus // Virus |
Person to person spread from infected stool |
Vomiting, watery diarrhea, abdominal pain or cramps // Dehydration |
1-5 days after exposure // 1-3 days |
Hydration, anti-nausea meds, NO antibiotics |
Babies under 1 and kids younger than 5 years of age, daycare centers |
| Norovirus // Virus |
Person to person spread from infected stool or vomit, food, infected surfaces |
Sudden onset vomiting, diarrhea, abdominal pain or cramps, low-grade fever // Dehydration |
10-72 hours after exposure // 1-3 days |
Hydration, anti-nausea meds, NO antibiotics |
Most common GI illness in the US, highly contagious, outbreaks in schools, nursing homes, and cruise ships. Wear gloves when handling soiled items |
| Rotavirus // Virus |
Person to person spread from infected stool |
Vomiting, watery diarrhea, fever which may be high, abdominal pain or cramps // Dehydration, seizures |
1-2 days after exposure // 1-4 days |
Hydration, anti-nausea meds, NO antibiotics |
Babies, young children, older adults |
| Sapovirus // Virus |
Person to person spread from infected stool or vomit, infected surfaces |
Vomiting, watery diarrhea, abdominal pain or cramps, headache // Dehydration |
1-4 days after exposure // 1-4 days |
Hydration, anti-nausea meds, NO antibiotics |
Most common among young children although affects people of all ages, highly contagious |
| Campylobacter // Bacteria |
Improperly cooked or prepared food (chicken), untreated water, unpasteurized milk |
Diarrhea (can be bloody), abdominal pain or cramps, headache, fever // Infection in the blood stream, arthritis, muscle weakness (GB) |
2-4 days after exposure // 5-7 days |
Hydration, antibiotics if prolonged illness |
Children younger than 4 years and young adults, organism is found in the intestines of birds, cats, dogs, hamsters, and cows. Separate other foods from raw poultry, drink pasteurized milk, and wash hands after cat or dog exposure |
| Clostridium difficile toxin // Bacterial toxin |
Organism often acquired in healthcare settings. Disease usually follows antibiotics or GI surgery |
Diarrhea (sometimes bloody), abdominal pain or cramps // Severe diarrhea and recurrence after treatment |
Incubation variable // 5-7 days (may be prolonged) |
Hydration, stopping other antibiotics if possible, specific antibiotics to target just C. difficile. Metronidazole 30 mg/kg/day po div q8h. Vancomycin 40 mg/kg/day po div q6h |
Hospital and long-term care settings, children younger than 5 years often carry bacterial toxin but are not symptomatic. Children younger than 1 year old should not be treated. Other diagnoses and the clinical picture should be considered in deciding whether to treat children 1-3 years of age. Wash hands with soap and water, alcohol-based cleaners do not kill the bacteria. Avoid unnecessary antibiotics |
| Enterotoxigenic E. coli (ETEC) // Bacterial toxin |
Travel to developing countries (but also in the US), contaminated food, ice, water |
Watery diarrhea, abdominal pain or cramps, fever, headache, vomiting // Dehydration |
1-3 days after exposure // 3-4 days |
Hydration, anti-nausea medications, bismuth subsalicylate (Pepto) for kids >12 years, antibiotics may shorten duration. Azithromycin 10 mg/kg/day for 3 days |
Exposure to contaminated food, water, or ice with human or animal waste. Common in tropical or developing countries and travelers outside of the US. Avoid untreated water or ice. Avoid untreated water and ice, eat cooked foods that are piping hot |
| Shiga-like toxin producing E. coli (STEC) including O157 // Bacteria |
Undercooked or contaminated food, spread through person to person transmission |
Diarrhea is often bloody, severe abdominal cramps, vomiting // Dehydration, 5-10% hemolytic uremic syndrome (HUS) that causes kidney injury |
2-8 days after exposure // 4-7 days |
Hydration, NO antibiotics or anti-diarrheal meds (Immodium) as these may make HUS more likely |
Undercooked ground beef, contaminated lettuce, sprouts, spinach, unpasteurized milk or juices, contaminated water in lakes, pools and water parks |
| Enteroaggregative E. coli (EAEC) // Bacteria |
Person to person transmission, also spread via contaminated food |
Watery diarrhea (sometimes with mucous), abdominal pain or cramps // Dehydration |
1-3 days after exposure // 3-4 (up to 14) days |
Hydration, antibiotics may shorten duration although not usually necessary |
Children in both poor and wealthy countries, adults who travel to developing countries, contaminated water, ice, and food |
| Enteropathogenic E. coli (EPEC) // Bacteria |
Person to person transmission |
Diarrhea and vomiting |
Can be prolonged in poor countries // Dehydration |
Hydration, antibiotics NOT recommended in the US |
Infants and children in developing countries. Detected at similar rates in healthy and ill children in more developed settings and therefore may not be associated with disease |
| Shigella or enteroinvasive E. coli (EIEC) // Bacteria |
Person to person transmission, very low infectious dose. Can contaminate surfaces, water |
Diarrhea (sometimes with blood), abdominal pain or cramps, fever |
1-3 days after exposure // 2-7 days |
Hydration, NO anti-diarrheal meds, antibiotics may shorten the duration and reduce transmission. Azithromycin 10 mg/kg/day for 3 days. Alternatives include: Ciprofloxacin 30 mg/kg/day div q12h for 5 days and Ceftriaxone 75 mg/kg/day for 2 days |
Extremely contagious, can be shed after illness ends. Avoid contaminated food or water (including lakes) |
| Plesiomonas // Bacteria |
Contaminated water, shellfish, drinking or swimming in contaminated water |
Diarrhea (may have mucous or blood), abdominal pain or cramps, fever, chills |
1-2 days after exposure // 1-3 days |
Hydration, for severe illness antibiotics may be necessary. Ciprofloxacin 30 mg/kg/day div q12h for 5 days. Alternatives include TMP/SXZ |
Organism found in the intestines of sick people and animals, tropical regions, reptiles, and tropical fish. Avoid raw shellfish, contaminated swimming parks, pools, and drinking water |
| Salmonella // Bacteria |
Contaminated or undercooked food, meat, poultry, reptiles, or amphibians |
Diarrhea (sometimes bloody), abdominal pain or cramps, headache, body aches, fever |
12-72 hours after exposure // 3-7 days |
Hydration, NO antibiotics for GI disease, antibiotics may be used for bacteremia. Treat if younger than 6 months of age, severely immunocompromised, or extraintestinal infection |
Bacteria are found in the intestines of birds (chickens), reptiles, amphibians, cows, pigs, and rodents. Infects all ages, especially kids younger than 4 years. Avoid undercooked meat, poultry, eggs, contaminating other foods with raw meat, and contact with reptiles |
| Vibrio // Bacteria |
Foodborne: organism lives in salty or brackish water in fish and shellfish |
Watery diarrhea (may be bloody or mucousy), vomiting, abdominal pain or cramps, occassionally fever // Severe illness or bloodstream infection |
12-72 hours after exposure // 2-5 days |
Hydration, antibiotics only for severe illness, sepsis, or immune compromised patients. Doxycycline 4 mg/kg/day div q12h for 5 days |
Severe illness in immunocompromised patients and those with liver disease. Contaminated fish, shellfish, warmer months, contaminated water with human waste containing Vibrio |
| Yersinia // Bacteria |
Spread via contaminated food, raw or undercooked pork |
Diarrhea (blood or mucous possible), vomiting, fever // Abdominal symptoms mimicking appendicitis, mesenteric adenitis, post-infectious reactive arthritis |
4-6 hours after exposure // 4-6 days |
Hydration, antibiotics not used for gastroenteritis. Treat complications |
Contaminated food and milk, raw or undercooked pork (chitterlings - hog intestines) |
| Cryptosporidium // Parasite |
Contaminated and/or improperly purified water, survive for an extended time in water, person to person transmission, found in the intestines of cows, common in developing countries |
Nausea, fatigue, frequent watery diarrhea, abdominal pain or cramps // Dehydration, weight loss, prolonged diarrhea in immunocompromised patients |
7-10 days after exposure // 10-14 days |
Hydration, consider treatment with Nitazoxanide 200 mg po q12h with food for 3 days (if >= 4 years of age) |
Avoid contaminated drinking water, swimming pools, parks, wash hands after contact with cows/calves |
| Cyclospora // Parasite |
World-wide, contaminated produce |
Symptoms wax and wane, nausea, poor appetite, gas, bloating, diarrhea, abdominal cramps, fatigue, low-grade fever, weight loss // Severe weight loss, gall bladder infection |
2-14 days after exposure // 3-4 weeks |
Hydration, treat with TMP/SXZ 10 mg/kg div BID for 7-10 days |
Produce (raspberries, lettuce, basil) |
| Entamoeba histolytica (amebiasis) // Parasite |
Contaminated food or water with human waste, person to person transmission possible |
Most people do not develop symptoms, mild diarrhea to severe diarrhea (blood and mucous), abdominal pain, weight loss // Abscesses in the liver, lungs, and brain |
Several weeks after exposure // Many weeks |
Hydration, Metronidazole 35-50 mg/kg div q8h for 7-10 days. Tinidazole 50 mg/kg/day po for 3 days |
Tropical countries with poor sanitation, human waste contaminating food and water |
| Giardia // Parasite |
Swallowing water contaminated with Giardia organisms, contaminated surfaces, person to person |
Nausea, loss of appetite, gas, bloating, diarrhea with greasy floating stools // Dehydration, weight loss, retarded growth in children |
7-14 days after exposure // Several days to months |
Hydration, Tinidazole 50 mg/kg one dose (max 200 mg). Metronidazole 15 mg/kg/day po div q8h for 5-7 days |
Contaminated lakes, ponds, streams, drinking water, stool exposure, daycare centers |