Title: Diarrhea in Children- A Major Global Killer (part 1)<br/>Author: Jon Mark Hirshon<br/><a href='http://umem.org/profiles/faculty/96/'>[Click to email author]</a><hr/><p>
        <strong>Background:</strong></p>
<p>
        While diarrhea in adults can be inconvenient and briefly debilitating, in children it can be fatal.  Globally, diarrheal diseases are the second leading cause of death for children under five.</p>
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                Approximately 760,000 children under five die each year from diarrhea
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                                Kills 2,200 children daily- more than AIDS, malaria and measles combined</li>
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                Most of the diarrhea can be prevented
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                                Safe drinking water</li>
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                                Adequate sanitation and hygiene</li>
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                Diarrhea is also a leading cause of malnutrition</li>
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         </p>
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        <strong>Clinical types of Diarrhea (with common infectious causes):</strong></p>
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                Acute watery diarrhea lasting hours or days (e.g. <em>rotavirus, norovirus, Vibrio cholerae</em>)</li>
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                Acute bloody diarrhea, a.k.a. dysentery (e.g.<em> Entamoeba histolytica, Shigella, Salmonella, Campylobacter, E. coli</em>)</li>
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                Persistent diarrhea lasting longer than 14 days (e.g. parasites, <em>C. difficile</em>)</li>
</ul>
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         </p>
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        <strong>Clinical assessment:</strong></p>
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                Early dehydration- no signs or symptoms</li>
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                Moderate dehydration
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                                Thirst</li>
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                                Irritability/tiredness/lightheadedness</li>
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                                Dry mucous membranes/decreased tears</li>
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                                Decreased urine output/dark (concentrated) urine</li>
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                                Sunken eyes</li>
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                                Decreased capillary refill (2-4 sec)*</li>
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                                Decreased skin turgor*</li>
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                                Increased respiratory rate*</li>
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        </li>
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                Severe dehydration
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                                Decreased mental status</li>
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                                Shock (rapid heart rate, low blood pressure)</li>
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                                Minimal or no urine output</li>
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                                Very sunken eyes/no tears</li>
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                                Parched/cracked mucous membranes</li>
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                                Marked decreased capillary refill (> 4 sec)*</li>
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                                Skin tenting*</li>
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                                Markedly increased respiratory rate*</li>
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        </li>
</ul>
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         </p>
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        *Best indicators of hydration status</p>
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         </p>
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        <strong>Next week: Prevention and Treatment</strong></p>
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         </p>
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         </p>
<fieldset><legend>References</legend>

                <p>
        <a href="http://www.who.int/mediacentre/factsheets/fs330/en/">http://www.who.int/mediacentre/factsheets/fs330/en/</a></p>
<p>
        <a href="http://www.cdc.gov/healthywater/global/diarrhea-burden.html">http://www.cdc.gov/healthywater/global/diarrhea-burden.html</a></p>
<p>
        http://emedicine.medscape.com/article/906999-clinical#a0217</p>
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