Diarrhea and Dehydration

In a disaster scenario a child with diarrhea may present with three potentially severe or very severe clinical conditions: (1) acute watery diarrhea (including cholera), which lasts several hours or days, and can cause dehydration, (2) acute bloody diarrhea or dysentery, which may cause intestinal damage, sepsis, malnutrition and dehydration, and (3) persistent diarrhea (diarrhea that lasts more than 14 days).

All children with diarrhea should be assessed to determine the duration of diarrhea, if there is blood in the stools, and if dehydration is present.

Acute watery diarrhea is mainly caused by rotavirus, Norwalk-like virus, enterotoxigenic Escherichia coli (ETEC), Vibrio cholerae, Staphylococcus aureus, Clostridium difficile, Giardia, and cryptosporidia. Most frequent pathogens associated with acute bloody diarrhea are Shigella and Entamoeba histolytica. Campylobacter sp, invasive Escherichia coli, Salmonella, Aeromonas organisms, C. difficile, and Yersinia sp can also cause bloody diarrhea.