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>
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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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<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>
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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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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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*Best indicators of hydration status</p>
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<strong>Next week: Prevention and Treatment</strong></p>
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<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>
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http://emedicine.medscape.com/article/906999-clinical#a0217</p>
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