Acute bloody diarrhea cases in Cordillera down by 6 percent

Acute bloody diarrhea cases in the region for the first ten months of this year reached 1,421 cases which is 6 percent lower than the 1,515 cases reported by the health department during the same period last  year.

From January 1 to November 1, 2018, the Cordillera office of the Department of Health (DOH-CAR) said that there were no diarrhea-related deaths that were reported during the established period this year compared to the lone fatality that was recorded by the agency for the same period last year.

The report added that the cases were from Benguet – 607 cases, followed by Mountain Province with 312 cases, Ifugao – 240 cases, Baguio City – 159 cases, Apayao – 36 cases, Abra – 15 cases, Kalinga – 15 cases and non-CAR provinces – 42 cases.

Karen B. Lonogan, program officer of the DOH-CAR’s regional epidemiology and surveillance unit, revealed that there were more males who were afflicted with the illness wherein it reached 739 or 52 percent of the total number of persons who were infected with the said illness.

According to her, the age range of the affected individuals were from 1 month to 99 years old with a median of 13 years old.

Lonogan explained that laboratory results show that entamoeba histolytica was the most common micro-organism seen from the stool submitted by the patients and that clustering of acute bloody diarrhea cases were noted in Benguet, Ifugao and Mountain Province.

Acute bloody diarrhea, with or without vomiting and fever, commonly is associated with pathogenic bacteria in pediatric patients. This dysenteric process commonly has been associated with Salmonella, Shigella, and Campylobacter sp. Aeromonas recently has been implicated as a causative agent of bloody diarrhea. In one study of patients with Aeromonas-positive diarrhea, 30 percent had blood in their stools, 37 percent had vomiting, and 31percent had fever.

Diarrhea due to Salmonella, Shigella, and Campylobacter is usually self-limiting, with most patients showing significant improvement a few days after the onset of illness. Often, the patient's symptoms have resolved by the time that stool cultures are positive.

Moreover, a cute bloody diarrhea should be considered a medical emergency. Its causes are frequently serious or actionable or both and are usually identified. However, acute bloody diarrhea as a stand-alone clinical presentation has received little scholarly attention in the past several decades. Although the range of possible causes of acute bloody diarrhea is broad, infectious considerations are paramount and should always be prioritized in the evaluation of such patients. History, examination, and laboratory testing should be focused on minimizing time to diagnosis (and, by extension, to implementing appropriate therapy). Strategically chosen tests and imaging, avoidance of extraneous diagnostic pursuits, and provision of supportive care while awaiting diagnostic clarity are central to the adroit management of patients with acute bloody diarrhea. Diagnostic considerations differ somewhat between adults and children but have many elements in common, including the need for vigilance in detecting Escherichia coli infection.   - Dexter A. See