TOPIC: GASTROENRTERITIS

Gastroenteritis, often referred to as the stomach flu, is an inflammation of the stomach and intestine,
typically caused by viral or bacterial infection. Common symptoms include diarrhea, vomiting,
abdominal pain and sometimes fever. It can be caused by norovirus, rotavirus, salmonella and E. coli.
Gastroenteritis is highly contagious and spread through contaminated food or water, person-to-person
contact, or contact with contaminated surface. It is a significant public health concern globally,
particularly in developing countries like Solomon Islands, where access to clean water and proper
sanitation may be limited.

Proper hygiene practices such as handwashing and food safety measures are essential for prevention.
While most cases resolve on their own, with the rest and hydration, severe cases may require medical
attention to prevent dehydration and complication.

However, gastroenteritis can lead to various complication, especially if left untreated or if the
individual is particularly vulnerable, with that, it would lead to some potential complications such as,
dehydration, which happen particularly in children, older adults and individuals with weakened
immune system. Severe dehydration can be life threatening if not properly addressed. If not properly
addressed, it will lead to a kidney problem, imbalance in electrolytes, such as sodium, potassium and
chloride, which are essential for proper bodily functions. These imbalances can lead to weakness,
dizziness and severe cardiac arrythmia.

Promoting medical attention is crucial to prevent or manage these complications, effectively. If

symptoms of dehydration other severe complications develop, its essential to seek medical care
immediately.
 CASE SCENARIO

There has been an outbreak of gastroenteritis in a village, and is caused by rotavirus. Fifty (50) out of
the 150 residing in the village have been present at the clinic with diarrhea and vomiting for the past 3
days. Two children have been admitted to the hospital.

Data Percentage of Incidence.

Infected = (50/150) * 100% = 33%

Uninfected = (100/150) * 100% = 67%

Hospitalized = (2/150) * 100% = 1 % of total population.

Not hospitalized = (148/150) * 100% = 99% of total population.

Pie Chart of Incidence

Village Residences with symptoms of Gastoenteritis

Infected
33%

Uninfected
67%

Infected Uninfected
 SOURCE OF INFECTION (Breaking the chain)

Infection Agent

Rotavirus is a common cause of gastroenteritis, particularly, among infants and young children.
Rotavirus is a double stranded RNA virus belonging to the Reoviridae family. It is highly contagious and
a leading cause of severe diarrhea and vomiting especially on children under the age of five. Also, it
can lead to severe dehydration in young children and may require medical treatment, including
rehydration therapy and in more severe condition, hospitalization.

Reservoir or Host

Rotavirus primarily affects humans and is commonly found in stools of an infected person, and in
waters and in foods when someone with rotavirus handle or prepare food. It is then commonly
transmitted from person to person. Also, the reservoir of rotavirus is the gastrointestinal tract and
stools of infected humans.

Portal of Exit

The portal of exit for rotavirus in gastroenteritis is typically through faeces, when an infected individual
sheds rotavirus in their stool. The virus can contaminate the environment, surfaces and objects
serving as a potential source of transmission to others.

Mode of Transmission

The mode of transmission of the rotavirus in gastroenteritis is primarily through the faecal-oral-route.
Rotavirus is highly contagious and can pass on to others through close contact. This can occur when an
infected individual does not wash their hands properly after using the bathroom and then touches
surfaces or objects that the other can come in contact with.

Rotavirus can survive on surfaces and on objects, contaminated with faecal matter from an infected
individual. When the other touches this contaminated surfaces or objects and touches his/her mouth
afterwards, or ingest food or drinks water, he/she then become infected with the virus.

It can also be transmitted through the ingestion of food and water contaminated with the virus. This
can happen if the food or water is prepared or handled by an infected individual, who does not
practice proper hygiene. It is also transmitted through respiratory droplets when an infected person
coughs or sneezes.

Portal of Entry

The primary portal of entry for the rotavirus in gastroenteritis is through the mouth. Rotavirus enters
the body when a person ingests the virus, typically through contaminated food, water or objects. Once
ingested, the virus travels to the gastrointestinal tract where it infects the lining of the small intestine,
leading to inflammation and symptoms of gastroenteritis, such as diarrhea, vomiting, fever and
abdominal pain.

Susceptible Host

The susceptible host of rotavirus in gastroenteritis primarily includes individuals who have not
developed immunity to the virus, particularly young children under the age of five. Children under the
age of five are most susceptible to being infected by the rotavirus with severe gastroenteritis, because
they have not yet developed immunity to the virus and their immune systems are still developing.
 ASSESSMENT / DIAGNOSE AND TREATMENT OF GASTROENTERITIS

Assessment / Diagnose

Do assessment on the members of the village by taking their vital signs and perform laboratory tests
such as stool sample analysis to confirm the presence of rotavirus. Also assess their water sources,
however in the case of a community outbreak that affects these 50 patients, an epidemiological
investigation will be conducted to identify common sources of exposure and potential modes of
transmission. Throughout this assessment, I am now able to confirm that this particular village has
been affected by rotavirus.

Treatments

Treatment for rotavirus gastroenteritis in patients typically involves supportive care for example home
care, to manage symptoms and prevent complication. One of the treatments is fluid replacement.
Rehydration is crucial to replace fluids and electrolytes which were lost through diarrhea and
vomiting. Oral rehydration solutions (ORS) containing electrolytes and glucose are recommended for
mild to moderate dehydration. In severe cases, intravenous (IV) fluid can be necessary.

Mothers are encouraged to continue breastfeeding or formula feeding infants. However, small
frequent meals or glucose are offered to older children and adults are to continue taking and
maintaining their nutritional intake. Avoid fatty, spicy and high fibre foods that may exacerbate.

Provide medication for symptom relief, such as antiemetics, anti-nausea. Medication may be
prescribed to help control vomiting and drink plenty of fluids with good rest.

NURSING MANAGEMENT

Nursing Intervention

In my nursing interventions for rotavirus in gastroenteritis, I will focus on providing supportive care,
promoting hydration, managing symptoms and preventing complication. Here’s a brief descriptive
overview.

1. Fluid Replacement

Administer oral rehydration solutions (ORS) or intravenous (IV) fluids as prescribed to restore fluid
and electrolyte balance and prevent dehydration.

2. Nutritional Support

Encourage small, frequent meals or snacks that are easy to digest and provide adequate nutrition.
Monitor oral intake and offer nutritional supplements as needed.

3. Monitoring

Regularly assess vital signs, fluid intake and output and signs of dehydration (e.g. Dry mucous
membrane, decreased urine outputs), to detect changes in the patient’s condition.

4. Education and Support

Educate patients and caregivers about rotavirus, including its symptoms, preventive measures and
provide instructions on proper hygiene, food safety and when to seek medication attention, also
encourage adequate rest and sleep to support the body’s healing process and conserve energy.
 Screening

The nursing screening for rotavirus in gastroenteritis involves a systematic assessment to identify
patients at risk or presented with symptoms. Therefore, as a nurse, we should assess patients for
symptoms that are commonly associated with rotavirus.

Obtain medical history, this is for underlying any health conditions that may increased the risk of
complication from the rotavirus infection.

Lastly, collecting of stool sample from patient with symptoms suggestive of rotavirus. This sample can
be sent for laboratory testing to detect the presence of rotavirus.

Protection

Protection against rotavirus in this community, parents should make sure their children are well
vaccinated, encourage them to promote regular hand washing with soap and water, especially after
using the toilet, changing diapers and before preparing food.

Ensuring the community to practicing proper food handling, storage and drink clean water, to reduce
the risk of rotavirus.

In addition, good sanitation is much more needed to provide clean drinking water and proper sewage
disposal, to help prevent the spread of rotavirus. Also, the 50 infected patients were isolated from the
non-infected ones right away.

Isolation

Isolation of rotavirus is to practice isolation precaution to prevent the spread among the non-infected
people in the community and infected ones within their homes or healthcare settings. That means no
close contact and restricted movements.

Practice hand hygiene and environmental hygiene to maintain clean environment among people. Also
release patients 4-6 days if symptom free signs are shown.

Prevention

Encourage parents to vaccinate their children and practice good hygiene, food safety, environmental
hygiene and do isolation precautions to reduce exposure to infected person’s and the risk of obtaining
the virus.

EVALUATION

Throughout the assessment of the outbreak of gastroenteritis in the village of 150 residents, the result
came out as rotavirus infected 50 (33%) and 2 children (1%) were hospitalized for medication. This is
due to unhygienic practices, no proper sanitation and lack of knowledge of the virus.

Therefore, I recommend that a health team should be created by the Health Authority purposely to do
awareness and teach these people more about the rotavirus, its transmission, preventive measures
and safety approaches towards the virus. I also appeal for proper sanitation in order to reduce the
spread of the virus.
 HEALTH PROMOTION FOR FUTURE OUTBREAKS OF GASTROENTERITIS

One effective health promotion strategy to prevent future outbreaks of rotavirus in gastroenteritis
within a community is to focus on improving hygiene practices, promotion of vaccination among
children against rotavirus and promotion of clean water and food safety which is also very important
to consider. For example, educate community members about the significance of clean water and
food hygiene practices. This includes ensuring that drinking water is from a clean and reliable source
and also proper storing and preparing of food.

Appeal for proper sanitation facilities for the safe disposal of human waste (faeces and urine), as well
as having the ability to maintain hygienic conditions, through services such as garbage collection,
water management and waste water treatment and disposal.

PLAN AND STRATEGY FOR GASTROENTERITIS

Strategic Plans

To effectively manage rotavirus gastroenteritis, the following are strategies for implementation.

1. Vaccination – Encourage routine vaccination of infant in the village.

2. Sanitation – Appeal for facilities to be built with good places for waste management, safe
disposal of human waste (faeces and urine), as well as having the ability to maintain hygienic
condition.
3. Educational Awareness – Educate communities or the particular village about the safety of
food and about this virus and also on good hygiene.

CONCLUSION

Effective prevention of rotavirus gastroenteritis requires a multifaceted approach, including routine

vaccination, safe food, and good sanitation, surveillance and clinical management. Public health
efforts vaccines, education and awareness and diagnostic treatments among communities.

By implementing comprehensive strategies and collaborating across sectors, we can mitigate the
burden of rotavirus reduce morbidity and mortality. Improve the health and well-being of children in
communities and also worldwide. Continued investment in rotavirus prevention to achieve global
health equity and eliminate the burden of rotavirus.

Together, with concerted efforts from healthcare providers, policymakers, researchers and
communities, we can work towards a future where rotavirus gastroenteritis is no longer a threat to
public health.
 REFERNCES

1. Center for Disease Control and Prevention (n.d). Rotavirus.

Retrieved April 1, 2024, from https://www.cdc.gov/rotavirus/index.html
2. Transmission of Rotavirus (n.d).
Retrieved April 1, 2024, from https://www.cdc.gov/rotavirus/about/transmission/html
3. Howard, K.B., Gloria, M.B., Joanne, M.D., Cheryl, M.W. (2017). Nursing Intervention
Classification (NIC) (7th ed.). Mosby.
4. World Health Organization, (2009). Generic Protocol for monitoring impact of retrovirus
vaccination on gastroenteritis disease burden and viral strains.
Retrieved April 1, 2024, from https://www.who.int/immunization/documents/who-ivb-
09.02/en/