PubAnnotation

Id	Subject	Object	Predicate	Lexical cue
TextSentencer_T1	0-35	Sentence	denotes	Epidemiology of Infectious Diarrhea
TextSentencer_T1	0-35	Sentence	denotes	Epidemiology of Infectious Diarrhea
TextSentencer_T2	37-45	Sentence	denotes	Abstract
TextSentencer_T2	37-45	Sentence	denotes	Abstract
TextSentencer_T3	48-194	Sentence	denotes	Diarrhea is a symptom of very diverse causes, and it is characterized by three circumstances: consistency, number, and volume of waste excretions.
TextSentencer_T3	48-194	Sentence	denotes	Diarrhea is a symptom of very diverse causes, and it is characterized by three circumstances: consistency, number, and volume of waste excretions.
TextSentencer_T4	195-288	Sentence	denotes	The consistency of the feces is liquid, or pastelike, adapting to the form of its receptacle.
TextSentencer_T4	195-288	Sentence	denotes	The consistency of the feces is liquid, or pastelike, adapting to the form of its receptacle.
TextSentencer_T5	289-475	Sentence	denotes	The frequency and volume of the excretions can be seen to increase within a highly variable range, starting with very slight diarrhea up to that which can put the patient's life at risk.
TextSentencer_T5	289-475	Sentence	denotes	The frequency and volume of the excretions can be seen to increase within a highly variable range, starting with very slight diarrhea up to that which can put the patient's life at risk.
TextSentencer_T6	476-532	Sentence	denotes	The volume of feces in a healthy adult is almost 300 ml.
TextSentencer_T6	476-532	Sentence	denotes	The volume of feces in a healthy adult is almost 300 ml.
TextSentencer_T7	533-622	Sentence	denotes	Diarrhea's pathogenic mechanism is responsible for an acceleration of intestinal transit.
TextSentencer_T7	533-622	Sentence	denotes	Diarrhea's pathogenic mechanism is responsible for an acceleration of intestinal transit.
TextSentencer_T8	623-795	Sentence	denotes	The World Health Organization (WHO) defines diarrhea as ''the passage of three or more loose or liquid stools per day, or more frequently than is normal for the individual.
TextSentencer_T8	623-795	Sentence	denotes	The World Health Organization (WHO) defines diarrhea as ''the passage of three or more loose or liquid stools per day, or more frequently than is normal for the individual.
TextSentencer_T9	796-928	Sentence	denotes	It is usually a symptom of gastrointestinal infection, which can be caused by a variety of bacterial, viral and parasitic organisms.
TextSentencer_T9	796-928	Sentence	denotes	It is usually a symptom of gastrointestinal infection, which can be caused by a variety of bacterial, viral and parasitic organisms.
TextSentencer_T10	929-1065	Sentence	denotes	Infection is spread through contaminated food or drinking-water, or from person to person as a result of poor hygiene.'' Dr. Sherwood L.
TextSentencer_T10	929-1065	Sentence	denotes	Infection is spread through contaminated food or drinking-water, or from person to person as a result of poor hygiene.'' Dr. Sherwood L.
TextSentencer_T11	1066-1478	Sentence	denotes	Gorbach states: ''Acute diarrhea is often defined as the occurrence of three or more unformed bowel movements a day or any number of such movements when accompanied by fever, abdominal cramps, or vomiting.'' While carrying out studies epidemiologists can use other operative definitions adapted to the objectives of each study, taking into account the sensitivity and specificity of the definitions in each case.
TextSentencer_T11	1066-1478	Sentence	denotes	Gorbach states: ''Acute diarrhea is often defined as the occurrence of three or more unformed bowel movements a day or any number of such movements when accompanied by fever, abdominal cramps, or vomiting.'' While carrying out studies epidemiologists can use other operative definitions adapted to the objectives of each study, taking into account the sensitivity and specificity of the definitions in each case.
TextSentencer_T12	1479-1534	Sentence	denotes	From this three clinical syndromes can be described: a.
TextSentencer_T12	1479-1534	Sentence	denotes	From this three clinical syndromes can be described: a.
TextSentencer_T13	1535-1557	Sentence	denotes	Acute watery diarrhea:
TextSentencer_T13	1535-1557	Sentence	denotes	Acute watery diarrhea:
TextSentencer_T14	1558-1653	Sentence	denotes	Beginning abruptly, it consists of the passing of a great amount of liquid feces without blood.
TextSentencer_T14	1558-1653	Sentence	denotes	Beginning abruptly, it consists of the passing of a great amount of liquid feces without blood.
TextSentencer_T15	1654-1861	Sentence	denotes	Main symptoms usually remain for less than 7 days (but can persist up to 2 weeks at most); it can be accompanied by vomiting and fever, but it also presents a greater problem, the possibility of dehydration.
TextSentencer_T15	1654-1861	Sentence	denotes	Main symptoms usually remain for less than 7 days (but can persist up to 2 weeks at most); it can be accompanied by vomiting and fever, but it also presents a greater problem, the possibility of dehydration.
TextSentencer_T16	1862-1931	Sentence	denotes	It is a result of the alteration of absorption and secretion balance.
TextSentencer_T16	1862-1931	Sentence	denotes	It is a result of the alteration of absorption and secretion balance.
TextSentencer_T17	1932-2069	Sentence	denotes	Causal agents include rotavirus, Campylobacter, nontyphoidal Salmonella, enterotoxigenic Escherichia coli, Vibrio cholerae, and so on. b.
TextSentencer_T17	1932-2069	Sentence	denotes	Causal agents include rotavirus, Campylobacter, nontyphoidal Salmonella, enterotoxigenic Escherichia coli, Vibrio cholerae, and so on. b.
TextSentencer_T18	2070-2080	Sentence	denotes	Dysentery:
TextSentencer_T18	2070-2080	Sentence	denotes	Dysentery:
TextSentencer_T19	2081-2174	Sentence	denotes	When diarrhea is accompanied by visible traces of blood in the feces, it is called dysentery.
TextSentencer_T19	2081-2174	Sentence	denotes	When diarrhea is accompanied by visible traces of blood in the feces, it is called dysentery.
TextSentencer_T20	2175-2368	Sentence	denotes	It is a result of damage suffered by intestinal mucus in the colon ravaged by an external agent, such as Shigella dysenteriae, nontyphoidal Salmonella, Entamoeba histolytica, and Campylobacter.
TextSentencer_T20	2175-2368	Sentence	denotes	It is a result of damage suffered by intestinal mucus in the colon ravaged by an external agent, such as Shigella dysenteriae, nontyphoidal Salmonella, Entamoeba histolytica, and Campylobacter.
TextSentencer_T21	2369-2423	Sentence	denotes	Rapid weight loss is the most frequent consequence. c.
TextSentencer_T21	2369-2423	Sentence	denotes	Rapid weight loss is the most frequent consequence. c.
TextSentencer_T22	2424-2444	Sentence	denotes	Persistent diarrhea:
TextSentencer_T22	2424-2444	Sentence	denotes	Persistent diarrhea:
TextSentencer_T23	2445-2527	Sentence	denotes	With a duration of more than 14 days, it can start as acute diarrhea or dysentery.
TextSentencer_T23	2445-2527	Sentence	denotes	With a duration of more than 14 days, it can start as acute diarrhea or dysentery.
TextSentencer_T24	2528-2604	Sentence	denotes	It should not be confused with chronic diarrhea due to noninfectious causes.
TextSentencer_T24	2528-2604	Sentence	denotes	It should not be confused with chronic diarrhea due to noninfectious causes.
TextSentencer_T25	2605-2669	Sentence	denotes	It can produce noticeable weight loss and a risk of dehydration.
TextSentencer_T25	2605-2669	Sentence	denotes	It can produce noticeable weight loss and a risk of dehydration.
TextSentencer_T26	2670-2758	Sentence	denotes	Causal agents include Shigella, enteroaggregative E. coli, Cryptosporidium, and Giardia.
TextSentencer_T26	2670-2758	Sentence	denotes	Causal agents include Shigella, enteroaggregative E. coli, Cryptosporidium, and Giardia.
TextSentencer_T27	2759-2988	Sentence	denotes	The consequent effects of diarrhea can be highly variable: from a slight and transitory condition that spontaneously resolves itself to its more severe incarnations where loss of water and electrolytes can be an important factor.
TextSentencer_T27	2759-2988	Sentence	denotes	The consequent effects of diarrhea can be highly variable: from a slight and transitory condition that spontaneously resolves itself to its more severe incarnations where loss of water and electrolytes can be an important factor.
TextSentencer_T28	2989-3134	Sentence	denotes	The resulting hypovolemic shock can cause renal failure, disorders in other organs, and in the most vulnerable patients it can prove to be fatal.
TextSentencer_T28	2989-3134	Sentence	denotes	The resulting hypovolemic shock can cause renal failure, disorders in other organs, and in the most vulnerable patients it can prove to be fatal.
TextSentencer_T29	3135-3341	Sentence	denotes	The appearance of diarrhea results from confrontation between aggressive external elements (a causal agent's toxicity or virulence, the quantity of the inoculant dose) and the body's own defense mechanisms.
TextSentencer_T29	3135-3341	Sentence	denotes	The appearance of diarrhea results from confrontation between aggressive external elements (a causal agent's toxicity or virulence, the quantity of the inoculant dose) and the body's own defense mechanisms.
TextSentencer_T30	3342-3611	Sentence	denotes	Among the defense mechanisms combating infectious agents, the following can be highlighted: gastric acid, gastrointestinal mucus, intestinal motility, bile salts, regular intestinal bacteria, macrophage cells, lymphocyte cells, and type IgA immunoglobulin in the mucus.
TextSentencer_T30	3342-3611	Sentence	denotes	Among the defense mechanisms combating infectious agents, the following can be highlighted: gastric acid, gastrointestinal mucus, intestinal motility, bile salts, regular intestinal bacteria, macrophage cells, lymphocyte cells, and type IgA immunoglobulin in the mucus.
TextSentencer_T31	3612-3922	Sentence	denotes	Additionally, there are genetic factors that can affect resistance to particular infections; for example, blood group 'O' individuals are at greater risk of suffering from cholera, whereas the socalled nonsecretory individuals, with certain FUT 2 gene mutations, are partially resistant to norovirus infection.
TextSentencer_T31	3612-3922	Sentence	denotes	Additionally, there are genetic factors that can affect resistance to particular infections; for example, blood group 'O' individuals are at greater risk of suffering from cholera, whereas the socalled nonsecretory individuals, with certain FUT 2 gene mutations, are partially resistant to norovirus infection.
TextSentencer_T32	3923-4172	Sentence	denotes	Other specific external circumstances such as the ingestion of alcohol or (nonvolatile) red wine could act as protective factors against infection by Salmonella when the ingestion of the microorganism and those kind of drinks is almost simultaneous.
TextSentencer_T32	3923-4172	Sentence	denotes	Other specific external circumstances such as the ingestion of alcohol or (nonvolatile) red wine could act as protective factors against infection by Salmonella when the ingestion of the microorganism and those kind of drinks is almost simultaneous.
TextSentencer_T33	4173-4233	Sentence	denotes	There are few vaccines effective against diarrheal diseases.
TextSentencer_T33	4173-4233	Sentence	denotes	There are few vaccines effective against diarrheal diseases.
TextSentencer_T34	4234-4336	Sentence	denotes	Recently, a vaccine against rotavirus has been authorized, which is expected to show positive results.
TextSentencer_T34	4234-4336	Sentence	denotes	Recently, a vaccine against rotavirus has been authorized, which is expected to show positive results.
TextSentencer_T35	4337-4500	Sentence	denotes	Occasionally, diarrhea presents itself as an accompanying symptom of chronic conditions, such as the collateral effect of some medicines or a sign of malnutrition.
TextSentencer_T35	4337-4500	Sentence	denotes	Occasionally, diarrhea presents itself as an accompanying symptom of chronic conditions, such as the collateral effect of some medicines or a sign of malnutrition.
TextSentencer_T36	4501-4671	Sentence	denotes	However, this article discusses diarrhea as the principal effect of infections and poisoning by microorganisms, ingestion of animals, plants, or compound chemical toxins.
TextSentencer_T36	4501-4671	Sentence	denotes	However, this article discusses diarrhea as the principal effect of infections and poisoning by microorganisms, ingestion of animals, plants, or compound chemical toxins.
TextSentencer_T37	4672-4806	Sentence	denotes	In this context, it is very common to associate diarrhea with the ingestion of food that is either contaminated or well past its best.
TextSentencer_T37	4672-4806	Sentence	denotes	In this context, it is very common to associate diarrhea with the ingestion of food that is either contaminated or well past its best.
TextSentencer_T38	4807-4932	Sentence	denotes	But infections and food poisonings do not always present themselves as the clinical profile in which diarrhea is predominant.
TextSentencer_T38	4807-4932	Sentence	denotes	But infections and food poisonings do not always present themselves as the clinical profile in which diarrhea is predominant.
TextSentencer_T39	4933-5068	Sentence	denotes	For example, in botulism or some marine biotoxins the essential factors are the neurological signs -diarrhea may or may not be present.
TextSentencer_T39	4933-5068	Sentence	denotes	For example, in botulism or some marine biotoxins the essential factors are the neurological signs -diarrhea may or may not be present.
TextSentencer_T40	5069-5287	Sentence	denotes	Infant mortality from acute diarrhea has reduced throughout the last years of the twentieth century, essentially due to improvements in sanitation and the implementation of Oral Rehydration Therapy programs by the WHO.
TextSentencer_T40	5069-5287	Sentence	denotes	Infant mortality from acute diarrhea has reduced throughout the last years of the twentieth century, essentially due to improvements in sanitation and the implementation of Oral Rehydration Therapy programs by the WHO.
TextSentencer_T41	5288-5356	Sentence	denotes	Even so, in the year 2000, it caused approximately 2 million deaths.
TextSentencer_T41	5288-5356	Sentence	denotes	Even so, in the year 2000, it caused approximately 2 million deaths.
TextSentencer_T42	5357-5407	Sentence	denotes	The vast majority was related to avoidable causes.
TextSentencer_T42	5357-5407	Sentence	denotes	The vast majority was related to avoidable causes.
TextSentencer_T43	5408-5495	Sentence	denotes	In the distribution of diarrhea cases there are geographic and age-related differences.
TextSentencer_T43	5408-5495	Sentence	denotes	In the distribution of diarrhea cases there are geographic and age-related differences.
TextSentencer_T44	5496-5671	Sentence	denotes	With as much respect to etiology as to the seriousness of the cases, somewhat different patterns have been found, according to whether the countries are industrialized or not.
TextSentencer_T44	5496-5671	Sentence	denotes	With as much respect to etiology as to the seriousness of the cases, somewhat different patterns have been found, according to whether the countries are industrialized or not.
TextSentencer_T45	5672-5880	Sentence	denotes	Certain parasites and cholera, for example (of whom the WHO is continuously in international pursuit), are still frequent in some underdeveloped regions where favorable conditions for their propagation exist.
TextSentencer_T45	5672-5880	Sentence	denotes	Certain parasites and cholera, for example (of whom the WHO is continuously in international pursuit), are still frequent in some underdeveloped regions where favorable conditions for their propagation exist.
TextSentencer_T46	5881-6015	Sentence	denotes	Bad conditions of individual hygiene, nutrition, and existing public sanitation in many poor countries favor the presence of diarrhea.
TextSentencer_T46	5881-6015	Sentence	denotes	Bad conditions of individual hygiene, nutrition, and existing public sanitation in many poor countries favor the presence of diarrhea.
TextSentencer_T47	6016-6330	Sentence	denotes	Even when incidences of the infection do not display such great geographic differences, in the case of some viruses, the indicators in terms of its lethality are noticeably different; for example, rotavirus is very frequent in all types of countries, but its severity (mortality rate) is greater in poor countries.
TextSentencer_T47	6016-6330	Sentence	denotes	Even when incidences of the infection do not display such great geographic differences, in the case of some viruses, the indicators in terms of its lethality are noticeably different; for example, rotavirus is very frequent in all types of countries, but its severity (mortality rate) is greater in poor countries.
TextSentencer_T48	6331-6490	Sentence	denotes	In England and Wales, the microorganisms that most frequently cause diarrhea are Campylobacter, rotavirus, norovirus, Salmonella, Giardia, and Cryptosporidium.
TextSentencer_T48	6331-6490	Sentence	denotes	In England and Wales, the microorganisms that most frequently cause diarrhea are Campylobacter, rotavirus, norovirus, Salmonella, Giardia, and Cryptosporidium.
TextSentencer_T49	6491-6662	Sentence	denotes	Since means have been available for the virological diagnosis of gastroenteritis, it has been seen that viruses are the most common cause of diarrhea in Western countries.
TextSentencer_T49	6491-6662	Sentence	denotes	Since means have been available for the virological diagnosis of gastroenteritis, it has been seen that viruses are the most common cause of diarrhea in Western countries.
TextSentencer_T50	6663-6872	Sentence	denotes	Generally they do not cause very serious illnesses at the individual level, but they are responsible for a considerable social burden in the form of hospital admissions and scholastic and employee absenteeism.
TextSentencer_T50	6663-6872	Sentence	denotes	Generally they do not cause very serious illnesses at the individual level, but they are responsible for a considerable social burden in the form of hospital admissions and scholastic and employee absenteeism.
TextSentencer_T51	6873-7029	Sentence	denotes	The age of patients, the seriousness of the illness, and the capabilities of laboratories are factors that determine the scope of the etiological diagnosis.
TextSentencer_T51	6873-7029	Sentence	denotes	The age of patients, the seriousness of the illness, and the capabilities of laboratories are factors that determine the scope of the etiological diagnosis.
TextSentencer_T52	7030-7129	Sentence	denotes	Age also relates to the etiology of diarrhea ( Figure 1 ) and to the probability of fecal analyses.
TextSentencer_T52	7030-7129	Sentence	denotes	Age also relates to the etiology of diarrhea ( Figure 1 ) and to the probability of fecal analyses.
TextSentencer_T53	7130-7301	Sentence	denotes	Faced with a similar clinical profile, a child does not have the same probability as an adult of receiving an etiological diagnosis: in the child's case it is more likely.
TextSentencer_T53	7130-7301	Sentence	denotes	Faced with a similar clinical profile, a child does not have the same probability as an adult of receiving an etiological diagnosis: in the child's case it is more likely.
TextSentencer_T54	7302-7372	Sentence	denotes	The same happens with serious conditions in comparison to slight ones.
TextSentencer_T54	7302-7372	Sentence	denotes	The same happens with serious conditions in comparison to slight ones.
TextSentencer_T55	7373-7433	Sentence	denotes	The slight diarrheas often go without etiological diagnosis.
TextSentencer_T55	7373-7433	Sentence	denotes	The slight diarrheas often go without etiological diagnosis.
TextSentencer_T56	7434-7559	Sentence	denotes	This is also the case with conditions caused by agents that are not detected by the laboratory participating in the analysis.
TextSentencer_T56	7434-7559	Sentence	denotes	This is also the case with conditions caused by agents that are not detected by the laboratory participating in the analysis.
TextSentencer_T57	7560-7661	Sentence	denotes	Age bias, age, and technical ability need to be considered when analyzing epidemiological statistics.
TextSentencer_T57	7560-7661	Sentence	denotes	Age bias, age, and technical ability need to be considered when analyzing epidemiological statistics.
TextSentencer_T58	7662-7998	Sentence	denotes	However, epidemiological studies were performed in England and Holland at the end of 1990s and in the United States in 2001 and 2002, in which a thorough fecal examination of all patients was undertaken, independent of their age and the seriousness of their condition, including those patients who no longer showed symptoms of diarrhea.
TextSentencer_T58	7662-7998	Sentence	denotes	However, epidemiological studies were performed in England and Holland at the end of 1990s and in the United States in 2001 and 2002, in which a thorough fecal examination of all patients was undertaken, independent of their age and the seriousness of their condition, including those patients who no longer showed symptoms of diarrhea.
TextSentencer_T59	7999-8194	Sentence	denotes	In these studies, fecal examination was also carried out in healthy control subjects, so that the frequency in which specific microorganisms appeared could be compared with asymptomatic subjects.
TextSentencer_T59	7999-8194	Sentence	denotes	In these studies, fecal examination was also carried out in healthy control subjects, so that the frequency in which specific microorganisms appeared could be compared with asymptomatic subjects.
TextSentencer_T60	8195-8379	Sentence	denotes	Usually the etiological diagnosis of acute infectious (or toxic) diarrhea is obtained by fecal analysis: wet mount, coproculture, antigen detection, toxin detection, or other analyses.
TextSentencer_T60	8195-8379	Sentence	denotes	Usually the etiological diagnosis of acute infectious (or toxic) diarrhea is obtained by fecal analysis: wet mount, coproculture, antigen detection, toxin detection, or other analyses.
TextSentencer_T61	8380-8537	Sentence	denotes	Specialized laboratories can use more complex techniques that, generally, prove to be more sensitive and specific, but are also more expensive and difficult.
TextSentencer_T61	8380-8537	Sentence	denotes	Specialized laboratories can use more complex techniques that, generally, prove to be more sensitive and specific, but are also more expensive and difficult.
TextSentencer_T62	8538-8635	Sentence	denotes	Nevertheless, many of the coprocultures a standard laboratory requests and examines are negative.
TextSentencer_T62	8538-8635	Sentence	denotes	Nevertheless, many of the coprocultures a standard laboratory requests and examines are negative.
TextSentencer_T63	8636-8938	Sentence	denotes	A negative result can be the consequence of the following reasons: diarrhea is not actually infectious, it is caused by an agent for which the laboratory has no data, there is a failure in the test sensitivity, the patient may have taken antibiotics, or there may have been problems in fecal transport.
TextSentencer_T63	8636-8938	Sentence	denotes	A negative result can be the consequence of the following reasons: diarrhea is not actually infectious, it is caused by an agent for which the laboratory has no data, there is a failure in the test sensitivity, the patient may have taken antibiotics, or there may have been problems in fecal transport.
TextSentencer_T64	8939-9071	Sentence	denotes	Cases that have returned negative results are a mixture of etiologies, and for that reason further investigation makes little sense.
TextSentencer_T64	8939-9071	Sentence	denotes	Cases that have returned negative results are a mixture of etiologies, and for that reason further investigation makes little sense.
TextSentencer_T65	9072-9263	Sentence	denotes	In the EDICS study (Study of Infectious Diarrhea in Castellón) of risk factors in infantile diarrhea, no risk factors were found associated to the cases with a negative fecal analysis result.
TextSentencer_T65	9072-9263	Sentence	denotes	In the EDICS study (Study of Infectious Diarrhea in Castellón) of risk factors in infantile diarrhea, no risk factors were found associated to the cases with a negative fecal analysis result.
TextSentencer_T66	9264-9364	Sentence	denotes	On the contrary, risk factors were found in cases of campylobacteriosis, salmonelosis, or rotavirus.
TextSentencer_T66	9264-9364	Sentence	denotes	On the contrary, risk factors were found in cases of campylobacteriosis, salmonelosis, or rotavirus.
TextSentencer_T67	9365-9513	Sentence	denotes	This indeed suggests that the group of negatives is a mixture of different etiological cases without common origin and with few shared risk factors.
TextSentencer_T67	9365-9513	Sentence	denotes	This indeed suggests that the group of negatives is a mixture of different etiological cases without common origin and with few shared risk factors.
TextSentencer_T68	9514-9708	Sentence	denotes	The appearance of vomit as an initial symptom, the absence of fecal blood (macro-or microscopic,) and low PCR (reactive C protein) are signs suggestive of viral etiology, especially in children.
TextSentencer_T68	9514-9708	Sentence	denotes	The appearance of vomit as an initial symptom, the absence of fecal blood (macro-or microscopic,) and low PCR (reactive C protein) are signs suggestive of viral etiology, especially in children.
TextSentencer_T69	9709-9869	Sentence	denotes	Faced with an epidemiological case of diarrhea two questions arise: one, if the etiology is already known; two, if there are more cases related to the original.
TextSentencer_T69	9709-9869	Sentence	denotes	Faced with an epidemiological case of diarrhea two questions arise: one, if the etiology is already known; two, if there are more cases related to the original.
TextSentencer_T70	9870-9972	Sentence	denotes	These two elements are represented in Table 1 , where each cell signifies a distinct epidemic concern.
TextSentencer_T70	9870-9972	Sentence	denotes	These two elements are represented in Table 1 , where each cell signifies a distinct epidemic concern.
TextSentencer_T71	9973-10134	Sentence	denotes	There are noticeable differences in modes of approaching the epidemiological study of diarrhea cases according to their sporadicity or pertinence to an outbreak.
TextSentencer_T71	9973-10134	Sentence	denotes	There are noticeable differences in modes of approaching the epidemiological study of diarrhea cases according to their sporadicity or pertinence to an outbreak.
TextSentencer_T72	10135-10222	Sentence	denotes	Certain microorganisms have a preference to appear fundamentally as one of these forms.
TextSentencer_T72	10135-10222	Sentence	denotes	Certain microorganisms have a preference to appear fundamentally as one of these forms.
TextSentencer_T73	10223-10356	Sentence	denotes	As such, Campylobacter or rotavirus constitutes the majority of sporadic cases, not excluding the possibility of producing outbreaks.
TextSentencer_T73	10223-10356	Sentence	denotes	As such, Campylobacter or rotavirus constitutes the majority of sporadic cases, not excluding the possibility of producing outbreaks.
TextSentencer_T74	10357-10480	Sentence	denotes	On the contrary, Salmonella and, especially, norovirus more characteristically present themselves in the form of outbreaks.
TextSentencer_T74	10357-10480	Sentence	denotes	On the contrary, Salmonella and, especially, norovirus more characteristically present themselves in the form of outbreaks.
TextSentencer_T75	10481-10693	Sentence	denotes	From the epidemiological point of view, it could be said that epidemic cases 'come' to the investigator as one, whereas the investigator 'goes' in search of the sporadic cases and reunites them for their studies.
TextSentencer_T75	10481-10693	Sentence	denotes	From the epidemiological point of view, it could be said that epidemic cases 'come' to the investigator as one, whereas the investigator 'goes' in search of the sporadic cases and reunites them for their studies.
TextSentencer_T76	10694-10869	Sentence	denotes	Among the sporadic cases there is a group, which in fact belongs to small clusters, that escapes common systems of epidemiological monitoring and needs special investigations.
TextSentencer_T76	10694-10869	Sentence	denotes	Among the sporadic cases there is a group, which in fact belongs to small clusters, that escapes common systems of epidemiological monitoring and needs special investigations.
TextSentencer_T77	10870-11064	Sentence	denotes	This group of apparently sporadic cases (but which, in fact, are not sporadic) can only be detected by the existence of an exceptionally good monitoring system or by performing specific studies.
TextSentencer_T77	10870-11064	Sentence	denotes	This group of apparently sporadic cases (but which, in fact, are not sporadic) can only be detected by the existence of an exceptionally good monitoring system or by performing specific studies.
TextSentencer_T78	11065-11471	Sentence	denotes	Steen Ettenberg and other collaborators performed a specific study on cases registered throughout Denmark in the 1990s and found that 13.3% of Salmonella enteritidis, 10.4% of Shigella sonnei, 5.6% of Salmonella serotype Typhimurium, 3.2% of Campylobacter, and 2.0% of Yersinia enterocolitica cases belonged to this type of clusters, which is a large majority unknown to epidemiological monitoring systems.
TextSentencer_T78	11065-11471	Sentence	denotes	Steen Ettenberg and other collaborators performed a specific study on cases registered throughout Denmark in the 1990s and found that 13.3% of Salmonella enteritidis, 10.4% of Shigella sonnei, 5.6% of Salmonella serotype Typhimurium, 3.2% of Campylobacter, and 2.0% of Yersinia enterocolitica cases belonged to this type of clusters, which is a large majority unknown to epidemiological monitoring systems.
TextSentencer_T79	11472-11642	Sentence	denotes	In absolute terms, the cases of campylobacteriosis were the most numerous due to the large amount of patients diagnosed with the infection in the last years of the study.
TextSentencer_T79	11472-11642	Sentence	denotes	In absolute terms, the cases of campylobacteriosis were the most numerous due to the large amount of patients diagnosed with the infection in the last years of the study.
TextSentencer_T80	11643-11812	Sentence	denotes	In a much smaller study in Castellón (Spain), 10 clusters of this type were identified after systematic investigation of coprocultures in an area of 250 000 inhabitants.
TextSentencer_T80	11643-11812	Sentence	denotes	In a much smaller study in Castellón (Spain), 10 clusters of this type were identified after systematic investigation of coprocultures in an area of 250 000 inhabitants.
TextSentencer_T81	11813-11917	Sentence	denotes	Small family clusters of Campylobacter, S. enteritidis, rotavirus, and intestinal adenovirus were found.
TextSentencer_T81	11813-11917	Sentence	denotes	Small family clusters of Campylobacter, S. enteritidis, rotavirus, and intestinal adenovirus were found.
TextSentencer_T82	11918-12055	Sentence	denotes	In addition to the etiology and level of aggregation, a third question arises: the source of infection and its mechanism of transmission.
TextSentencer_T82	11918-12055	Sentence	denotes	In addition to the etiology and level of aggregation, a third question arises: the source of infection and its mechanism of transmission.
TextSentencer_T83	12056-12147	Sentence	denotes	When the etiology is well known, the epidemiology of the agent involved is generally known.
TextSentencer_T83	12056-12147	Sentence	denotes	When the etiology is well known, the epidemiology of the agent involved is generally known.
TextSentencer_T84	12148-12273	Sentence	denotes	Table 2 summarizes some epidemiological characteristics of five infection sources and significant mechanisms of transmission.
TextSentencer_T84	12148-12273	Sentence	denotes	Table 2 summarizes some epidemiological characteristics of five infection sources and significant mechanisms of transmission.
TextSentencer_T85	12274-12441	Sentence	denotes	Figures 2 and 3 represent two outbreaks of diarrhea by norovirus in residential homes for the elderly; these charts clearly demonstrate two mechanisms of transmission.
TextSentencer_T85	12274-12441	Sentence	denotes	Figures 2 and 3 represent two outbreaks of diarrhea by norovirus in residential homes for the elderly; these charts clearly demonstrate two mechanisms of transmission.
TextSentencer_T86	12442-12728	Sentence	denotes	Figure 2 shows a specific outbreak transmitted by foods (foodborne point source outbreak), and Figure 3 shows an outbreak, beginning gradually and progressively exacerbating, in which the transmission mechanism was predominantly 'person to person' and environmental (surfaces, fomites).
TextSentencer_T86	12442-12728	Sentence	denotes	Figure 2 shows a specific outbreak transmitted by foods (foodborne point source outbreak), and Figure 3 shows an outbreak, beginning gradually and progressively exacerbating, in which the transmission mechanism was predominantly 'person to person' and environmental (surfaces, fomites).
TextSentencer_T87	12729-12938	Sentence	denotes	Figure 4 represents a simple theoretical diagram for the investigation of transmissible disease cases by using the ARMIGO system (agent, reservoir, mechanism of transmission, individual, groups, other people).
TextSentencer_T87	12729-12938	Sentence	denotes	Figure 4 represents a simple theoretical diagram for the investigation of transmissible disease cases by using the ARMIGO system (agent, reservoir, mechanism of transmission, individual, groups, other people).
TextSentencer_T88	12939-13102	Sentence	denotes	Following an outline inspired by the epidemic cases of Table 1 , three situations can be distinguished according to the characteristics of the affected population.
TextSentencer_T88	12939-13102	Sentence	denotes	Following an outline inspired by the epidemic cases of Table 1 , three situations can be distinguished according to the characteristics of the affected population.
TextSentencer_T89	13103-13284	Sentence	denotes	First, a defined, open population with a specific exposure, which refers to people who only momentarily shared an exposure factor, for example, attending a shared dinner or banquet.
TextSentencer_T89	13103-13284	Sentence	denotes	First, a defined, open population with a specific exposure, which refers to people who only momentarily shared an exposure factor, for example, attending a shared dinner or banquet.
TextSentencer_T90	13285-13467	Sentence	denotes	Second, a defined, closed population with lasting exposure factors, for example, permanent residents within a closed institution, who continually share meals, places, and activities.
TextSentencer_T90	13285-13467	Sentence	denotes	Second, a defined, closed population with lasting exposure factors, for example, permanent residents within a closed institution, who continually share meals, places, and activities.
TextSentencer_T91	13468-13721	Sentence	denotes	And third, an indefinite population, with or without specific exposure, which occurs when there is no obvious relationship between people and they are implicated in an outbreak, solely by sharing an exposure factor distributed throughout the population.
TextSentencer_T91	13468-13721	Sentence	denotes	And third, an indefinite population, with or without specific exposure, which occurs when there is no obvious relationship between people and they are implicated in an outbreak, solely by sharing an exposure factor distributed throughout the population.
TextSentencer_T92	13722-13896	Sentence	denotes	In the case of laboratory analysis, an epidemic is identified where some rare microorganism in unusually large numbers of people is detected in a fairly prolonged time frame.
TextSentencer_T92	13722-13896	Sentence	denotes	In the case of laboratory analysis, an epidemic is identified where some rare microorganism in unusually large numbers of people is detected in a fairly prolonged time frame.
TextSentencer_T93	13897-14102	Sentence	denotes	For example, an outbreak that occurred in the United States in the first half of 2008 was produced by Salmonella Saintpaul with the same genetic fingerprint that affected more than 500 people in 32 states.
TextSentencer_T93	13897-14102	Sentence	denotes	For example, an outbreak that occurred in the United States in the first half of 2008 was produced by Salmonella Saintpaul with the same genetic fingerprint that affected more than 500 people in 32 states.
TextSentencer_T94	14103-14194	Sentence	denotes	The epidemic was related to the consumption of tomatoes distributed throughout the country.
TextSentencer_T94	14103-14194	Sentence	denotes	The epidemic was related to the consumption of tomatoes distributed throughout the country.
TextSentencer_T95	14195-14362	Sentence	denotes	Table 3 shows the agents that most frequently cause diarrhea, and Table 4 summarizes the more relevant epidemiological features of the diarrhea caused by these agents.
TextSentencer_T95	14195-14362	Sentence	denotes	Table 3 shows the agents that most frequently cause diarrhea, and Table 4 summarizes the more relevant epidemiological features of the diarrhea caused by these agents.
TextSentencer_T96	14363-14412	Sentence	denotes	Some of these microorganisms are discussed below.
TextSentencer_T96	14363-14412	Sentence	denotes	Some of these microorganisms are discussed below.
TextSentencer_T97	14413-14511	Sentence	denotes	This was identified by Ruth Bishop in 1973 and was named as such because of its 'wheel-like' form.
TextSentencer_T97	14413-14511	Sentence	denotes	This was identified by Ruth Bishop in 1973 and was named as such because of its 'wheel-like' form.
TextSentencer_T98	14512-14592	Sentence	denotes	There are various groups of rotavirus capable of producing infections in humans.
TextSentencer_T98	14512-14592	Sentence	denotes	There are various groups of rotavirus capable of producing infections in humans.
TextSentencer_T99	14593-14663	Sentence	denotes	The vast majority of cases are children infected by group A rotavirus.
TextSentencer_T99	14593-14663	Sentence	denotes	The vast majority of cases are children infected by group A rotavirus.
TextSentencer_T100	14664-14749	Sentence	denotes	Group B is related to diarrheas in adults and group C to slight diarrheas at any age.
TextSentencer_T100	14664-14749	Sentence	denotes	Group B is related to diarrheas in adults and group C to slight diarrheas at any age.
TextSentencer_T101	14750-14825	Sentence	denotes	Other serogroups are zoonotic and are possibly transmitted by some animals.
TextSentencer_T101	14750-14825	Sentence	denotes	Other serogroups are zoonotic and are possibly transmitted by some animals.
TextSentencer_T102	14826-14919	Sentence	denotes	Rotavirus is the main etiological agent for serious diarrheas in children all over the world.
TextSentencer_T102	14826-14919	Sentence	denotes	Rotavirus is the main etiological agent for serious diarrheas in children all over the world.
TextSentencer_T103	14920-15009	Sentence	denotes	At a very young age, a large number of children have already been infected or reinfected.
TextSentencer_T103	14920-15009	Sentence	denotes	At a very young age, a large number of children have already been infected or reinfected.
TextSentencer_T104	15010-15069	Sentence	denotes	Rotavirus has limited capabilities for producing outbreaks.
TextSentencer_T104	15010-15069	Sentence	denotes	Rotavirus has limited capabilities for producing outbreaks.
TextSentencer_T105	15070-15145	Sentence	denotes	The most important problems it constitutes are sporadic and hospital cases.
TextSentencer_T105	15070-15145	Sentence	denotes	The most important problems it constitutes are sporadic and hospital cases.
TextSentencer_T106	15146-15220	Sentence	denotes	Many cases are relatively serious infections that require hospitalization.
TextSentencer_T106	15146-15220	Sentence	denotes	Many cases are relatively serious infections that require hospitalization.
TextSentencer_T107	15221-15403	Sentence	denotes	According to a study of common rotaviral diarrhea in children under 5 years of age, carried out in 2000 and again in 2004 in Castellón, almost half of the patients were hospitalized.
TextSentencer_T107	15221-15403	Sentence	denotes	According to a study of common rotaviral diarrhea in children under 5 years of age, carried out in 2000 and again in 2004 in Castellón, almost half of the patients were hospitalized.
TextSentencer_T108	15404-15547	Sentence	denotes	In nonindustrialized countries, hospitalizations are fewer because welfare services are less accessible; mortality rates, however, are greater.
TextSentencer_T108	15404-15547	Sentence	denotes	In nonindustrialized countries, hospitalizations are fewer because welfare services are less accessible; mortality rates, however, are greater.
TextSentencer_T109	15548-15727	Sentence	denotes	Year 2006 saw the 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 August September Notification and control authorization of two new oral vaccines that promise to be effective:
TextSentencer_T109	15548-15727	Sentence	denotes	Year 2006 saw the 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 August September Notification and control authorization of two new oral vaccines that promise to be effective:
TextSentencer_T110	15728-15753	Sentence	denotes	RotaTeq s and Rotarix s .
TextSentencer_T110	15728-15753	Sentence	denotes	RotaTeq s and Rotarix s .
TextSentencer_T111	15754-15844	Sentence	denotes	Previously known as 'Agent Norwalk,' this virus was identified by Albert Kapikian in 1972.
TextSentencer_T111	15754-15844	Sentence	denotes	Previously known as 'Agent Norwalk,' this virus was identified by Albert Kapikian in 1972.
TextSentencer_T112	15845-16050	Sentence	denotes	It is related to the Caliciviridae family, of which only norovirus and sapovirus cause diarrhea in humans -the former preferentially causing epidemic cases (outbreaks) and the latter causing sporadic ones.
TextSentencer_T112	15845-16050	Sentence	denotes	It is related to the Caliciviridae family, of which only norovirus and sapovirus cause diarrhea in humans -the former preferentially causing epidemic cases (outbreaks) and the latter causing sporadic ones.
TextSentencer_T113	16051-16195	Sentence	denotes	Norovirus, especially genogroups I and II, actually constitutes the most frequent cause of viral diarrhea epidemics in industrialized countries.
TextSentencer_T113	16051-16195	Sentence	denotes	Norovirus, especially genogroups I and II, actually constitutes the most frequent cause of viral diarrhea epidemics in industrialized countries.
TextSentencer_T114	16196-16381	Sentence	denotes	If rotavirus is characterized by producing sporadic cases, norovirus characteristically produces outbreaks; especially in semi-enclosed spaces such as residential homes for the elderly.
TextSentencer_T114	16196-16381	Sentence	denotes	If rotavirus is characterized by producing sporadic cases, norovirus characteristically produces outbreaks; especially in semi-enclosed spaces such as residential homes for the elderly.
TextSentencer_T115	16382-16469	Sentence	denotes	The infection originates from diverse sources: foods, water, patients, and environment.
TextSentencer_T115	16382-16469	Sentence	denotes	The infection originates from diverse sources: foods, water, patients, and environment.
TextSentencer_T116	16470-16506	Sentence	denotes	The fingers are easily contaminated.
TextSentencer_T116	16470-16506	Sentence	denotes	The fingers are easily contaminated.
TextSentencer_T117	16507-16589	Sentence	denotes	A small dose of inoculant is sufficient to produce symptoms in susceptible people.
TextSentencer_T117	16507-16589	Sentence	denotes	A small dose of inoculant is sufficient to produce symptoms in susceptible people.
TextSentencer_T118	16590-16672	Sentence	denotes	On wood, metal, or plastic surfaces, the virus can survive for hours or even days.
TextSentencer_T118	16590-16672	Sentence	denotes	On wood, metal, or plastic surfaces, the virus can survive for hours or even days.
TextSentencer_T119	16673-16814	Sentence	denotes	It has been proven that transmission is possible through typical hand-to-surface contact, such as door handles, telephone receivers, or taps.
TextSentencer_T119	16673-16814	Sentence	denotes	It has been proven that transmission is possible through typical hand-to-surface contact, such as door handles, telephone receivers, or taps.
TextSentencer_T120	16815-17023	Sentence	denotes	An experimental study found that contaminated fingers could transfer the virus to the clean surfaces they touch by up to seven times, and at least 14 people could be contaminated by touching the same surface.
TextSentencer_T120	16815-17023	Sentence	denotes	An experimental study found that contaminated fingers could transfer the virus to the clean surfaces they touch by up to seven times, and at least 14 people could be contaminated by touching the same surface.
TextSentencer_T121	17024-17125	Sentence	denotes	Alternatively, it is known that certain subjects are genetically resistant to infection by norovirus.
TextSentencer_T121	17024-17125	Sentence	denotes	Alternatively, it is known that certain subjects are genetically resistant to infection by norovirus.
TextSentencer_T122	17126-17258	Sentence	denotes	The polymorphism of gene FUT 2 divides into secretory and nonsecretory individuals, who are susceptible and resistant, respectively.
TextSentencer_T122	17126-17258	Sentence	denotes	The polymorphism of gene FUT 2 divides into secretory and nonsecretory individuals, who are susceptible and resistant, respectively.
TextSentencer_T123	17259-17316	Sentence	denotes	Approximately 20% of Caucasian subjects are nonsecretory.
TextSentencer_T123	17259-17316	Sentence	denotes	Approximately 20% of Caucasian subjects are nonsecretory.
TextSentencer_T124	17317-17476	Sentence	denotes	However, recently it has been seen that nonsecretory subjects are not totally resistant, suggesting some norovirus strains use alternative routes of infection.
TextSentencer_T124	17317-17476	Sentence	denotes	However, recently it has been seen that nonsecretory subjects are not totally resistant, suggesting some norovirus strains use alternative routes of infection.
TextSentencer_T125	17477-17560	Sentence	denotes	The characteristics of norovirus make it difficult to produce a vaccine against it.
TextSentencer_T125	17477-17560	Sentence	denotes	The characteristics of norovirus make it difficult to produce a vaccine against it.
TextSentencer_T126	17561-17641	Sentence	denotes	These serotypes generally cause cases of infantile diarrhea throughout the year.
TextSentencer_T126	17561-17641	Sentence	denotes	These serotypes generally cause cases of infantile diarrhea throughout the year.
TextSentencer_T127	17642-17734	Sentence	denotes	The only demonstrated mechanism of infectious transmission is direct contact between people.
TextSentencer_T127	17642-17734	Sentence	denotes	The only demonstrated mechanism of infectious transmission is direct contact between people.
TextSentencer_T128	17735-17782	Sentence	denotes	Perhaps they have a limited epidemic potential.
TextSentencer_T128	17735-17782	Sentence	denotes	Perhaps they have a limited epidemic potential.
TextSentencer_T129	17783-17845	Sentence	denotes	The infectious capacity of this virus is not accurately known.
TextSentencer_T129	17783-17845	Sentence	denotes	The infectious capacity of this virus is not accurately known.
TextSentencer_T130	17846-17932	Sentence	denotes	This was first identified in 1975 in a fecal examination among children with diarrhea.
TextSentencer_T130	17846-17932	Sentence	denotes	This was first identified in 1975 in a fecal examination among children with diarrhea.
TextSentencer_T131	17933-18051	Sentence	denotes	The Astroviridae family, to which it belongs, was established in 1993, and was named after its star-shaped appearance.
TextSentencer_T131	17933-18051	Sentence	denotes	The Astroviridae family, to which it belongs, was established in 1993, and was named after its star-shaped appearance.
TextSentencer_T132	18052-18193	Sentence	denotes	It causes diarrhea in children and adults, with a slight seasonal pattern of predominance in cold months in regions with a temperate climate.
TextSentencer_T132	18052-18193	Sentence	denotes	It causes diarrhea in children and adults, with a slight seasonal pattern of predominance in cold months in regions with a temperate climate.
TextSentencer_T133	18194-18280	Sentence	denotes	The infectious capacity is high, perhaps very few viral particles can produce disease.
TextSentencer_T133	18194-18280	Sentence	denotes	The infectious capacity is high, perhaps very few viral particles can produce disease.
TextSentencer_T134	18281-18363	Sentence	denotes	Epidemiological data suggest that immunity does not last and is serotype specific.
TextSentencer_T134	18281-18363	Sentence	denotes	Epidemiological data suggest that immunity does not last and is serotype specific.
TextSentencer_T135	18364-18424	Sentence	denotes	Few laboratories can diagnose the routine of this infection.
TextSentencer_T135	18364-18424	Sentence	denotes	Few laboratories can diagnose the routine of this infection.
TextSentencer_T136	18425-18533	Sentence	denotes	It is believed that the virus can be an important factor in hospital diarrheas as much as in external cases.
TextSentencer_T136	18425-18533	Sentence	denotes	It is believed that the virus can be an important factor in hospital diarrheas as much as in external cases.
TextSentencer_T137	18534-18575	Sentence	denotes	These belong to the Coronaviridae family.
TextSentencer_T137	18534-18575	Sentence	denotes	These belong to the Coronaviridae family.
TextSentencer_T138	18576-18671	Sentence	denotes	Among the viruses that cause diarrhea in humans, they are the only ones that possess envelopes.
TextSentencer_T138	18576-18671	Sentence	denotes	Among the viruses that cause diarrhea in humans, they are the only ones that possess envelopes.
TextSentencer_T139	18672-18801	Sentence	denotes	It is believed that the torovirus produces acute diarrhea in children and can also be an important factor in nosocomial diarrhea.
TextSentencer_T139	18672-18801	Sentence	denotes	It is believed that the torovirus produces acute diarrhea in children and can also be an important factor in nosocomial diarrhea.
TextSentencer_T140	18802-19039	Sentence	denotes	Coronavirus occasionally produces diarrhea, but it gained importance as a result of severe acute respiratory syndrome (SARS) outbreaks, originated by coronavirus with a great capacity for environmental and person-to-person dissemination.
TextSentencer_T140	18802-19039	Sentence	denotes	Coronavirus occasionally produces diarrhea, but it gained importance as a result of severe acute respiratory syndrome (SARS) outbreaks, originated by coronavirus with a great capacity for environmental and person-to-person dissemination.
TextSentencer_T141	19040-19118	Sentence	denotes	The elimination of the virus in feces is less at the beginning of the illness.
TextSentencer_T141	19040-19118	Sentence	denotes	The elimination of the virus in feces is less at the beginning of the illness.
TextSentencer_T142	19119-19208	Sentence	denotes	However, viral particles have been found several months after the symptoms first started.
TextSentencer_T142	19119-19208	Sentence	denotes	However, viral particles have been found several months after the symptoms first started.
TextSentencer_T143	19209-19356	Sentence	denotes	Campylobacter, especially Campylobacter jejuni, is responsible for the majority of bacterial gastroenteritis cases in the industrialized countries.
TextSentencer_T143	19209-19356	Sentence	denotes	Campylobacter, especially Campylobacter jejuni, is responsible for the majority of bacterial gastroenteritis cases in the industrialized countries.
TextSentencer_T144	19357-19408	Sentence	denotes	It is a germ that grows little or nothing in foods.
TextSentencer_T144	19357-19408	Sentence	denotes	It is a germ that grows little or nothing in foods.
TextSentencer_T145	19409-19506	Sentence	denotes	This is the probable cause of its limited epidemic potential and the scarcity of known outbreaks.
TextSentencer_T145	19409-19506	Sentence	denotes	This is the probable cause of its limited epidemic potential and the scarcity of known outbreaks.
TextSentencer_T146	19507-19596	Sentence	denotes	Some relationships to the ingestion of milk or public drinking water have been described.
TextSentencer_T146	19507-19596	Sentence	denotes	Some relationships to the ingestion of milk or public drinking water have been described.
TextSentencer_T147	19597-19746	Sentence	denotes	However, the majority of diagnosed cases are sporadic, essentially occurring in very small children and with little evidence of any seasonal pattern.
TextSentencer_T147	19597-19746	Sentence	denotes	However, the majority of diagnosed cases are sporadic, essentially occurring in very small children and with little evidence of any seasonal pattern.
TextSentencer_T148	19747-19905	Sentence	denotes	It is possible -as happens with other microorganisms -that this predominance of diagnosed cases in children may be the consequence of a diagnostical age bias.
TextSentencer_T148	19747-19905	Sentence	denotes	It is possible -as happens with other microorganisms -that this predominance of diagnosed cases in children may be the consequence of a diagnostical age bias.
TextSentencer_T149	19906-20085	Sentence	denotes	Studies on intestinal infection where adult participants were asked to provide fecal cultures revealed that Campylobacter is also frequent in adolescents, adults, and the elderly.
TextSentencer_T149	19906-20085	Sentence	denotes	Studies on intestinal infection where adult participants were asked to provide fecal cultures revealed that Campylobacter is also frequent in adolescents, adults, and the elderly.
TextSentencer_T150	20086-20168	Sentence	denotes	The majority of diagnosed intestinal infections do not require hospital admission.
TextSentencer_T150	20086-20168	Sentence	denotes	The majority of diagnosed intestinal infections do not require hospital admission.
TextSentencer_T151	20169-20269	Sentence	denotes	According to the authors of this article, only 15% of cases resulted in patients being hospitalized.
TextSentencer_T151	20169-20269	Sentence	denotes	According to the authors of this article, only 15% of cases resulted in patients being hospitalized.
TextSentencer_T152	20270-20388	Sentence	denotes	Reservoirs of Campylobacter are not only found in farm animals, essentially avian, but also found in bovine livestock.
TextSentencer_T152	20270-20388	Sentence	denotes	Reservoirs of Campylobacter are not only found in farm animals, essentially avian, but also found in bovine livestock.
TextSentencer_T153	20389-20490	Sentence	denotes	Companion animals, if they have diarrhea when very young, can pose an infection risk to their owners.
TextSentencer_T153	20389-20490	Sentence	denotes	Companion animals, if they have diarrhea when very young, can pose an infection risk to their owners.
TextSentencer_T154	20491-20653	Sentence	denotes	The study of risk factors in Campylobacter infection presents difficulties given that the majority of cases are sporadic and in children under the age of 2 years.
TextSentencer_T154	20491-20653	Sentence	denotes	The study of risk factors in Campylobacter infection presents difficulties given that the majority of cases are sporadic and in children under the age of 2 years.
TextSentencer_T155	20654-20726	Sentence	denotes	Exposure to avian or bovine meat products has been related to infection.
TextSentencer_T155	20654-20726	Sentence	denotes	Exposure to avian or bovine meat products has been related to infection.
TextSentencer_T156	20727-20913	Sentence	denotes	Exposure is not necessarily by direct consumption; the presence of these products in home kitchens presents a risk factor, probably by cross-contamination due to poor hygienic practices.
TextSentencer_T156	20727-20913	Sentence	denotes	Exposure is not necessarily by direct consumption; the presence of these products in home kitchens presents a risk factor, probably by cross-contamination due to poor hygienic practices.
TextSentencer_T157	20914-21114	Sentence	denotes	The existence of other diarrhea cases in the patient's nearby surroundings implies that there are small groupings, small outbreaks not identified by conventional systems of epidemiological monitoring.
TextSentencer_T157	20914-21114	Sentence	denotes	The existence of other diarrhea cases in the patient's nearby surroundings implies that there are small groupings, small outbreaks not identified by conventional systems of epidemiological monitoring.
TextSentencer_T158	21115-21281	Sentence	denotes	Salmonella owes its name to the North American Veterinarian Daniel Elmer Salmon, who was one of the pioneers of microbiology toward the end of the nineteenth century.
TextSentencer_T158	21115-21281	Sentence	denotes	Salmonella owes its name to the North American Veterinarian Daniel Elmer Salmon, who was one of the pioneers of microbiology toward the end of the nineteenth century.
TextSentencer_T159	21282-21350	Sentence	denotes	Diarrhea by Salmonella is a very common zoonosis all over the world.
TextSentencer_T159	21282-21350	Sentence	denotes	Diarrhea by Salmonella is a very common zoonosis all over the world.
TextSentencer_T160	21351-21465	Sentence	denotes	The clinical profile in many patients consists of diarrhea with fever and an exaggerated variable state of health.
TextSentencer_T160	21351-21465	Sentence	denotes	The clinical profile in many patients consists of diarrhea with fever and an exaggerated variable state of health.
TextSentencer_T161	21466-21696	Sentence	denotes	In the nontyphoidal Salmonella group, there are more than 2500 serotypes that can cause gastroenteritis in humans, most common are S. enteritidis and S. typhimurium, although many others have been identified on numerous occasions.
TextSentencer_T161	21466-21696	Sentence	denotes	In the nontyphoidal Salmonella group, there are more than 2500 serotypes that can cause gastroenteritis in humans, most common are S. enteritidis and S. typhimurium, although many others have been identified on numerous occasions.
TextSentencer_T162	21697-21874	Sentence	denotes	When available, the serotype and fagotype are laboratory data that aid in the investigation of epidemiological factors and the infection source (eggs, birds, and other animals).
TextSentencer_T162	21697-21874	Sentence	denotes	When available, the serotype and fagotype are laboratory data that aid in the investigation of epidemiological factors and the infection source (eggs, birds, and other animals).
TextSentencer_T163	21875-21947	Sentence	denotes	Some serotypes have a preference to form reservoirs in specific animals.
TextSentencer_T163	21875-21947	Sentence	denotes	Some serotypes have a preference to form reservoirs in specific animals.
TextSentencer_T164	21948-22059	Sentence	denotes	Chickens and hens are principal reservoirs of S. enteritidis; however, pigs and cattle transmit S. typhimurium.
TextSentencer_T164	21948-22059	Sentence	denotes	Chickens and hens are principal reservoirs of S. enteritidis; however, pigs and cattle transmit S. typhimurium.
TextSentencer_T165	22060-22162	Sentence	denotes	Other serotypes such as S. hadar, S. virchow, and S. heidelberg are also present in chickens and hens.
TextSentencer_T165	22060-22162	Sentence	denotes	Other serotypes such as S. hadar, S. virchow, and S. heidelberg are also present in chickens and hens.
TextSentencer_T166	22163-22221	Sentence	denotes	Reptiles are transmitters of some less frequent serotypes.
TextSentencer_T166	22163-22221	Sentence	denotes	Reptiles are transmitters of some less frequent serotypes.
TextSentencer_T167	22222-22261	Sentence	denotes	Hen eggshells can also be contaminated.
TextSentencer_T167	22222-22261	Sentence	denotes	Hen eggshells can also be contaminated.
TextSentencer_T168	22262-22381	Sentence	denotes	But a remarkable fact is the vertical transmission of Salmonella in hens, laying eggs that are internally contaminated.
TextSentencer_T168	22262-22381	Sentence	denotes	But a remarkable fact is the vertical transmission of Salmonella in hens, laying eggs that are internally contaminated.
TextSentencer_T169	22382-22451	Sentence	denotes	Adequate data about the prevalence of contaminated eggs do not exist.
TextSentencer_T169	22382-22451	Sentence	denotes	Adequate data about the prevalence of contaminated eggs do not exist.
TextSentencer_T170	22452-22589	Sentence	denotes	At the beginning of the 1990s, random sampling was carried out for a study in Castellón, the estimation was little more than 1 in a 1000.
TextSentencer_T170	22452-22589	Sentence	denotes	At the beginning of the 1990s, random sampling was carried out for a study in Castellón, the estimation was little more than 1 in a 1000.
TextSentencer_T171	22590-22743	Sentence	denotes	Also, common vegetables (tomatoes, watermelon) and foods with little water activity such as chocolate or powdered milk have been implicated in outbreaks.
TextSentencer_T171	22590-22743	Sentence	denotes	Also, common vegetables (tomatoes, watermelon) and foods with little water activity such as chocolate or powdered milk have been implicated in outbreaks.
TextSentencer_T172	22744-22802	Sentence	denotes	An outbreak was even transmitted by marijuana consumption.
TextSentencer_T172	22744-22802	Sentence	denotes	An outbreak was even transmitted by marijuana consumption.
TextSentencer_T173	22803-22917	Sentence	denotes	In 2008, an outbreak in the United States transmitted by tomatoes affected more than 500 people in some 30 states.
TextSentencer_T173	22803-22917	Sentence	denotes	In 2008, an outbreak in the United States transmitted by tomatoes affected more than 500 people in some 30 states.
TextSentencer_T174	22918-23012	Sentence	denotes	When investigating outbreaks, the possibility of secondary cases has to be taken into account.
TextSentencer_T174	22918-23012	Sentence	denotes	When investigating outbreaks, the possibility of secondary cases has to be taken into account.
TextSentencer_T175	23013-23170	Sentence	denotes	It is not believed that there are chronic carriers as with S. typhi, but the feces of some patients can remain contagious for months, especially in children.
TextSentencer_T175	23013-23170	Sentence	denotes	It is not believed that there are chronic carriers as with S. typhi, but the feces of some patients can remain contagious for months, especially in children.
TextSentencer_T176	23171-23280	Sentence	denotes	These situations and the cases with few symptoms are particularly important when they occur in food handlers.
TextSentencer_T176	23171-23280	Sentence	denotes	These situations and the cases with few symptoms are particularly important when they occur in food handlers.
TextSentencer_T177	23281-23528	Sentence	denotes	The infectious dose, the conditions surrounding its ingestion (accompanying food, antacid medication, etc.) and some characteristics of the host can act as factors that greatly modify the incubation period and the severity of the clinical profile.
TextSentencer_T177	23281-23528	Sentence	denotes	The infectious dose, the conditions surrounding its ingestion (accompanying food, antacid medication, etc.) and some characteristics of the host can act as factors that greatly modify the incubation period and the severity of the clinical profile.
TextSentencer_T178	23529-23614	Sentence	denotes	Symptoms can start from 6 h up to 3 days after the ingestion of contaminated produce.
TextSentencer_T178	23529-23614	Sentence	denotes	Symptoms can start from 6 h up to 3 days after the ingestion of contaminated produce.
TextSentencer_T179	23615-23748	Sentence	denotes	Some greasy foods facilitate Salmonella's crossing the stomach without being eliminated by the extreme acidity of the gastric juices.
TextSentencer_T179	23615-23748	Sentence	denotes	Some greasy foods facilitate Salmonella's crossing the stomach without being eliminated by the extreme acidity of the gastric juices.
TextSentencer_T180	23749-23891	Sentence	denotes	It has been suggested, when faced with infection by S. ohio, that the simultaneous ingestion of alcohol (or red wine) has a protective effect.
TextSentencer_T180	23749-23891	Sentence	denotes	It has been suggested, when faced with infection by S. ohio, that the simultaneous ingestion of alcohol (or red wine) has a protective effect.
TextSentencer_T181	23892-23928	Sentence	denotes	Several serotypes of Shigella exist.
TextSentencer_T181	23892-23928	Sentence	denotes	Several serotypes of Shigella exist.
TextSentencer_T182	23929-24047	Sentence	denotes	Of them, S. dysenteriae type 1 is responsible for the most serious cases, bacillary dysentery, due to the Shiga toxin.
TextSentencer_T182	23929-24047	Sentence	denotes	Of them, S. dysenteriae type 1 is responsible for the most serious cases, bacillary dysentery, due to the Shiga toxin.
TextSentencer_T183	24048-24185	Sentence	denotes	Other serotypes are S. sonnei, S. flexneri, and S. boydii, which in general produce less severe profiles, accompanied by watery diarrhea.
TextSentencer_T183	24048-24185	Sentence	denotes	Other serotypes are S. sonnei, S. flexneri, and S. boydii, which in general produce less severe profiles, accompanied by watery diarrhea.
TextSentencer_T184	24186-24244	Sentence	denotes	The geographic distribution of each serotype is different.
TextSentencer_T184	24186-24244	Sentence	denotes	The geographic distribution of each serotype is different.
TextSentencer_T185	24245-24298	Sentence	denotes	In industrialized countries the impact is diminished.
TextSentencer_T185	24245-24298	Sentence	denotes	In industrialized countries the impact is diminished.
TextSentencer_T186	24299-24395	Sentence	denotes	In Asia, it seems that incidents of shigellosis maintain a presence but tend to be less serious.
TextSentencer_T186	24299-24395	Sentence	denotes	In Asia, it seems that incidents of shigellosis maintain a presence but tend to be less serious.
TextSentencer_T187	24396-24438	Sentence	denotes	Little is known about incidents in Africa.
TextSentencer_T187	24396-24438	Sentence	denotes	Little is known about incidents in Africa.
TextSentencer_T188	24439-24575	Sentence	denotes	The infectious dose is very low (from 10 to 100 bacilli); therefore, secondary cases are very frequent due to easily contaminated hands.
TextSentencer_T188	24439-24575	Sentence	denotes	The infectious dose is very low (from 10 to 100 bacilli); therefore, secondary cases are very frequent due to easily contaminated hands.
TextSentencer_T189	24576-24623	Sentence	denotes	Shigella produces outbreaks and sporadic cases.
TextSentencer_T189	24576-24623	Sentence	denotes	Shigella produces outbreaks and sporadic cases.
TextSentencer_T190	24624-24688	Sentence	denotes	The incubation period of S. dysenteriae is longer, up to a week.
TextSentencer_T190	24624-24688	Sentence	denotes	The incubation period of S. dysenteriae is longer, up to a week.
TextSentencer_T191	24689-24834	Sentence	denotes	Carriers can be asymptomatic for weeks, and with antibiotic treatment they could reduce the time needed for elimination of Shigella in the feces.
TextSentencer_T191	24689-24834	Sentence	denotes	Carriers can be asymptomatic for weeks, and with antibiotic treatment they could reduce the time needed for elimination of Shigella in the feces.
TextSentencer_T192	24835-24902	Sentence	denotes	However, the appearance of antibiotic resistance has been observed.
TextSentencer_T192	24835-24902	Sentence	denotes	However, the appearance of antibiotic resistance has been observed.
TextSentencer_T193	24903-24968	Sentence	denotes	The protection from natural infection it offers is type specific.
TextSentencer_T193	24903-24968	Sentence	denotes	The protection from natural infection it offers is type specific.
TextSentencer_T194	24969-25048	Sentence	denotes	Within the Yersinia genus there are numerous nonvirulent environmental strains.
TextSentencer_T194	24969-25048	Sentence	denotes	Within the Yersinia genus there are numerous nonvirulent environmental strains.
TextSentencer_T195	25049-25151	Sentence	denotes	Those that most frequently cause intestinal infection are Y. enterocolitica and Y. pseudotuberculosis.
TextSentencer_T195	25049-25151	Sentence	denotes	Those that most frequently cause intestinal infection are Y. enterocolitica and Y. pseudotuberculosis.
TextSentencer_T196	25152-25656	Sentence	denotes	The former (whose taxonomic classification has undergone important changes from its initial description in 1934 as Flavobacterium pseudomallei to the denomination Yersinia at the beginning of the 1960s) produces a diarrhea profile that includes abdominal pain and, sometimes, fever; the latter (whose first identification dates from many years earlier, in 1883) produces a clinical profile in which it is worth mentioning the symptoms of Mesenteric adenitis, which can sometimes simulate an appendicitis.
TextSentencer_T196	25152-25656	Sentence	denotes	The former (whose taxonomic classification has undergone important changes from its initial description in 1934 as Flavobacterium pseudomallei to the denomination Yersinia at the beginning of the 1960s) produces a diarrhea profile that includes abdominal pain and, sometimes, fever; the latter (whose first identification dates from many years earlier, in 1883) produces a clinical profile in which it is worth mentioning the symptoms of Mesenteric adenitis, which can sometimes simulate an appendicitis.
TextSentencer_T197	25657-25824	Sentence	denotes	Not all strains of Y. enterocolitica are pathogenic in humans; furthermore, different pathogenic serotypes and biotypes are unequally distributed among the population.
TextSentencer_T197	25657-25824	Sentence	denotes	Not all strains of Y. enterocolitica are pathogenic in humans; furthermore, different pathogenic serotypes and biotypes are unequally distributed among the population.
TextSentencer_T198	25825-25974	Sentence	denotes	Specific culture media are required for the identification of Yersinia from human fecal samples; standard culture mediums are not usually sufficient.
TextSentencer_T198	25825-25974	Sentence	denotes	Specific culture media are required for the identification of Yersinia from human fecal samples; standard culture mediums are not usually sufficient.
TextSentencer_T199	25975-26112	Sentence	denotes	Changes in laboratory practice have been considered an explanation for observed increases in the 1980s and some geographical differences.
TextSentencer_T199	25975-26112	Sentence	denotes	Changes in laboratory practice have been considered an explanation for observed increases in the 1980s and some geographical differences.
TextSentencer_T200	26113-26172	Sentence	denotes	The large majority of Y. enterocolitica cases are sporadic.
TextSentencer_T200	26113-26172	Sentence	denotes	The large majority of Y. enterocolitica cases are sporadic.
TextSentencer_T201	26173-26283	Sentence	denotes	In many countries with temperate climates, the patients are usually small children diagnosed in winter months.
TextSentencer_T201	26173-26283	Sentence	denotes	In many countries with temperate climates, the patients are usually small children diagnosed in winter months.
TextSentencer_T202	26284-26345	Sentence	denotes	The percentage of total diagnosed cases of diarrhea is small.
TextSentencer_T202	26284-26345	Sentence	denotes	The percentage of total diagnosed cases of diarrhea is small.
TextSentencer_T203	26346-26466	Sentence	denotes	The Y. pseudotuberculosis species is less frequent and little knowledge exists regarding its mechanisms of transmission.
TextSentencer_T203	26346-26466	Sentence	denotes	The Y. pseudotuberculosis species is less frequent and little knowledge exists regarding its mechanisms of transmission.
TextSentencer_T204	26467-26560	Sentence	denotes	There have been cases grouped in spatiotemporal clusters without a commonly identified nexus.
TextSentencer_T204	26467-26560	Sentence	denotes	There have been cases grouped in spatiotemporal clusters without a commonly identified nexus.
TextSentencer_T205	26561-26667	Sentence	denotes	In these clusters no secondary cases were observed, suggesting the source was most probably environmental.
TextSentencer_T205	26561-26667	Sentence	denotes	In these clusters no secondary cases were observed, suggesting the source was most probably environmental.
TextSentencer_T206	26668-26723	Sentence	denotes	Y. enterocolitica is frequently found in pig's tonsils.
TextSentencer_T206	26668-26723	Sentence	denotes	Y. enterocolitica is frequently found in pig's tonsils.
TextSentencer_T207	26724-26804	Sentence	denotes	In the case of Y. pseudotuberculosis, the reservoirs are wild rodents and birds.
TextSentencer_T207	26724-26804	Sentence	denotes	In the case of Y. pseudotuberculosis, the reservoirs are wild rodents and birds.
TextSentencer_T208	26805-26882	Sentence	denotes	There is a possibility that some humans may be carriers of Y. enterocolitica.
TextSentencer_T208	26805-26882	Sentence	denotes	There is a possibility that some humans may be carriers of Y. enterocolitica.
TextSentencer_T209	26883-27000	Sentence	denotes	Also, Yersinia, from these reservoirs, may contaminate foods or water, which will then infect those who consume them.
TextSentencer_T209	26883-27000	Sentence	denotes	Also, Yersinia, from these reservoirs, may contaminate foods or water, which will then infect those who consume them.
TextSentencer_T210	27001-27114	Sentence	denotes	In the case of Y. pseudotuberculosis, there are recorded outbreaks transmitted by 'iceberg' lettuce and radishes.
TextSentencer_T210	27001-27114	Sentence	denotes	In the case of Y. pseudotuberculosis, there are recorded outbreaks transmitted by 'iceberg' lettuce and radishes.
TextSentencer_T211	27115-27302	Sentence	denotes	It is postulated that initially the infection is caused by waters contaminated by animal reservoirs, which indicates that the washing of fresh vegetables is a method to prevent infection.
TextSentencer_T211	27115-27302	Sentence	denotes	It is postulated that initially the infection is caused by waters contaminated by animal reservoirs, which indicates that the washing of fresh vegetables is a method to prevent infection.
TextSentencer_T212	27303-27525	Sentence	denotes	But an outbreak that occurred in Finland in 1998 experimentally demonstrated the possibility of internal contamination of the lettuces, with the result that in such an eventuality external washing would have little effect.
TextSentencer_T212	27303-27525	Sentence	denotes	But an outbreak that occurred in Finland in 1998 experimentally demonstrated the possibility of internal contamination of the lettuces, with the result that in such an eventuality external washing would have little effect.
TextSentencer_T213	27526-27646	Sentence	denotes	Escherichia coli is a bacterium that forms part of the normal intestinal flora in humans and other warm-blooded animals.
TextSentencer_T213	27526-27646	Sentence	denotes	Escherichia coli is a bacterium that forms part of the normal intestinal flora in humans and other warm-blooded animals.
TextSentencer_T214	27647-27761	Sentence	denotes	Nevertheless, in the 1960s, it was discovered that certain strains of E. coli had a pathogenic capacity in humans.
TextSentencer_T214	27647-27761	Sentence	denotes	Nevertheless, in the 1960s, it was discovered that certain strains of E. coli had a pathogenic capacity in humans.
TextSentencer_T215	27762-27787	Sentence	denotes	There are many serotypes.
TextSentencer_T215	27762-27787	Sentence	denotes	There are many serotypes.
TextSentencer_T216	27788-27991	Sentence	denotes	Their capacity to produce different clinical syndromes and affect different age groups is a factor unique to each serotype, ranging from 'traveler's diarrhea' to a serious profile of hemorrhagic colitis.
TextSentencer_T216	27788-27991	Sentence	denotes	Their capacity to produce different clinical syndromes and affect different age groups is a factor unique to each serotype, ranging from 'traveler's diarrhea' to a serious profile of hemorrhagic colitis.
TextSentencer_T217	27992-28287	Sentence	denotes	The serotypes able to cause diarrhea are enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enteroinvasive E. coli (EIEC), enteroaggregative E. coli (EAEC), and most virulent of all enterohemorrhagic E. coli, also named verocytotoxic E. coli (EHEC or VCEC) of the serotype O157:H7.
TextSentencer_T217	27992-28287	Sentence	denotes	The serotypes able to cause diarrhea are enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enteroinvasive E. coli (EIEC), enteroaggregative E. coli (EAEC), and most virulent of all enterohemorrhagic E. coli, also named verocytotoxic E. coli (EHEC or VCEC) of the serotype O157:H7.
TextSentencer_T218	28288-28365	Sentence	denotes	The geographic distribution and transmission channels vary between serotypes.
TextSentencer_T218	28288-28365	Sentence	denotes	The geographic distribution and transmission channels vary between serotypes.
TextSentencer_T219	28366-28627	Sentence	denotes	Among the clinical characteristics of these infections, it is worth mentioning a serious complication of serotype O157:H7, hemolytic-uremic syndrome (HUS), which appears mainly in children, and can be exacerbated by taking antidiarrheal or antibiotic medicines.
TextSentencer_T219	28366-28627	Sentence	denotes	Among the clinical characteristics of these infections, it is worth mentioning a serious complication of serotype O157:H7, hemolytic-uremic syndrome (HUS), which appears mainly in children, and can be exacerbated by taking antidiarrheal or antibiotic medicines.
TextSentencer_T220	28628-28897	Sentence	denotes	This virulent stock of E. coli is transmitted mainly through ingestion of contaminated meat from bovine livestock, but it is also possible that there are other environmental routes of contagion by contact with surfaces or dust and sawdust in farms and zoological parks.
TextSentencer_T220	28628-28897	Sentence	denotes	This virulent stock of E. coli is transmitted mainly through ingestion of contaminated meat from bovine livestock, but it is also possible that there are other environmental routes of contagion by contact with surfaces or dust and sawdust in farms and zoological parks.
TextSentencer_T221	28898-28976	Sentence	denotes	Recent studies suggest that EAEC can cause both traveler and chronic diarrhea.
TextSentencer_T221	28898-28976	Sentence	denotes	Recent studies suggest that EAEC can cause both traveler and chronic diarrhea.
TextSentencer_T222	28977-29091	Sentence	denotes	Furthermore, the inflammatory response to this infection depends on human genetic factors linked to interleukin-8.
TextSentencer_T222	28977-29091	Sentence	denotes	Furthermore, the inflammatory response to this infection depends on human genetic factors linked to interleukin-8.
TextSentencer_T223	29092-29243	Sentence	denotes	This is a microorganism that can cause serious diarrhea, occasionally as pseudomembranous colitis, especially in hospitalized and debilitated patients.
TextSentencer_T223	29092-29243	Sentence	denotes	This is a microorganism that can cause serious diarrhea, occasionally as pseudomembranous colitis, especially in hospitalized and debilitated patients.
TextSentencer_T224	29244-29330	Sentence	denotes	Usually, it is triggered by taking antibiotics for therapeutic or preventive purposes.
TextSentencer_T224	29244-29330	Sentence	denotes	Usually, it is triggered by taking antibiotics for therapeutic or preventive purposes.
TextSentencer_T225	29331-29429	Sentence	denotes	Nevertheless, slight cases exist that are not diagnosed and are only detected in specific studies.
TextSentencer_T225	29331-29429	Sentence	denotes	Nevertheless, slight cases exist that are not diagnosed and are only detected in specific studies.
TextSentencer_T226	29430-29603	Sentence	denotes	The asymptomatic carrying and elimination of bacterial spores is relatively frequent in small children, but it is only patients with established diarrhea who are contagious.
TextSentencer_T226	29430-29603	Sentence	denotes	The asymptomatic carrying and elimination of bacterial spores is relatively frequent in small children, but it is only patients with established diarrhea who are contagious.
TextSentencer_T227	29604-29707	Sentence	denotes	The origin of diarrhea from microorganisms previously present in the same individual can be endogenous.
TextSentencer_T227	29604-29707	Sentence	denotes	The origin of diarrhea from microorganisms previously present in the same individual can be endogenous.
TextSentencer_T228	29708-29932	Sentence	denotes	These microorganisms are stimulated when intestinal flora is altered as a result of taking antibiotics; this can happen for 4-9 days at the beginning of an antibiotic course and even later, up to 6 or 8 weeks after starting.
TextSentencer_T228	29708-29932	Sentence	denotes	These microorganisms are stimulated when intestinal flora is altered as a result of taking antibiotics; this can happen for 4-9 days at the beginning of an antibiotic course and even later, up to 6 or 8 weeks after starting.
TextSentencer_T229	29933-30019	Sentence	denotes	In these cases, it is difficult to speak of an incubation period in the classic sense.
TextSentencer_T229	29933-30019	Sentence	denotes	In these cases, it is difficult to speak of an incubation period in the classic sense.
TextSentencer_T230	30020-30128	Sentence	denotes	There may also be exogenous contagion from environmental spores or C. difficile excreted by another patient.
TextSentencer_T230	30020-30128	Sentence	denotes	There may also be exogenous contagion from environmental spores or C. difficile excreted by another patient.
TextSentencer_T231	30129-30273	Sentence	denotes	In some countries improvement in diagnostical methods has contributed to the increased number of diagnoses, especially in hospitalized patients.
TextSentencer_T231	30129-30273	Sentence	denotes	In some countries improvement in diagnostical methods has contributed to the increased number of diagnoses, especially in hospitalized patients.
TextSentencer_T232	30274-30321	Sentence	denotes	It is rare that it produces communal outbreaks.
TextSentencer_T232	30274-30321	Sentence	denotes	It is rare that it produces communal outbreaks.
TextSentencer_T233	30322-30390	Sentence	denotes	When it appears in an epidemic form it usually does so in hospitals.
TextSentencer_T233	30322-30390	Sentence	denotes	When it appears in an epidemic form it usually does so in hospitals.
TextSentencer_T234	30391-30571	Sentence	denotes	According to what is known of its clinical and epidemiological characteristics, cholera only produces the V. cholerae serogroups O1 and O139, the latter confined to Southeast Asia.
TextSentencer_T234	30391-30571	Sentence	denotes	According to what is known of its clinical and epidemiological characteristics, cholera only produces the V. cholerae serogroups O1 and O139, the latter confined to Southeast Asia.
TextSentencer_T235	30572-30728	Sentence	denotes	Other serogroups, denominated 'non-O1' and 'non-O139,' usually present themselves as sporadic cases or small outbreaks with an incubation period of 12-14 h.
TextSentencer_T235	30572-30728	Sentence	denotes	Other serogroups, denominated 'non-O1' and 'non-O139,' usually present themselves as sporadic cases or small outbreaks with an incubation period of 12-14 h.
TextSentencer_T236	30729-30853	Sentence	denotes	As per epidemiological characteristics of cholera, it is easily spread through water or foods but not from person to person.
TextSentencer_T236	30729-30853	Sentence	denotes	As per epidemiological characteristics of cholera, it is easily spread through water or foods but not from person to person.
TextSentencer_T237	30854-30983	Sentence	denotes	In countries where there is overcrowding, poor nutrition, and poor environmental hygiene, cholera remains a very serious problem.
TextSentencer_T237	30854-30983	Sentence	denotes	In countries where there is overcrowding, poor nutrition, and poor environmental hygiene, cholera remains a very serious problem.
TextSentencer_T238	30984-31060	Sentence	denotes	People with blood group O are generally more susceptible to severe diseases.
TextSentencer_T238	30984-31060	Sentence	denotes	People with blood group O are generally more susceptible to severe diseases.
TextSentencer_T239	31061-31201	Sentence	denotes	Clostridium perfringens, Bacillus cereus, and Vibrio parahaemolyticus All these cause diarrhea through the consumption of contaminated food.
TextSentencer_T239	31061-31201	Sentence	denotes	Clostridium perfringens, Bacillus cereus, and Vibrio parahaemolyticus All these cause diarrhea through the consumption of contaminated food.
TextSentencer_T240	31202-31317	Sentence	denotes	The first two have the capacity to form spores and are found in terrestrial environments (the ground, for example).
TextSentencer_T240	31202-31317	Sentence	denotes	The first two have the capacity to form spores and are found in terrestrial environments (the ground, for example).
TextSentencer_T241	31318-31409	Sentence	denotes	V. parahaemolyticus is halophilic and is found in marine environments and seafood products.
TextSentencer_T241	31318-31409	Sentence	denotes	V. parahaemolyticus is halophilic and is found in marine environments and seafood products.
TextSentencer_T242	31410-31469	Sentence	denotes	Person-to-person transmission, if it exists, would be rare.
TextSentencer_T242	31410-31469	Sentence	denotes	Person-to-person transmission, if it exists, would be rare.
TextSentencer_T243	31470-31551	Sentence	denotes	Diarrheas caused by parasites usually have a more prolonged and insidious course.
TextSentencer_T243	31470-31551	Sentence	denotes	Diarrheas caused by parasites usually have a more prolonged and insidious course.
TextSentencer_T244	31552-31614	Sentence	denotes	Relapses and chronic forms are frequent and cause weight loss.
TextSentencer_T244	31552-31614	Sentence	denotes	Relapses and chronic forms are frequent and cause weight loss.
TextSentencer_T245	31615-31690	Sentence	denotes	They are usually resistant to the levels of chlorination in drinking water.
TextSentencer_T245	31615-31690	Sentence	denotes	They are usually resistant to the levels of chlorination in drinking water.
TextSentencer_T246	31691-31763	Sentence	denotes	Entamoeba histolytica is frequent in tropical and subtropical countries.
TextSentencer_T246	31691-31763	Sentence	denotes	Entamoeba histolytica is frequent in tropical and subtropical countries.
TextSentencer_T247	31764-31906	Sentence	denotes	Patients with diarrhea dispose of the parasite in trophozoit form, a form with little infectious potential due to its environmental fragility.
TextSentencer_T247	31764-31906	Sentence	denotes	Patients with diarrhea dispose of the parasite in trophozoit form, a form with little infectious potential due to its environmental fragility.
TextSentencer_T248	31907-32075	Sentence	denotes	In contrast, a significant number of infected people remain asymptomatic for months or years, eliminating cysts that have a greater infectious capacity than trophozoit.
TextSentencer_T248	31907-32075	Sentence	denotes	In contrast, a significant number of infected people remain asymptomatic for months or years, eliminating cysts that have a greater infectious capacity than trophozoit.
TextSentencer_T249	32076-32136	Sentence	denotes	Giardia lamblia is distributed by people all over the world.
TextSentencer_T249	32076-32136	Sentence	denotes	Giardia lamblia is distributed by people all over the world.
TextSentencer_T250	32137-32305	Sentence	denotes	Outbreaks caused by Giardia are relatively common in day-care centers, especially when there are poor hygienic conditions that facilitate person-to-person transmission.
TextSentencer_T250	32137-32305	Sentence	denotes	Outbreaks caused by Giardia are relatively common in day-care centers, especially when there are poor hygienic conditions that facilitate person-to-person transmission.

TextSentencer_T1

0-35

Sentence

denotes

Epidemiology of Infectious Diarrhea

TextSentencer_T1

0-35

Sentence

denotes

Epidemiology of Infectious Diarrhea

TextSentencer_T2

37-45

Sentence

denotes

Abstract

TextSentencer_T2

37-45

Sentence

denotes

Abstract

TextSentencer_T3

48-194

Sentence

denotes

Diarrhea is a symptom of very diverse causes, and it is characterized by three circumstances: consistency, number, and volume of waste excretions.

TextSentencer_T3

48-194

Sentence

denotes

Diarrhea is a symptom of very diverse causes, and it is characterized by three circumstances: consistency, number, and volume of waste excretions.

TextSentencer_T4

195-288

Sentence

denotes

The consistency of the feces is liquid, or pastelike, adapting to the form of its receptacle.

TextSentencer_T4

195-288

Sentence

denotes

The consistency of the feces is liquid, or pastelike, adapting to the form of its receptacle.

TextSentencer_T5

289-475

Sentence

denotes

The frequency and volume of the excretions can be seen to increase within a highly variable range, starting with very slight diarrhea up to that which can put the patient's life at risk.

TextSentencer_T5

289-475

Sentence

denotes

The frequency and volume of the excretions can be seen to increase within a highly variable range, starting with very slight diarrhea up to that which can put the patient's life at risk.

TextSentencer_T6

476-532

Sentence

denotes

The volume of feces in a healthy adult is almost 300 ml.

TextSentencer_T6

476-532

Sentence

denotes

The volume of feces in a healthy adult is almost 300 ml.

TextSentencer_T7

533-622

Sentence

denotes

Diarrhea's pathogenic mechanism is responsible for an acceleration of intestinal transit.

TextSentencer_T7

533-622

Sentence

denotes

Diarrhea's pathogenic mechanism is responsible for an acceleration of intestinal transit.

TextSentencer_T8

623-795

Sentence

denotes

The World Health Organization (WHO) defines diarrhea as ''the passage of three or more loose or liquid stools per day, or more frequently than is normal for the individual.

TextSentencer_T8

623-795

Sentence

denotes

The World Health Organization (WHO) defines diarrhea as ''the passage of three or more loose or liquid stools per day, or more frequently than is normal for the individual.

TextSentencer_T9

796-928

Sentence

denotes

It is usually a symptom of gastrointestinal infection, which can be caused by a variety of bacterial, viral and parasitic organisms.

TextSentencer_T9

796-928

Sentence

denotes

It is usually a symptom of gastrointestinal infection, which can be caused by a variety of bacterial, viral and parasitic organisms.

TextSentencer_T10

929-1065

Sentence

denotes

Infection is spread through contaminated food or drinking-water, or from person to person as a result of poor hygiene.'' Dr. Sherwood L.

TextSentencer_T10

929-1065

Sentence

denotes

Infection is spread through contaminated food or drinking-water, or from person to person as a result of poor hygiene.'' Dr. Sherwood L.

TextSentencer_T11

1066-1478

Sentence

denotes

Gorbach states: ''Acute diarrhea is often defined as the occurrence of three or more unformed bowel movements a day or any number of such movements when accompanied by fever, abdominal cramps, or vomiting.'' While carrying out studies epidemiologists can use other operative definitions adapted to the objectives of each study, taking into account the sensitivity and specificity of the definitions in each case.

TextSentencer_T11

1066-1478

Sentence

denotes

Gorbach states: ''Acute diarrhea is often defined as the occurrence of three or more unformed bowel movements a day or any number of such movements when accompanied by fever, abdominal cramps, or vomiting.'' While carrying out studies epidemiologists can use other operative definitions adapted to the objectives of each study, taking into account the sensitivity and specificity of the definitions in each case.

TextSentencer_T12

1479-1534

Sentence

denotes

From this three clinical syndromes can be described: a.

TextSentencer_T12

1479-1534

Sentence

denotes

From this three clinical syndromes can be described: a.

TextSentencer_T13

1535-1557

Sentence

denotes

Acute watery diarrhea:

TextSentencer_T13

1535-1557

Sentence

denotes

Acute watery diarrhea:

TextSentencer_T14

1558-1653

Sentence

denotes

Beginning abruptly, it consists of the passing of a great amount of liquid feces without blood.

TextSentencer_T14

1558-1653

Sentence

denotes

Beginning abruptly, it consists of the passing of a great amount of liquid feces without blood.

TextSentencer_T15

1654-1861

Sentence

denotes

Main symptoms usually remain for less than 7 days (but can persist up to 2 weeks at most); it can be accompanied by vomiting and fever, but it also presents a greater problem, the possibility of dehydration.

TextSentencer_T15

1654-1861

Sentence

denotes

Main symptoms usually remain for less than 7 days (but can persist up to 2 weeks at most); it can be accompanied by vomiting and fever, but it also presents a greater problem, the possibility of dehydration.

TextSentencer_T16

1862-1931

Sentence

denotes

It is a result of the alteration of absorption and secretion balance.

TextSentencer_T16

1862-1931

Sentence

denotes

It is a result of the alteration of absorption and secretion balance.

TextSentencer_T17

1932-2069

Sentence

denotes

Causal agents include rotavirus, Campylobacter, nontyphoidal Salmonella, enterotoxigenic Escherichia coli, Vibrio cholerae, and so on. b.

TextSentencer_T17

1932-2069

Sentence

denotes

Causal agents include rotavirus, Campylobacter, nontyphoidal Salmonella, enterotoxigenic Escherichia coli, Vibrio cholerae, and so on. b.

TextSentencer_T18

2070-2080

Sentence

denotes

Dysentery:

TextSentencer_T18

2070-2080

Sentence

denotes

Dysentery:

TextSentencer_T19

2081-2174

Sentence

denotes

When diarrhea is accompanied by visible traces of blood in the feces, it is called dysentery.

TextSentencer_T19

2081-2174

Sentence

denotes

When diarrhea is accompanied by visible traces of blood in the feces, it is called dysentery.

TextSentencer_T20

2175-2368

Sentence

denotes

It is a result of damage suffered by intestinal mucus in the colon ravaged by an external agent, such as Shigella dysenteriae, nontyphoidal Salmonella, Entamoeba histolytica, and Campylobacter.

TextSentencer_T20

2175-2368

Sentence

denotes

It is a result of damage suffered by intestinal mucus in the colon ravaged by an external agent, such as Shigella dysenteriae, nontyphoidal Salmonella, Entamoeba histolytica, and Campylobacter.

TextSentencer_T21

2369-2423

Sentence

denotes

Rapid weight loss is the most frequent consequence. c.

TextSentencer_T21

2369-2423

Sentence

denotes

Rapid weight loss is the most frequent consequence. c.

TextSentencer_T22

2424-2444

Sentence

denotes

Persistent diarrhea:

TextSentencer_T22

2424-2444

Sentence

denotes

Persistent diarrhea:

TextSentencer_T23

2445-2527

Sentence

denotes

With a duration of more than 14 days, it can start as acute diarrhea or dysentery.

TextSentencer_T23

2445-2527

Sentence

denotes

With a duration of more than 14 days, it can start as acute diarrhea or dysentery.

TextSentencer_T24

2528-2604

Sentence

denotes

It should not be confused with chronic diarrhea due to noninfectious causes.

TextSentencer_T24

2528-2604

Sentence

denotes

It should not be confused with chronic diarrhea due to noninfectious causes.

TextSentencer_T25

2605-2669

Sentence

denotes

It can produce noticeable weight loss and a risk of dehydration.

TextSentencer_T25

2605-2669

Sentence

denotes

It can produce noticeable weight loss and a risk of dehydration.

TextSentencer_T26

2670-2758

Sentence

denotes

Causal agents include Shigella, enteroaggregative E. coli, Cryptosporidium, and Giardia.

TextSentencer_T26

2670-2758

Sentence

denotes

Causal agents include Shigella, enteroaggregative E. coli, Cryptosporidium, and Giardia.

TextSentencer_T27

2759-2988

Sentence

denotes

The consequent effects of diarrhea can be highly variable: from a slight and transitory condition that spontaneously resolves itself to its more severe incarnations where loss of water and electrolytes can be an important factor.

TextSentencer_T27

2759-2988

Sentence

denotes

The consequent effects of diarrhea can be highly variable: from a slight and transitory condition that spontaneously resolves itself to its more severe incarnations where loss of water and electrolytes can be an important factor.

TextSentencer_T28

2989-3134

Sentence

denotes

The resulting hypovolemic shock can cause renal failure, disorders in other organs, and in the most vulnerable patients it can prove to be fatal.

TextSentencer_T28

2989-3134

Sentence

denotes

The resulting hypovolemic shock can cause renal failure, disorders in other organs, and in the most vulnerable patients it can prove to be fatal.

TextSentencer_T29

3135-3341

Sentence

denotes

The appearance of diarrhea results from confrontation between aggressive external elements (a causal agent's toxicity or virulence, the quantity of the inoculant dose) and the body's own defense mechanisms.

TextSentencer_T29

3135-3341

Sentence

denotes

The appearance of diarrhea results from confrontation between aggressive external elements (a causal agent's toxicity or virulence, the quantity of the inoculant dose) and the body's own defense mechanisms.

TextSentencer_T30

3342-3611

Sentence

denotes

Among the defense mechanisms combating infectious agents, the following can be highlighted: gastric acid, gastrointestinal mucus, intestinal motility, bile salts, regular intestinal bacteria, macrophage cells, lymphocyte cells, and type IgA immunoglobulin in the mucus.

TextSentencer_T30

3342-3611

Sentence

denotes

Among the defense mechanisms combating infectious agents, the following can be highlighted: gastric acid, gastrointestinal mucus, intestinal motility, bile salts, regular intestinal bacteria, macrophage cells, lymphocyte cells, and type IgA immunoglobulin in the mucus.

TextSentencer_T31

3612-3922

Sentence

denotes

Additionally, there are genetic factors that can affect resistance to particular infections; for example, blood group 'O' individuals are at greater risk of suffering from cholera, whereas the socalled nonsecretory individuals, with certain FUT 2 gene mutations, are partially resistant to norovirus infection.

TextSentencer_T31

3612-3922

Sentence

denotes

Additionally, there are genetic factors that can affect resistance to particular infections; for example, blood group 'O' individuals are at greater risk of suffering from cholera, whereas the socalled nonsecretory individuals, with certain FUT 2 gene mutations, are partially resistant to norovirus infection.

TextSentencer_T32

3923-4172

Sentence

denotes

Other specific external circumstances such as the ingestion of alcohol or (nonvolatile) red wine could act as protective factors against infection by Salmonella when the ingestion of the microorganism and those kind of drinks is almost simultaneous.

TextSentencer_T32

3923-4172

Sentence

denotes

Other specific external circumstances such as the ingestion of alcohol or (nonvolatile) red wine could act as protective factors against infection by Salmonella when the ingestion of the microorganism and those kind of drinks is almost simultaneous.

TextSentencer_T33

4173-4233

Sentence

denotes

There are few vaccines effective against diarrheal diseases.

TextSentencer_T33

4173-4233

Sentence

denotes

There are few vaccines effective against diarrheal diseases.

TextSentencer_T34

4234-4336

Sentence

denotes

Recently, a vaccine against rotavirus has been authorized, which is expected to show positive results.

TextSentencer_T34

4234-4336

Sentence

denotes

Recently, a vaccine against rotavirus has been authorized, which is expected to show positive results.

TextSentencer_T35

4337-4500

Sentence

denotes

Occasionally, diarrhea presents itself as an accompanying symptom of chronic conditions, such as the collateral effect of some medicines or a sign of malnutrition.

TextSentencer_T35

4337-4500

Sentence

denotes

Occasionally, diarrhea presents itself as an accompanying symptom of chronic conditions, such as the collateral effect of some medicines or a sign of malnutrition.

TextSentencer_T36

4501-4671

Sentence

denotes

However, this article discusses diarrhea as the principal effect of infections and poisoning by microorganisms, ingestion of animals, plants, or compound chemical toxins.

TextSentencer_T36

4501-4671

Sentence

denotes

However, this article discusses diarrhea as the principal effect of infections and poisoning by microorganisms, ingestion of animals, plants, or compound chemical toxins.

TextSentencer_T37

4672-4806

Sentence

denotes

In this context, it is very common to associate diarrhea with the ingestion of food that is either contaminated or well past its best.

TextSentencer_T37

4672-4806

Sentence

denotes

In this context, it is very common to associate diarrhea with the ingestion of food that is either contaminated or well past its best.

TextSentencer_T38

4807-4932

Sentence

denotes

But infections and food poisonings do not always present themselves as the clinical profile in which diarrhea is predominant.

TextSentencer_T38

4807-4932

Sentence

denotes

But infections and food poisonings do not always present themselves as the clinical profile in which diarrhea is predominant.

TextSentencer_T39

4933-5068

Sentence

denotes

For example, in botulism or some marine biotoxins the essential factors are the neurological signs -diarrhea may or may not be present.

TextSentencer_T39

4933-5068

Sentence

denotes

For example, in botulism or some marine biotoxins the essential factors are the neurological signs -diarrhea may or may not be present.

TextSentencer_T40

5069-5287

Sentence

denotes

Infant mortality from acute diarrhea has reduced throughout the last years of the twentieth century, essentially due to improvements in sanitation and the implementation of Oral Rehydration Therapy programs by the WHO.

TextSentencer_T40

5069-5287

Sentence

denotes

Infant mortality from acute diarrhea has reduced throughout the last years of the twentieth century, essentially due to improvements in sanitation and the implementation of Oral Rehydration Therapy programs by the WHO.

TextSentencer_T41

5288-5356

Sentence

denotes

Even so, in the year 2000, it caused approximately 2 million deaths.

TextSentencer_T41

5288-5356

Sentence

denotes

Even so, in the year 2000, it caused approximately 2 million deaths.

TextSentencer_T42

5357-5407

Sentence

denotes

The vast majority was related to avoidable causes.

TextSentencer_T42

5357-5407

Sentence

denotes

The vast majority was related to avoidable causes.

TextSentencer_T43

5408-5495

Sentence

denotes

In the distribution of diarrhea cases there are geographic and age-related differences.

TextSentencer_T43

5408-5495

Sentence

denotes

In the distribution of diarrhea cases there are geographic and age-related differences.

TextSentencer_T44

5496-5671

Sentence

denotes

With as much respect to etiology as to the seriousness of the cases, somewhat different patterns have been found, according to whether the countries are industrialized or not.

TextSentencer_T44

5496-5671

Sentence

denotes

With as much respect to etiology as to the seriousness of the cases, somewhat different patterns have been found, according to whether the countries are industrialized or not.

TextSentencer_T45

5672-5880

Sentence

denotes

Certain parasites and cholera, for example (of whom the WHO is continuously in international pursuit), are still frequent in some underdeveloped regions where favorable conditions for their propagation exist.

TextSentencer_T45

5672-5880

Sentence

denotes

Certain parasites and cholera, for example (of whom the WHO is continuously in international pursuit), are still frequent in some underdeveloped regions where favorable conditions for their propagation exist.

TextSentencer_T46

5881-6015

Sentence

denotes

Bad conditions of individual hygiene, nutrition, and existing public sanitation in many poor countries favor the presence of diarrhea.

TextSentencer_T46

5881-6015

Sentence

denotes

Bad conditions of individual hygiene, nutrition, and existing public sanitation in many poor countries favor the presence of diarrhea.

TextSentencer_T47

6016-6330

Sentence

denotes

Even when incidences of the infection do not display such great geographic differences, in the case of some viruses, the indicators in terms of its lethality are noticeably different; for example, rotavirus is very frequent in all types of countries, but its severity (mortality rate) is greater in poor countries.

TextSentencer_T47

6016-6330

Sentence

denotes

Even when incidences of the infection do not display such great geographic differences, in the case of some viruses, the indicators in terms of its lethality are noticeably different; for example, rotavirus is very frequent in all types of countries, but its severity (mortality rate) is greater in poor countries.

TextSentencer_T48

6331-6490

Sentence

denotes

In England and Wales, the microorganisms that most frequently cause diarrhea are Campylobacter, rotavirus, norovirus, Salmonella, Giardia, and Cryptosporidium.

TextSentencer_T48

6331-6490

Sentence

denotes

In England and Wales, the microorganisms that most frequently cause diarrhea are Campylobacter, rotavirus, norovirus, Salmonella, Giardia, and Cryptosporidium.

TextSentencer_T49

6491-6662

Sentence

denotes

Since means have been available for the virological diagnosis of gastroenteritis, it has been seen that viruses are the most common cause of diarrhea in Western countries.

TextSentencer_T49

6491-6662

Sentence

denotes

Since means have been available for the virological diagnosis of gastroenteritis, it has been seen that viruses are the most common cause of diarrhea in Western countries.

TextSentencer_T50

6663-6872

Sentence

denotes

Generally they do not cause very serious illnesses at the individual level, but they are responsible for a considerable social burden in the form of hospital admissions and scholastic and employee absenteeism.

TextSentencer_T50

6663-6872

Sentence

denotes

Generally they do not cause very serious illnesses at the individual level, but they are responsible for a considerable social burden in the form of hospital admissions and scholastic and employee absenteeism.

TextSentencer_T51

6873-7029

Sentence

denotes

The age of patients, the seriousness of the illness, and the capabilities of laboratories are factors that determine the scope of the etiological diagnosis.

TextSentencer_T51

6873-7029

Sentence

denotes

The age of patients, the seriousness of the illness, and the capabilities of laboratories are factors that determine the scope of the etiological diagnosis.

TextSentencer_T52

7030-7129

Sentence

denotes

Age also relates to the etiology of diarrhea ( Figure 1 ) and to the probability of fecal analyses.

TextSentencer_T52

7030-7129

Sentence

denotes

Age also relates to the etiology of diarrhea ( Figure 1 ) and to the probability of fecal analyses.

TextSentencer_T53

7130-7301

Sentence

denotes

Faced with a similar clinical profile, a child does not have the same probability as an adult of receiving an etiological diagnosis: in the child's case it is more likely.

TextSentencer_T53

7130-7301

Sentence

denotes

Faced with a similar clinical profile, a child does not have the same probability as an adult of receiving an etiological diagnosis: in the child's case it is more likely.

TextSentencer_T54

7302-7372

Sentence

denotes

The same happens with serious conditions in comparison to slight ones.

TextSentencer_T54

7302-7372

Sentence

denotes

The same happens with serious conditions in comparison to slight ones.

TextSentencer_T55

7373-7433

Sentence

denotes

The slight diarrheas often go without etiological diagnosis.

TextSentencer_T55

7373-7433

Sentence

denotes

The slight diarrheas often go without etiological diagnosis.

TextSentencer_T56

7434-7559

Sentence

denotes

This is also the case with conditions caused by agents that are not detected by the laboratory participating in the analysis.

TextSentencer_T56

7434-7559

Sentence

denotes

This is also the case with conditions caused by agents that are not detected by the laboratory participating in the analysis.

TextSentencer_T57

7560-7661

Sentence

denotes

Age bias, age, and technical ability need to be considered when analyzing epidemiological statistics.

TextSentencer_T57

7560-7661

Sentence

denotes

Age bias, age, and technical ability need to be considered when analyzing epidemiological statistics.

TextSentencer_T58

7662-7998

Sentence

denotes

However, epidemiological studies were performed in England and Holland at the end of 1990s and in the United States in 2001 and 2002, in which a thorough fecal examination of all patients was undertaken, independent of their age and the seriousness of their condition, including those patients who no longer showed symptoms of diarrhea.

TextSentencer_T58

7662-7998

Sentence

denotes

However, epidemiological studies were performed in England and Holland at the end of 1990s and in the United States in 2001 and 2002, in which a thorough fecal examination of all patients was undertaken, independent of their age and the seriousness of their condition, including those patients who no longer showed symptoms of diarrhea.

TextSentencer_T59

7999-8194

Sentence

denotes

In these studies, fecal examination was also carried out in healthy control subjects, so that the frequency in which specific microorganisms appeared could be compared with asymptomatic subjects.

TextSentencer_T59

7999-8194

Sentence

denotes

In these studies, fecal examination was also carried out in healthy control subjects, so that the frequency in which specific microorganisms appeared could be compared with asymptomatic subjects.

TextSentencer_T60

8195-8379

Sentence

denotes

Usually the etiological diagnosis of acute infectious (or toxic) diarrhea is obtained by fecal analysis: wet mount, coproculture, antigen detection, toxin detection, or other analyses.

TextSentencer_T60

8195-8379

Sentence

denotes

Usually the etiological diagnosis of acute infectious (or toxic) diarrhea is obtained by fecal analysis: wet mount, coproculture, antigen detection, toxin detection, or other analyses.

TextSentencer_T61

8380-8537

Sentence

denotes

Specialized laboratories can use more complex techniques that, generally, prove to be more sensitive and specific, but are also more expensive and difficult.

TextSentencer_T61

8380-8537

Sentence

denotes

Specialized laboratories can use more complex techniques that, generally, prove to be more sensitive and specific, but are also more expensive and difficult.

TextSentencer_T62

8538-8635

Sentence

denotes

Nevertheless, many of the coprocultures a standard laboratory requests and examines are negative.

TextSentencer_T62

8538-8635

Sentence

denotes

Nevertheless, many of the coprocultures a standard laboratory requests and examines are negative.

TextSentencer_T63

8636-8938

Sentence

denotes

A negative result can be the consequence of the following reasons: diarrhea is not actually infectious, it is caused by an agent for which the laboratory has no data, there is a failure in the test sensitivity, the patient may have taken antibiotics, or there may have been problems in fecal transport.

TextSentencer_T63

8636-8938

Sentence

denotes

A negative result can be the consequence of the following reasons: diarrhea is not actually infectious, it is caused by an agent for which the laboratory has no data, there is a failure in the test sensitivity, the patient may have taken antibiotics, or there may have been problems in fecal transport.

TextSentencer_T64

8939-9071

Sentence

denotes

Cases that have returned negative results are a mixture of etiologies, and for that reason further investigation makes little sense.

TextSentencer_T64

8939-9071

Sentence

denotes

Cases that have returned negative results are a mixture of etiologies, and for that reason further investigation makes little sense.

TextSentencer_T65

9072-9263

Sentence

denotes

In the EDICS study (Study of Infectious Diarrhea in Castellón) of risk factors in infantile diarrhea, no risk factors were found associated to the cases with a negative fecal analysis result.

TextSentencer_T65

9072-9263

Sentence

denotes

In the EDICS study (Study of Infectious Diarrhea in Castellón) of risk factors in infantile diarrhea, no risk factors were found associated to the cases with a negative fecal analysis result.

TextSentencer_T66

9264-9364

Sentence

denotes

On the contrary, risk factors were found in cases of campylobacteriosis, salmonelosis, or rotavirus.

TextSentencer_T66

9264-9364

Sentence

denotes

On the contrary, risk factors were found in cases of campylobacteriosis, salmonelosis, or rotavirus.

TextSentencer_T67

9365-9513

Sentence

denotes

This indeed suggests that the group of negatives is a mixture of different etiological cases without common origin and with few shared risk factors.

TextSentencer_T67

9365-9513

Sentence

denotes

This indeed suggests that the group of negatives is a mixture of different etiological cases without common origin and with few shared risk factors.

TextSentencer_T68

9514-9708

Sentence

denotes

The appearance of vomit as an initial symptom, the absence of fecal blood (macro-or microscopic,) and low PCR (reactive C protein) are signs suggestive of viral etiology, especially in children.

TextSentencer_T68

9514-9708

Sentence

denotes

The appearance of vomit as an initial symptom, the absence of fecal blood (macro-or microscopic,) and low PCR (reactive C protein) are signs suggestive of viral etiology, especially in children.

TextSentencer_T69

9709-9869

Sentence

denotes

Faced with an epidemiological case of diarrhea two questions arise: one, if the etiology is already known; two, if there are more cases related to the original.

TextSentencer_T69

9709-9869

Sentence

denotes

Faced with an epidemiological case of diarrhea two questions arise: one, if the etiology is already known; two, if there are more cases related to the original.

TextSentencer_T70

9870-9972

Sentence

denotes

These two elements are represented in Table 1 , where each cell signifies a distinct epidemic concern.

TextSentencer_T70

9870-9972

Sentence

denotes

These two elements are represented in Table 1 , where each cell signifies a distinct epidemic concern.

TextSentencer_T71

9973-10134

Sentence

denotes

There are noticeable differences in modes of approaching the epidemiological study of diarrhea cases according to their sporadicity or pertinence to an outbreak.

TextSentencer_T71

9973-10134

Sentence

denotes

There are noticeable differences in modes of approaching the epidemiological study of diarrhea cases according to their sporadicity or pertinence to an outbreak.

TextSentencer_T72

10135-10222

Sentence

denotes

Certain microorganisms have a preference to appear fundamentally as one of these forms.

TextSentencer_T72

10135-10222

Sentence

denotes

Certain microorganisms have a preference to appear fundamentally as one of these forms.

TextSentencer_T73

10223-10356

Sentence

denotes

As such, Campylobacter or rotavirus constitutes the majority of sporadic cases, not excluding the possibility of producing outbreaks.

TextSentencer_T73

10223-10356

Sentence

denotes

As such, Campylobacter or rotavirus constitutes the majority of sporadic cases, not excluding the possibility of producing outbreaks.

TextSentencer_T74

10357-10480

Sentence

denotes

On the contrary, Salmonella and, especially, norovirus more characteristically present themselves in the form of outbreaks.

TextSentencer_T74

10357-10480

Sentence

denotes

On the contrary, Salmonella and, especially, norovirus more characteristically present themselves in the form of outbreaks.

TextSentencer_T75

10481-10693

Sentence

denotes

From the epidemiological point of view, it could be said that epidemic cases 'come' to the investigator as one, whereas the investigator 'goes' in search of the sporadic cases and reunites them for their studies.

TextSentencer_T75

10481-10693

Sentence

denotes

From the epidemiological point of view, it could be said that epidemic cases 'come' to the investigator as one, whereas the investigator 'goes' in search of the sporadic cases and reunites them for their studies.

TextSentencer_T76

10694-10869

Sentence

denotes

Among the sporadic cases there is a group, which in fact belongs to small clusters, that escapes common systems of epidemiological monitoring and needs special investigations.

TextSentencer_T76

10694-10869

Sentence

denotes

Among the sporadic cases there is a group, which in fact belongs to small clusters, that escapes common systems of epidemiological monitoring and needs special investigations.

TextSentencer_T77

10870-11064

Sentence

denotes

This group of apparently sporadic cases (but which, in fact, are not sporadic) can only be detected by the existence of an exceptionally good monitoring system or by performing specific studies.

TextSentencer_T77

10870-11064

Sentence

denotes

This group of apparently sporadic cases (but which, in fact, are not sporadic) can only be detected by the existence of an exceptionally good monitoring system or by performing specific studies.

TextSentencer_T78

11065-11471

Sentence

denotes

Steen Ettenberg and other collaborators performed a specific study on cases registered throughout Denmark in the 1990s and found that 13.3% of Salmonella enteritidis, 10.4% of Shigella sonnei, 5.6% of Salmonella serotype Typhimurium, 3.2% of Campylobacter, and 2.0% of Yersinia enterocolitica cases belonged to this type of clusters, which is a large majority unknown to epidemiological monitoring systems.

TextSentencer_T78

11065-11471

Sentence

denotes

Steen Ettenberg and other collaborators performed a specific study on cases registered throughout Denmark in the 1990s and found that 13.3% of Salmonella enteritidis, 10.4% of Shigella sonnei, 5.6% of Salmonella serotype Typhimurium, 3.2% of Campylobacter, and 2.0% of Yersinia enterocolitica cases belonged to this type of clusters, which is a large majority unknown to epidemiological monitoring systems.

TextSentencer_T79

11472-11642

Sentence

denotes

In absolute terms, the cases of campylobacteriosis were the most numerous due to the large amount of patients diagnosed with the infection in the last years of the study.

TextSentencer_T79

11472-11642

Sentence

denotes

In absolute terms, the cases of campylobacteriosis were the most numerous due to the large amount of patients diagnosed with the infection in the last years of the study.

TextSentencer_T80

11643-11812

Sentence

denotes

In a much smaller study in Castellón (Spain), 10 clusters of this type were identified after systematic investigation of coprocultures in an area of 250 000 inhabitants.

TextSentencer_T80

11643-11812

Sentence

denotes

In a much smaller study in Castellón (Spain), 10 clusters of this type were identified after systematic investigation of coprocultures in an area of 250 000 inhabitants.

TextSentencer_T81

11813-11917

Sentence

denotes

Small family clusters of Campylobacter, S. enteritidis, rotavirus, and intestinal adenovirus were found.

TextSentencer_T81

11813-11917

Sentence

denotes

Small family clusters of Campylobacter, S. enteritidis, rotavirus, and intestinal adenovirus were found.

TextSentencer_T82

11918-12055

Sentence

denotes

In addition to the etiology and level of aggregation, a third question arises: the source of infection and its mechanism of transmission.

TextSentencer_T82

11918-12055

Sentence

denotes

In addition to the etiology and level of aggregation, a third question arises: the source of infection and its mechanism of transmission.

TextSentencer_T83

12056-12147

Sentence

denotes

When the etiology is well known, the epidemiology of the agent involved is generally known.

TextSentencer_T83

12056-12147

Sentence

denotes

When the etiology is well known, the epidemiology of the agent involved is generally known.

TextSentencer_T84

12148-12273

Sentence

denotes

Table 2 summarizes some epidemiological characteristics of five infection sources and significant mechanisms of transmission.

TextSentencer_T84

12148-12273

Sentence

denotes

Table 2 summarizes some epidemiological characteristics of five infection sources and significant mechanisms of transmission.

TextSentencer_T85

12274-12441

Sentence

denotes

Figures 2 and 3 represent two outbreaks of diarrhea by norovirus in residential homes for the elderly; these charts clearly demonstrate two mechanisms of transmission.

TextSentencer_T85

12274-12441

Sentence

denotes

Figures 2 and 3 represent two outbreaks of diarrhea by norovirus in residential homes for the elderly; these charts clearly demonstrate two mechanisms of transmission.

TextSentencer_T86

12442-12728

Sentence

denotes

Figure 2 shows a specific outbreak transmitted by foods (foodborne point source outbreak), and Figure 3 shows an outbreak, beginning gradually and progressively exacerbating, in which the transmission mechanism was predominantly 'person to person' and environmental (surfaces, fomites).

TextSentencer_T86

12442-12728

Sentence

denotes

Figure 2 shows a specific outbreak transmitted by foods (foodborne point source outbreak), and Figure 3 shows an outbreak, beginning gradually and progressively exacerbating, in which the transmission mechanism was predominantly 'person to person' and environmental (surfaces, fomites).

TextSentencer_T87

12729-12938

Sentence

denotes

Figure 4 represents a simple theoretical diagram for the investigation of transmissible disease cases by using the ARMIGO system (agent, reservoir, mechanism of transmission, individual, groups, other people).

TextSentencer_T87

12729-12938

Sentence

denotes

Figure 4 represents a simple theoretical diagram for the investigation of transmissible disease cases by using the ARMIGO system (agent, reservoir, mechanism of transmission, individual, groups, other people).

TextSentencer_T88

12939-13102

Sentence

denotes

Following an outline inspired by the epidemic cases of Table 1 , three situations can be distinguished according to the characteristics of the affected population.

TextSentencer_T88

12939-13102

Sentence

denotes

Following an outline inspired by the epidemic cases of Table 1 , three situations can be distinguished according to the characteristics of the affected population.

TextSentencer_T89

13103-13284

Sentence

denotes

First, a defined, open population with a specific exposure, which refers to people who only momentarily shared an exposure factor, for example, attending a shared dinner or banquet.

TextSentencer_T89

13103-13284

Sentence

denotes

First, a defined, open population with a specific exposure, which refers to people who only momentarily shared an exposure factor, for example, attending a shared dinner or banquet.

TextSentencer_T90

13285-13467

Sentence

denotes

Second, a defined, closed population with lasting exposure factors, for example, permanent residents within a closed institution, who continually share meals, places, and activities.

TextSentencer_T90

13285-13467

Sentence

denotes

Second, a defined, closed population with lasting exposure factors, for example, permanent residents within a closed institution, who continually share meals, places, and activities.

TextSentencer_T91

13468-13721

Sentence

denotes

And third, an indefinite population, with or without specific exposure, which occurs when there is no obvious relationship between people and they are implicated in an outbreak, solely by sharing an exposure factor distributed throughout the population.

TextSentencer_T91

13468-13721

Sentence

denotes

And third, an indefinite population, with or without specific exposure, which occurs when there is no obvious relationship between people and they are implicated in an outbreak, solely by sharing an exposure factor distributed throughout the population.

TextSentencer_T92

13722-13896

Sentence

denotes

In the case of laboratory analysis, an epidemic is identified where some rare microorganism in unusually large numbers of people is detected in a fairly prolonged time frame.

TextSentencer_T92

13722-13896

Sentence

denotes

In the case of laboratory analysis, an epidemic is identified where some rare microorganism in unusually large numbers of people is detected in a fairly prolonged time frame.

TextSentencer_T93

13897-14102

Sentence

denotes

For example, an outbreak that occurred in the United States in the first half of 2008 was produced by Salmonella Saintpaul with the same genetic fingerprint that affected more than 500 people in 32 states.

TextSentencer_T93

13897-14102

Sentence

denotes

For example, an outbreak that occurred in the United States in the first half of 2008 was produced by Salmonella Saintpaul with the same genetic fingerprint that affected more than 500 people in 32 states.

TextSentencer_T94

14103-14194

Sentence

denotes

The epidemic was related to the consumption of tomatoes distributed throughout the country.

TextSentencer_T94

14103-14194

Sentence

denotes

The epidemic was related to the consumption of tomatoes distributed throughout the country.

TextSentencer_T95

14195-14362

Sentence

denotes

Table 3 shows the agents that most frequently cause diarrhea, and Table 4 summarizes the more relevant epidemiological features of the diarrhea caused by these agents.

TextSentencer_T95

14195-14362

Sentence

denotes

Table 3 shows the agents that most frequently cause diarrhea, and Table 4 summarizes the more relevant epidemiological features of the diarrhea caused by these agents.

TextSentencer_T96

14363-14412

Sentence

denotes

Some of these microorganisms are discussed below.

TextSentencer_T96

14363-14412

Sentence

denotes

Some of these microorganisms are discussed below.

TextSentencer_T97

14413-14511

Sentence

denotes

This was identified by Ruth Bishop in 1973 and was named as such because of its 'wheel-like' form.

TextSentencer_T97

14413-14511

Sentence

denotes

This was identified by Ruth Bishop in 1973 and was named as such because of its 'wheel-like' form.

TextSentencer_T98

14512-14592

Sentence

denotes

There are various groups of rotavirus capable of producing infections in humans.

TextSentencer_T98

14512-14592

Sentence

denotes

There are various groups of rotavirus capable of producing infections in humans.

TextSentencer_T99

14593-14663

Sentence

denotes

The vast majority of cases are children infected by group A rotavirus.

TextSentencer_T99

14593-14663

Sentence

denotes

The vast majority of cases are children infected by group A rotavirus.

TextSentencer_T100

14664-14749

Sentence

denotes

Group B is related to diarrheas in adults and group C to slight diarrheas at any age.

TextSentencer_T100

14664-14749

Sentence

denotes

Group B is related to diarrheas in adults and group C to slight diarrheas at any age.

TextSentencer_T101

14750-14825

Sentence

denotes

Other serogroups are zoonotic and are possibly transmitted by some animals.

TextSentencer_T101

14750-14825

Sentence

denotes

Other serogroups are zoonotic and are possibly transmitted by some animals.

TextSentencer_T102

14826-14919

Sentence

denotes

Rotavirus is the main etiological agent for serious diarrheas in children all over the world.

TextSentencer_T102

14826-14919

Sentence

denotes

Rotavirus is the main etiological agent for serious diarrheas in children all over the world.

TextSentencer_T103

14920-15009

Sentence

denotes

At a very young age, a large number of children have already been infected or reinfected.

TextSentencer_T103

14920-15009

Sentence

denotes

At a very young age, a large number of children have already been infected or reinfected.

TextSentencer_T104

15010-15069

Sentence

denotes

Rotavirus has limited capabilities for producing outbreaks.

TextSentencer_T104

15010-15069

Sentence

denotes

Rotavirus has limited capabilities for producing outbreaks.

TextSentencer_T105

15070-15145

Sentence

denotes

The most important problems it constitutes are sporadic and hospital cases.

TextSentencer_T105

15070-15145

Sentence

denotes

The most important problems it constitutes are sporadic and hospital cases.

TextSentencer_T106

15146-15220

Sentence

denotes

Many cases are relatively serious infections that require hospitalization.

TextSentencer_T106

15146-15220

Sentence

denotes

Many cases are relatively serious infections that require hospitalization.

TextSentencer_T107

15221-15403

Sentence

denotes

According to a study of common rotaviral diarrhea in children under 5 years of age, carried out in 2000 and again in 2004 in Castellón, almost half of the patients were hospitalized.

TextSentencer_T107

15221-15403

Sentence

denotes

According to a study of common rotaviral diarrhea in children under 5 years of age, carried out in 2000 and again in 2004 in Castellón, almost half of the patients were hospitalized.

TextSentencer_T108

15404-15547

Sentence

denotes

In nonindustrialized countries, hospitalizations are fewer because welfare services are less accessible; mortality rates, however, are greater.

TextSentencer_T108

15404-15547

Sentence

denotes

In nonindustrialized countries, hospitalizations are fewer because welfare services are less accessible; mortality rates, however, are greater.

TextSentencer_T109

15548-15727

Sentence

denotes

Year 2006 saw the 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 August September Notification and control authorization of two new oral vaccines that promise to be effective:

TextSentencer_T109

15548-15727

Sentence

denotes

Year 2006 saw the 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 August September Notification and control authorization of two new oral vaccines that promise to be effective:

TextSentencer_T110

15728-15753

Sentence

denotes

RotaTeq s and Rotarix s .

TextSentencer_T110

15728-15753

Sentence

denotes

RotaTeq s and Rotarix s .

TextSentencer_T111

15754-15844

Sentence

denotes

Previously known as 'Agent Norwalk,' this virus was identified by Albert Kapikian in 1972.

TextSentencer_T111

15754-15844

Sentence

denotes

Previously known as 'Agent Norwalk,' this virus was identified by Albert Kapikian in 1972.

TextSentencer_T112

15845-16050

Sentence

denotes

It is related to the Caliciviridae family, of which only norovirus and sapovirus cause diarrhea in humans -the former preferentially causing epidemic cases (outbreaks) and the latter causing sporadic ones.

TextSentencer_T112

15845-16050

Sentence

denotes

It is related to the Caliciviridae family, of which only norovirus and sapovirus cause diarrhea in humans -the former preferentially causing epidemic cases (outbreaks) and the latter causing sporadic ones.

TextSentencer_T113

16051-16195

Sentence

denotes

Norovirus, especially genogroups I and II, actually constitutes the most frequent cause of viral diarrhea epidemics in industrialized countries.

TextSentencer_T113

16051-16195

Sentence

denotes

Norovirus, especially genogroups I and II, actually constitutes the most frequent cause of viral diarrhea epidemics in industrialized countries.

TextSentencer_T114

16196-16381

Sentence

denotes

If rotavirus is characterized by producing sporadic cases, norovirus characteristically produces outbreaks; especially in semi-enclosed spaces such as residential homes for the elderly.

TextSentencer_T114

16196-16381

Sentence

denotes

If rotavirus is characterized by producing sporadic cases, norovirus characteristically produces outbreaks; especially in semi-enclosed spaces such as residential homes for the elderly.

TextSentencer_T115

16382-16469

Sentence

denotes

The infection originates from diverse sources: foods, water, patients, and environment.

TextSentencer_T115

16382-16469

Sentence

denotes

The infection originates from diverse sources: foods, water, patients, and environment.

TextSentencer_T116

16470-16506

Sentence

denotes

The fingers are easily contaminated.

TextSentencer_T116

16470-16506

Sentence

denotes

The fingers are easily contaminated.

TextSentencer_T117

16507-16589

Sentence

denotes

A small dose of inoculant is sufficient to produce symptoms in susceptible people.

TextSentencer_T117

16507-16589

Sentence

denotes

A small dose of inoculant is sufficient to produce symptoms in susceptible people.

TextSentencer_T118

16590-16672

Sentence

denotes

On wood, metal, or plastic surfaces, the virus can survive for hours or even days.

TextSentencer_T118

16590-16672

Sentence

denotes

On wood, metal, or plastic surfaces, the virus can survive for hours or even days.

TextSentencer_T119

16673-16814

Sentence

denotes

It has been proven that transmission is possible through typical hand-to-surface contact, such as door handles, telephone receivers, or taps.

TextSentencer_T119

16673-16814

Sentence

denotes

It has been proven that transmission is possible through typical hand-to-surface contact, such as door handles, telephone receivers, or taps.

TextSentencer_T120

16815-17023

Sentence

denotes

An experimental study found that contaminated fingers could transfer the virus to the clean surfaces they touch by up to seven times, and at least 14 people could be contaminated by touching the same surface.

TextSentencer_T120

16815-17023

Sentence

denotes

An experimental study found that contaminated fingers could transfer the virus to the clean surfaces they touch by up to seven times, and at least 14 people could be contaminated by touching the same surface.

TextSentencer_T121

17024-17125

Sentence

denotes

Alternatively, it is known that certain subjects are genetically resistant to infection by norovirus.

TextSentencer_T121

17024-17125

Sentence

denotes

Alternatively, it is known that certain subjects are genetically resistant to infection by norovirus.

TextSentencer_T122

17126-17258

Sentence

denotes

The polymorphism of gene FUT 2 divides into secretory and nonsecretory individuals, who are susceptible and resistant, respectively.

TextSentencer_T122

17126-17258

Sentence

denotes

The polymorphism of gene FUT 2 divides into secretory and nonsecretory individuals, who are susceptible and resistant, respectively.

TextSentencer_T123

17259-17316

Sentence

denotes

Approximately 20% of Caucasian subjects are nonsecretory.

TextSentencer_T123

17259-17316

Sentence

denotes

Approximately 20% of Caucasian subjects are nonsecretory.

TextSentencer_T124

17317-17476

Sentence

denotes

However, recently it has been seen that nonsecretory subjects are not totally resistant, suggesting some norovirus strains use alternative routes of infection.

TextSentencer_T124

17317-17476

Sentence

denotes

However, recently it has been seen that nonsecretory subjects are not totally resistant, suggesting some norovirus strains use alternative routes of infection.

TextSentencer_T125

17477-17560

Sentence

denotes

The characteristics of norovirus make it difficult to produce a vaccine against it.

TextSentencer_T125

17477-17560

Sentence

denotes

The characteristics of norovirus make it difficult to produce a vaccine against it.

TextSentencer_T126

17561-17641

Sentence

denotes

These serotypes generally cause cases of infantile diarrhea throughout the year.

TextSentencer_T126

17561-17641

Sentence

denotes

These serotypes generally cause cases of infantile diarrhea throughout the year.

TextSentencer_T127

17642-17734

Sentence

denotes

The only demonstrated mechanism of infectious transmission is direct contact between people.

TextSentencer_T127

17642-17734

Sentence

denotes

The only demonstrated mechanism of infectious transmission is direct contact between people.

TextSentencer_T128

17735-17782

Sentence

denotes

Perhaps they have a limited epidemic potential.

TextSentencer_T128

17735-17782

Sentence

denotes

Perhaps they have a limited epidemic potential.

TextSentencer_T129

17783-17845

Sentence

denotes

The infectious capacity of this virus is not accurately known.

TextSentencer_T129

17783-17845

Sentence

denotes

The infectious capacity of this virus is not accurately known.

TextSentencer_T130

17846-17932

Sentence

denotes

This was first identified in 1975 in a fecal examination among children with diarrhea.

TextSentencer_T130

17846-17932

Sentence

denotes

This was first identified in 1975 in a fecal examination among children with diarrhea.

TextSentencer_T131

17933-18051

Sentence

denotes

The Astroviridae family, to which it belongs, was established in 1993, and was named after its star-shaped appearance.

TextSentencer_T131

17933-18051

Sentence

denotes

The Astroviridae family, to which it belongs, was established in 1993, and was named after its star-shaped appearance.

TextSentencer_T132

18052-18193

Sentence

denotes

It causes diarrhea in children and adults, with a slight seasonal pattern of predominance in cold months in regions with a temperate climate.

TextSentencer_T132

18052-18193

Sentence

denotes

It causes diarrhea in children and adults, with a slight seasonal pattern of predominance in cold months in regions with a temperate climate.

TextSentencer_T133

18194-18280

Sentence

denotes

The infectious capacity is high, perhaps very few viral particles can produce disease.

TextSentencer_T133

18194-18280

Sentence

denotes

The infectious capacity is high, perhaps very few viral particles can produce disease.

TextSentencer_T134

18281-18363

Sentence

denotes

Epidemiological data suggest that immunity does not last and is serotype specific.

TextSentencer_T134

18281-18363

Sentence

denotes

Epidemiological data suggest that immunity does not last and is serotype specific.

TextSentencer_T135

18364-18424

Sentence

denotes

Few laboratories can diagnose the routine of this infection.

TextSentencer_T135

18364-18424

Sentence

denotes

Few laboratories can diagnose the routine of this infection.

TextSentencer_T136

18425-18533

Sentence

denotes

It is believed that the virus can be an important factor in hospital diarrheas as much as in external cases.

TextSentencer_T136

18425-18533

Sentence

denotes

It is believed that the virus can be an important factor in hospital diarrheas as much as in external cases.

TextSentencer_T137

18534-18575

Sentence

denotes

These belong to the Coronaviridae family.

TextSentencer_T137

18534-18575

Sentence

denotes

These belong to the Coronaviridae family.

TextSentencer_T138

18576-18671

Sentence

denotes

Among the viruses that cause diarrhea in humans, they are the only ones that possess envelopes.

TextSentencer_T138

18576-18671

Sentence

denotes

Among the viruses that cause diarrhea in humans, they are the only ones that possess envelopes.

TextSentencer_T139

18672-18801

Sentence

denotes

It is believed that the torovirus produces acute diarrhea in children and can also be an important factor in nosocomial diarrhea.

TextSentencer_T139

18672-18801

Sentence

denotes

It is believed that the torovirus produces acute diarrhea in children and can also be an important factor in nosocomial diarrhea.

TextSentencer_T140

18802-19039

Sentence

denotes

Coronavirus occasionally produces diarrhea, but it gained importance as a result of severe acute respiratory syndrome (SARS) outbreaks, originated by coronavirus with a great capacity for environmental and person-to-person dissemination.

TextSentencer_T140

18802-19039

Sentence

denotes

Coronavirus occasionally produces diarrhea, but it gained importance as a result of severe acute respiratory syndrome (SARS) outbreaks, originated by coronavirus with a great capacity for environmental and person-to-person dissemination.

TextSentencer_T141

19040-19118

Sentence

denotes

The elimination of the virus in feces is less at the beginning of the illness.

TextSentencer_T141

19040-19118

Sentence

denotes

The elimination of the virus in feces is less at the beginning of the illness.

TextSentencer_T142

19119-19208

Sentence

denotes

However, viral particles have been found several months after the symptoms first started.

TextSentencer_T142

19119-19208

Sentence

denotes

However, viral particles have been found several months after the symptoms first started.

TextSentencer_T143

19209-19356

Sentence

denotes

Campylobacter, especially Campylobacter jejuni, is responsible for the majority of bacterial gastroenteritis cases in the industrialized countries.

TextSentencer_T143

19209-19356

Sentence

denotes

Campylobacter, especially Campylobacter jejuni, is responsible for the majority of bacterial gastroenteritis cases in the industrialized countries.

TextSentencer_T144

19357-19408

Sentence

denotes

It is a germ that grows little or nothing in foods.

TextSentencer_T144

19357-19408

Sentence

denotes

It is a germ that grows little or nothing in foods.

TextSentencer_T145

19409-19506

Sentence

denotes

This is the probable cause of its limited epidemic potential and the scarcity of known outbreaks.

TextSentencer_T145

19409-19506

Sentence

denotes

This is the probable cause of its limited epidemic potential and the scarcity of known outbreaks.

TextSentencer_T146

19507-19596

Sentence

denotes

Some relationships to the ingestion of milk or public drinking water have been described.

TextSentencer_T146

19507-19596

Sentence

denotes

Some relationships to the ingestion of milk or public drinking water have been described.

TextSentencer_T147

19597-19746

Sentence

denotes

However, the majority of diagnosed cases are sporadic, essentially occurring in very small children and with little evidence of any seasonal pattern.

TextSentencer_T147

19597-19746

Sentence

denotes

However, the majority of diagnosed cases are sporadic, essentially occurring in very small children and with little evidence of any seasonal pattern.

TextSentencer_T148

19747-19905

Sentence

denotes

It is possible -as happens with other microorganisms -that this predominance of diagnosed cases in children may be the consequence of a diagnostical age bias.

TextSentencer_T148

19747-19905

Sentence

denotes

It is possible -as happens with other microorganisms -that this predominance of diagnosed cases in children may be the consequence of a diagnostical age bias.

TextSentencer_T149

19906-20085

Sentence

denotes

Studies on intestinal infection where adult participants were asked to provide fecal cultures revealed that Campylobacter is also frequent in adolescents, adults, and the elderly.

TextSentencer_T149

19906-20085

Sentence

denotes

Studies on intestinal infection where adult participants were asked to provide fecal cultures revealed that Campylobacter is also frequent in adolescents, adults, and the elderly.

TextSentencer_T150

20086-20168

Sentence

denotes

The majority of diagnosed intestinal infections do not require hospital admission.

TextSentencer_T150

20086-20168

Sentence

denotes

The majority of diagnosed intestinal infections do not require hospital admission.

TextSentencer_T151

20169-20269

Sentence

denotes

According to the authors of this article, only 15% of cases resulted in patients being hospitalized.

TextSentencer_T151

20169-20269

Sentence

denotes

According to the authors of this article, only 15% of cases resulted in patients being hospitalized.

TextSentencer_T152

20270-20388

Sentence

denotes

Reservoirs of Campylobacter are not only found in farm animals, essentially avian, but also found in bovine livestock.

TextSentencer_T152

20270-20388

Sentence

denotes

Reservoirs of Campylobacter are not only found in farm animals, essentially avian, but also found in bovine livestock.

TextSentencer_T153

20389-20490

Sentence

denotes

Companion animals, if they have diarrhea when very young, can pose an infection risk to their owners.

TextSentencer_T153

20389-20490

Sentence

denotes

Companion animals, if they have diarrhea when very young, can pose an infection risk to their owners.

TextSentencer_T154

20491-20653

Sentence

denotes

The study of risk factors in Campylobacter infection presents difficulties given that the majority of cases are sporadic and in children under the age of 2 years.

TextSentencer_T154

20491-20653

Sentence

denotes

The study of risk factors in Campylobacter infection presents difficulties given that the majority of cases are sporadic and in children under the age of 2 years.

TextSentencer_T155

20654-20726

Sentence

denotes

Exposure to avian or bovine meat products has been related to infection.

TextSentencer_T155

20654-20726

Sentence

denotes

Exposure to avian or bovine meat products has been related to infection.

TextSentencer_T156

20727-20913

Sentence

denotes

Exposure is not necessarily by direct consumption; the presence of these products in home kitchens presents a risk factor, probably by cross-contamination due to poor hygienic practices.

TextSentencer_T156

20727-20913

Sentence

denotes

Exposure is not necessarily by direct consumption; the presence of these products in home kitchens presents a risk factor, probably by cross-contamination due to poor hygienic practices.

TextSentencer_T157

20914-21114

Sentence

denotes

The existence of other diarrhea cases in the patient's nearby surroundings implies that there are small groupings, small outbreaks not identified by conventional systems of epidemiological monitoring.

TextSentencer_T157

20914-21114

Sentence

denotes

The existence of other diarrhea cases in the patient's nearby surroundings implies that there are small groupings, small outbreaks not identified by conventional systems of epidemiological monitoring.

TextSentencer_T158

21115-21281

Sentence

denotes

Salmonella owes its name to the North American Veterinarian Daniel Elmer Salmon, who was one of the pioneers of microbiology toward the end of the nineteenth century.

TextSentencer_T158

21115-21281

Sentence

denotes

Salmonella owes its name to the North American Veterinarian Daniel Elmer Salmon, who was one of the pioneers of microbiology toward the end of the nineteenth century.

TextSentencer_T159

21282-21350

Sentence

denotes

Diarrhea by Salmonella is a very common zoonosis all over the world.

TextSentencer_T159

21282-21350

Sentence

denotes

Diarrhea by Salmonella is a very common zoonosis all over the world.

TextSentencer_T160

21351-21465

Sentence

denotes

The clinical profile in many patients consists of diarrhea with fever and an exaggerated variable state of health.

TextSentencer_T160

21351-21465

Sentence

denotes

The clinical profile in many patients consists of diarrhea with fever and an exaggerated variable state of health.

TextSentencer_T161

21466-21696

Sentence

denotes

In the nontyphoidal Salmonella group, there are more than 2500 serotypes that can cause gastroenteritis in humans, most common are S. enteritidis and S. typhimurium, although many others have been identified on numerous occasions.

TextSentencer_T161

21466-21696

Sentence

denotes

In the nontyphoidal Salmonella group, there are more than 2500 serotypes that can cause gastroenteritis in humans, most common are S. enteritidis and S. typhimurium, although many others have been identified on numerous occasions.

TextSentencer_T162

21697-21874

Sentence

denotes

When available, the serotype and fagotype are laboratory data that aid in the investigation of epidemiological factors and the infection source (eggs, birds, and other animals).

TextSentencer_T162

21697-21874

Sentence

denotes

When available, the serotype and fagotype are laboratory data that aid in the investigation of epidemiological factors and the infection source (eggs, birds, and other animals).

TextSentencer_T163

21875-21947

Sentence

denotes

Some serotypes have a preference to form reservoirs in specific animals.

TextSentencer_T163

21875-21947

Sentence

denotes

Some serotypes have a preference to form reservoirs in specific animals.

TextSentencer_T164

21948-22059

Sentence

denotes

Chickens and hens are principal reservoirs of S. enteritidis; however, pigs and cattle transmit S. typhimurium.

TextSentencer_T164

21948-22059

Sentence

denotes

Chickens and hens are principal reservoirs of S. enteritidis; however, pigs and cattle transmit S. typhimurium.

TextSentencer_T165

22060-22162

Sentence

denotes

Other serotypes such as S. hadar, S. virchow, and S. heidelberg are also present in chickens and hens.

TextSentencer_T165

22060-22162

Sentence

denotes

Other serotypes such as S. hadar, S. virchow, and S. heidelberg are also present in chickens and hens.

TextSentencer_T166

22163-22221

Sentence

denotes

Reptiles are transmitters of some less frequent serotypes.

TextSentencer_T166

22163-22221

Sentence

denotes

Reptiles are transmitters of some less frequent serotypes.

TextSentencer_T167

22222-22261

Sentence

denotes

Hen eggshells can also be contaminated.

TextSentencer_T167

22222-22261

Sentence

denotes

Hen eggshells can also be contaminated.

TextSentencer_T168

22262-22381

Sentence

denotes

But a remarkable fact is the vertical transmission of Salmonella in hens, laying eggs that are internally contaminated.

TextSentencer_T168

22262-22381

Sentence

denotes

But a remarkable fact is the vertical transmission of Salmonella in hens, laying eggs that are internally contaminated.

TextSentencer_T169

22382-22451

Sentence

denotes

Adequate data about the prevalence of contaminated eggs do not exist.

TextSentencer_T169

22382-22451

Sentence

denotes

Adequate data about the prevalence of contaminated eggs do not exist.

TextSentencer_T170

22452-22589

Sentence

denotes

At the beginning of the 1990s, random sampling was carried out for a study in Castellón, the estimation was little more than 1 in a 1000.

TextSentencer_T170

22452-22589

Sentence

denotes

At the beginning of the 1990s, random sampling was carried out for a study in Castellón, the estimation was little more than 1 in a 1000.

TextSentencer_T171

22590-22743

Sentence

denotes

Also, common vegetables (tomatoes, watermelon) and foods with little water activity such as chocolate or powdered milk have been implicated in outbreaks.

TextSentencer_T171

22590-22743

Sentence

denotes

Also, common vegetables (tomatoes, watermelon) and foods with little water activity such as chocolate or powdered milk have been implicated in outbreaks.

TextSentencer_T172

22744-22802

Sentence

denotes

An outbreak was even transmitted by marijuana consumption.

TextSentencer_T172

22744-22802

Sentence

denotes

An outbreak was even transmitted by marijuana consumption.

TextSentencer_T173

22803-22917

Sentence

denotes

In 2008, an outbreak in the United States transmitted by tomatoes affected more than 500 people in some 30 states.

TextSentencer_T173

22803-22917

Sentence

denotes

In 2008, an outbreak in the United States transmitted by tomatoes affected more than 500 people in some 30 states.

TextSentencer_T174

22918-23012

Sentence

denotes

When investigating outbreaks, the possibility of secondary cases has to be taken into account.

TextSentencer_T174

22918-23012

Sentence

denotes

When investigating outbreaks, the possibility of secondary cases has to be taken into account.

TextSentencer_T175

23013-23170

Sentence

denotes

It is not believed that there are chronic carriers as with S. typhi, but the feces of some patients can remain contagious for months, especially in children.

TextSentencer_T175

23013-23170

Sentence

denotes

It is not believed that there are chronic carriers as with S. typhi, but the feces of some patients can remain contagious for months, especially in children.

TextSentencer_T176

23171-23280

Sentence

denotes

These situations and the cases with few symptoms are particularly important when they occur in food handlers.

TextSentencer_T176

23171-23280

Sentence

denotes

These situations and the cases with few symptoms are particularly important when they occur in food handlers.

TextSentencer_T177

23281-23528

Sentence

denotes

The infectious dose, the conditions surrounding its ingestion (accompanying food, antacid medication, etc.) and some characteristics of the host can act as factors that greatly modify the incubation period and the severity of the clinical profile.

TextSentencer_T177

23281-23528

Sentence

denotes

The infectious dose, the conditions surrounding its ingestion (accompanying food, antacid medication, etc.) and some characteristics of the host can act as factors that greatly modify the incubation period and the severity of the clinical profile.

TextSentencer_T178

23529-23614

Sentence

denotes

Symptoms can start from 6 h up to 3 days after the ingestion of contaminated produce.

TextSentencer_T178

23529-23614

Sentence

denotes

Symptoms can start from 6 h up to 3 days after the ingestion of contaminated produce.

TextSentencer_T179

23615-23748

Sentence

denotes

Some greasy foods facilitate Salmonella's crossing the stomach without being eliminated by the extreme acidity of the gastric juices.

TextSentencer_T179

23615-23748

Sentence

denotes

Some greasy foods facilitate Salmonella's crossing the stomach without being eliminated by the extreme acidity of the gastric juices.

TextSentencer_T180

23749-23891

Sentence

denotes

It has been suggested, when faced with infection by S. ohio, that the simultaneous ingestion of alcohol (or red wine) has a protective effect.

TextSentencer_T180

23749-23891

Sentence

denotes

It has been suggested, when faced with infection by S. ohio, that the simultaneous ingestion of alcohol (or red wine) has a protective effect.

TextSentencer_T181

23892-23928

Sentence

denotes

Several serotypes of Shigella exist.

TextSentencer_T181

23892-23928

Sentence

denotes

Several serotypes of Shigella exist.

TextSentencer_T182

23929-24047

Sentence

denotes

Of them, S. dysenteriae type 1 is responsible for the most serious cases, bacillary dysentery, due to the Shiga toxin.

TextSentencer_T182

23929-24047

Sentence

denotes

Of them, S. dysenteriae type 1 is responsible for the most serious cases, bacillary dysentery, due to the Shiga toxin.

TextSentencer_T183

24048-24185

Sentence

denotes

Other serotypes are S. sonnei, S. flexneri, and S. boydii, which in general produce less severe profiles, accompanied by watery diarrhea.

TextSentencer_T183

24048-24185

Sentence

denotes

Other serotypes are S. sonnei, S. flexneri, and S. boydii, which in general produce less severe profiles, accompanied by watery diarrhea.

TextSentencer_T184

24186-24244

Sentence

denotes

The geographic distribution of each serotype is different.

TextSentencer_T184

24186-24244

Sentence

denotes

The geographic distribution of each serotype is different.

TextSentencer_T185

24245-24298

Sentence

denotes

In industrialized countries the impact is diminished.

TextSentencer_T185

24245-24298

Sentence

denotes

In industrialized countries the impact is diminished.

TextSentencer_T186

24299-24395

Sentence

denotes

In Asia, it seems that incidents of shigellosis maintain a presence but tend to be less serious.

TextSentencer_T186

24299-24395

Sentence

denotes

In Asia, it seems that incidents of shigellosis maintain a presence but tend to be less serious.

TextSentencer_T187

24396-24438

Sentence

denotes

Little is known about incidents in Africa.

TextSentencer_T187

24396-24438

Sentence

denotes

Little is known about incidents in Africa.

TextSentencer_T188

24439-24575

Sentence

denotes

The infectious dose is very low (from 10 to 100 bacilli); therefore, secondary cases are very frequent due to easily contaminated hands.

TextSentencer_T188

24439-24575

Sentence

denotes

The infectious dose is very low (from 10 to 100 bacilli); therefore, secondary cases are very frequent due to easily contaminated hands.

TextSentencer_T189

24576-24623

Sentence

denotes

Shigella produces outbreaks and sporadic cases.

TextSentencer_T189

24576-24623

Sentence

denotes

Shigella produces outbreaks and sporadic cases.

TextSentencer_T190

24624-24688

Sentence

denotes

The incubation period of S. dysenteriae is longer, up to a week.

TextSentencer_T190

24624-24688

Sentence

denotes

The incubation period of S. dysenteriae is longer, up to a week.

TextSentencer_T191

24689-24834

Sentence

denotes

Carriers can be asymptomatic for weeks, and with antibiotic treatment they could reduce the time needed for elimination of Shigella in the feces.

TextSentencer_T191

24689-24834

Sentence

denotes

Carriers can be asymptomatic for weeks, and with antibiotic treatment they could reduce the time needed for elimination of Shigella in the feces.

TextSentencer_T192

24835-24902

Sentence

denotes

However, the appearance of antibiotic resistance has been observed.

TextSentencer_T192

24835-24902

Sentence

denotes

However, the appearance of antibiotic resistance has been observed.

TextSentencer_T193

24903-24968

Sentence

denotes

The protection from natural infection it offers is type specific.

TextSentencer_T193

24903-24968

Sentence

denotes

The protection from natural infection it offers is type specific.

TextSentencer_T194

24969-25048

Sentence

denotes

Within the Yersinia genus there are numerous nonvirulent environmental strains.

TextSentencer_T194

24969-25048

Sentence

denotes

Within the Yersinia genus there are numerous nonvirulent environmental strains.

TextSentencer_T195

25049-25151

Sentence

denotes

Those that most frequently cause intestinal infection are Y. enterocolitica and Y. pseudotuberculosis.

TextSentencer_T195

25049-25151

Sentence

denotes

Those that most frequently cause intestinal infection are Y. enterocolitica and Y. pseudotuberculosis.

TextSentencer_T196

25152-25656

Sentence

denotes

The former (whose taxonomic classification has undergone important changes from its initial description in 1934 as Flavobacterium pseudomallei to the denomination Yersinia at the beginning of the 1960s) produces a diarrhea profile that includes abdominal pain and, sometimes, fever; the latter (whose first identification dates from many years earlier, in 1883) produces a clinical profile in which it is worth mentioning the symptoms of Mesenteric adenitis, which can sometimes simulate an appendicitis.

TextSentencer_T196

25152-25656

Sentence

denotes

The former (whose taxonomic classification has undergone important changes from its initial description in 1934 as Flavobacterium pseudomallei to the denomination Yersinia at the beginning of the 1960s) produces a diarrhea profile that includes abdominal pain and, sometimes, fever; the latter (whose first identification dates from many years earlier, in 1883) produces a clinical profile in which it is worth mentioning the symptoms of Mesenteric adenitis, which can sometimes simulate an appendicitis.

TextSentencer_T197

25657-25824

Sentence

denotes

Not all strains of Y. enterocolitica are pathogenic in humans; furthermore, different pathogenic serotypes and biotypes are unequally distributed among the population.

TextSentencer_T197

25657-25824

Sentence

denotes

Not all strains of Y. enterocolitica are pathogenic in humans; furthermore, different pathogenic serotypes and biotypes are unequally distributed among the population.

TextSentencer_T198

25825-25974

Sentence

denotes

Specific culture media are required for the identification of Yersinia from human fecal samples; standard culture mediums are not usually sufficient.

TextSentencer_T198

25825-25974

Sentence

denotes

Specific culture media are required for the identification of Yersinia from human fecal samples; standard culture mediums are not usually sufficient.

TextSentencer_T199

25975-26112

Sentence

denotes

Changes in laboratory practice have been considered an explanation for observed increases in the 1980s and some geographical differences.

TextSentencer_T199

25975-26112

Sentence

denotes

Changes in laboratory practice have been considered an explanation for observed increases in the 1980s and some geographical differences.

TextSentencer_T200

26113-26172

Sentence

denotes

The large majority of Y. enterocolitica cases are sporadic.

TextSentencer_T200

26113-26172

Sentence

denotes

The large majority of Y. enterocolitica cases are sporadic.

TextSentencer_T201

26173-26283

Sentence

denotes

In many countries with temperate climates, the patients are usually small children diagnosed in winter months.

TextSentencer_T201

26173-26283

Sentence

denotes

In many countries with temperate climates, the patients are usually small children diagnosed in winter months.

TextSentencer_T202

26284-26345

Sentence

denotes

The percentage of total diagnosed cases of diarrhea is small.

TextSentencer_T202

26284-26345

Sentence

denotes

The percentage of total diagnosed cases of diarrhea is small.

TextSentencer_T203

26346-26466

Sentence

denotes

The Y. pseudotuberculosis species is less frequent and little knowledge exists regarding its mechanisms of transmission.

TextSentencer_T203

26346-26466

Sentence

denotes

The Y. pseudotuberculosis species is less frequent and little knowledge exists regarding its mechanisms of transmission.

TextSentencer_T204

26467-26560

Sentence

denotes

There have been cases grouped in spatiotemporal clusters without a commonly identified nexus.

TextSentencer_T204

26467-26560

Sentence

denotes

There have been cases grouped in spatiotemporal clusters without a commonly identified nexus.

TextSentencer_T205

26561-26667

Sentence

denotes

In these clusters no secondary cases were observed, suggesting the source was most probably environmental.

TextSentencer_T205

26561-26667

Sentence

denotes

In these clusters no secondary cases were observed, suggesting the source was most probably environmental.

TextSentencer_T206

26668-26723

Sentence

denotes

Y. enterocolitica is frequently found in pig's tonsils.

TextSentencer_T206

26668-26723

Sentence

denotes

Y. enterocolitica is frequently found in pig's tonsils.

TextSentencer_T207

26724-26804

Sentence

denotes

In the case of Y. pseudotuberculosis, the reservoirs are wild rodents and birds.

TextSentencer_T207

26724-26804

Sentence

denotes

In the case of Y. pseudotuberculosis, the reservoirs are wild rodents and birds.

TextSentencer_T208

26805-26882

Sentence

denotes

There is a possibility that some humans may be carriers of Y. enterocolitica.

TextSentencer_T208

26805-26882

Sentence

denotes

There is a possibility that some humans may be carriers of Y. enterocolitica.

TextSentencer_T209

26883-27000

Sentence

denotes

Also, Yersinia, from these reservoirs, may contaminate foods or water, which will then infect those who consume them.

TextSentencer_T209

26883-27000

Sentence

denotes

Also, Yersinia, from these reservoirs, may contaminate foods or water, which will then infect those who consume them.

TextSentencer_T210

27001-27114

Sentence

denotes

In the case of Y. pseudotuberculosis, there are recorded outbreaks transmitted by 'iceberg' lettuce and radishes.

TextSentencer_T210

27001-27114

Sentence

denotes

In the case of Y. pseudotuberculosis, there are recorded outbreaks transmitted by 'iceberg' lettuce and radishes.

TextSentencer_T211

27115-27302

Sentence

denotes

It is postulated that initially the infection is caused by waters contaminated by animal reservoirs, which indicates that the washing of fresh vegetables is a method to prevent infection.

TextSentencer_T211

27115-27302

Sentence

denotes

It is postulated that initially the infection is caused by waters contaminated by animal reservoirs, which indicates that the washing of fresh vegetables is a method to prevent infection.

TextSentencer_T212

27303-27525

Sentence

denotes

But an outbreak that occurred in Finland in 1998 experimentally demonstrated the possibility of internal contamination of the lettuces, with the result that in such an eventuality external washing would have little effect.

TextSentencer_T212

27303-27525

Sentence

denotes

But an outbreak that occurred in Finland in 1998 experimentally demonstrated the possibility of internal contamination of the lettuces, with the result that in such an eventuality external washing would have little effect.

TextSentencer_T213

27526-27646

Sentence

denotes

Escherichia coli is a bacterium that forms part of the normal intestinal flora in humans and other warm-blooded animals.

TextSentencer_T213

27526-27646

Sentence

denotes

Escherichia coli is a bacterium that forms part of the normal intestinal flora in humans and other warm-blooded animals.

TextSentencer_T214

27647-27761

Sentence

denotes

Nevertheless, in the 1960s, it was discovered that certain strains of E. coli had a pathogenic capacity in humans.

TextSentencer_T214

27647-27761

Sentence

denotes

Nevertheless, in the 1960s, it was discovered that certain strains of E. coli had a pathogenic capacity in humans.

TextSentencer_T215

27762-27787

Sentence

denotes

There are many serotypes.

TextSentencer_T215

27762-27787

Sentence

denotes

There are many serotypes.

TextSentencer_T216

27788-27991

Sentence

denotes

Their capacity to produce different clinical syndromes and affect different age groups is a factor unique to each serotype, ranging from 'traveler's diarrhea' to a serious profile of hemorrhagic colitis.

TextSentencer_T216

27788-27991

Sentence

denotes

Their capacity to produce different clinical syndromes and affect different age groups is a factor unique to each serotype, ranging from 'traveler's diarrhea' to a serious profile of hemorrhagic colitis.

TextSentencer_T217

27992-28287

Sentence

denotes

The serotypes able to cause diarrhea are enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enteroinvasive E. coli (EIEC), enteroaggregative E. coli (EAEC), and most virulent of all enterohemorrhagic E. coli, also named verocytotoxic E. coli (EHEC or VCEC) of the serotype O157:H7.

TextSentencer_T217

27992-28287

Sentence

denotes

The serotypes able to cause diarrhea are enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enteroinvasive E. coli (EIEC), enteroaggregative E. coli (EAEC), and most virulent of all enterohemorrhagic E. coli, also named verocytotoxic E. coli (EHEC or VCEC) of the serotype O157:H7.

TextSentencer_T218

28288-28365

Sentence

denotes

The geographic distribution and transmission channels vary between serotypes.

TextSentencer_T218

28288-28365

Sentence

denotes

The geographic distribution and transmission channels vary between serotypes.

TextSentencer_T219

28366-28627

Sentence

denotes

Among the clinical characteristics of these infections, it is worth mentioning a serious complication of serotype O157:H7, hemolytic-uremic syndrome (HUS), which appears mainly in children, and can be exacerbated by taking antidiarrheal or antibiotic medicines.

TextSentencer_T219

28366-28627

Sentence

denotes

Among the clinical characteristics of these infections, it is worth mentioning a serious complication of serotype O157:H7, hemolytic-uremic syndrome (HUS), which appears mainly in children, and can be exacerbated by taking antidiarrheal or antibiotic medicines.

TextSentencer_T220

28628-28897

Sentence

denotes

This virulent stock of E. coli is transmitted mainly through ingestion of contaminated meat from bovine livestock, but it is also possible that there are other environmental routes of contagion by contact with surfaces or dust and sawdust in farms and zoological parks.

TextSentencer_T220

28628-28897

Sentence

denotes

This virulent stock of E. coli is transmitted mainly through ingestion of contaminated meat from bovine livestock, but it is also possible that there are other environmental routes of contagion by contact with surfaces or dust and sawdust in farms and zoological parks.

TextSentencer_T221

28898-28976

Sentence

denotes

Recent studies suggest that EAEC can cause both traveler and chronic diarrhea.

TextSentencer_T221

28898-28976

Sentence

denotes

Recent studies suggest that EAEC can cause both traveler and chronic diarrhea.

TextSentencer_T222

28977-29091

Sentence

denotes

Furthermore, the inflammatory response to this infection depends on human genetic factors linked to interleukin-8.

TextSentencer_T222

28977-29091

Sentence

denotes

Furthermore, the inflammatory response to this infection depends on human genetic factors linked to interleukin-8.

TextSentencer_T223

29092-29243

Sentence

denotes

This is a microorganism that can cause serious diarrhea, occasionally as pseudomembranous colitis, especially in hospitalized and debilitated patients.

TextSentencer_T223

29092-29243

Sentence

denotes

This is a microorganism that can cause serious diarrhea, occasionally as pseudomembranous colitis, especially in hospitalized and debilitated patients.

TextSentencer_T224

29244-29330

Sentence

denotes

Usually, it is triggered by taking antibiotics for therapeutic or preventive purposes.

TextSentencer_T224

29244-29330

Sentence

denotes

Usually, it is triggered by taking antibiotics for therapeutic or preventive purposes.

TextSentencer_T225

29331-29429

Sentence

denotes

Nevertheless, slight cases exist that are not diagnosed and are only detected in specific studies.

TextSentencer_T225

29331-29429

Sentence

denotes

Nevertheless, slight cases exist that are not diagnosed and are only detected in specific studies.

TextSentencer_T226

29430-29603

Sentence

denotes

The asymptomatic carrying and elimination of bacterial spores is relatively frequent in small children, but it is only patients with established diarrhea who are contagious.

TextSentencer_T226

29430-29603

Sentence

denotes

The asymptomatic carrying and elimination of bacterial spores is relatively frequent in small children, but it is only patients with established diarrhea who are contagious.

TextSentencer_T227

29604-29707

Sentence

denotes

The origin of diarrhea from microorganisms previously present in the same individual can be endogenous.

TextSentencer_T227

29604-29707

Sentence

denotes

The origin of diarrhea from microorganisms previously present in the same individual can be endogenous.

TextSentencer_T228

29708-29932

Sentence

denotes

These microorganisms are stimulated when intestinal flora is altered as a result of taking antibiotics; this can happen for 4-9 days at the beginning of an antibiotic course and even later, up to 6 or 8 weeks after starting.

TextSentencer_T228

29708-29932

Sentence

denotes

These microorganisms are stimulated when intestinal flora is altered as a result of taking antibiotics; this can happen for 4-9 days at the beginning of an antibiotic course and even later, up to 6 or 8 weeks after starting.

TextSentencer_T229

29933-30019

Sentence

denotes

In these cases, it is difficult to speak of an incubation period in the classic sense.

TextSentencer_T229

29933-30019

Sentence

denotes

In these cases, it is difficult to speak of an incubation period in the classic sense.

TextSentencer_T230

30020-30128

Sentence

denotes

There may also be exogenous contagion from environmental spores or C. difficile excreted by another patient.

TextSentencer_T230

30020-30128

Sentence

denotes

There may also be exogenous contagion from environmental spores or C. difficile excreted by another patient.

TextSentencer_T231

30129-30273

Sentence

denotes

In some countries improvement in diagnostical methods has contributed to the increased number of diagnoses, especially in hospitalized patients.

TextSentencer_T231

30129-30273

Sentence

denotes

In some countries improvement in diagnostical methods has contributed to the increased number of diagnoses, especially in hospitalized patients.

TextSentencer_T232

30274-30321

Sentence

denotes

It is rare that it produces communal outbreaks.

TextSentencer_T232

30274-30321

Sentence

denotes

It is rare that it produces communal outbreaks.

TextSentencer_T233

30322-30390

Sentence

denotes

When it appears in an epidemic form it usually does so in hospitals.

TextSentencer_T233

30322-30390

Sentence

denotes

When it appears in an epidemic form it usually does so in hospitals.

TextSentencer_T234

30391-30571

Sentence

denotes

According to what is known of its clinical and epidemiological characteristics, cholera only produces the V. cholerae serogroups O1 and O139, the latter confined to Southeast Asia.

TextSentencer_T234

30391-30571

Sentence

denotes

According to what is known of its clinical and epidemiological characteristics, cholera only produces the V. cholerae serogroups O1 and O139, the latter confined to Southeast Asia.

TextSentencer_T235

30572-30728

Sentence

denotes

Other serogroups, denominated 'non-O1' and 'non-O139,' usually present themselves as sporadic cases or small outbreaks with an incubation period of 12-14 h.

TextSentencer_T235

30572-30728

Sentence

denotes

Other serogroups, denominated 'non-O1' and 'non-O139,' usually present themselves as sporadic cases or small outbreaks with an incubation period of 12-14 h.

TextSentencer_T236

30729-30853

Sentence

denotes

As per epidemiological characteristics of cholera, it is easily spread through water or foods but not from person to person.

TextSentencer_T236

30729-30853

Sentence

denotes

As per epidemiological characteristics of cholera, it is easily spread through water or foods but not from person to person.

TextSentencer_T237

30854-30983

Sentence

denotes

In countries where there is overcrowding, poor nutrition, and poor environmental hygiene, cholera remains a very serious problem.

TextSentencer_T237

30854-30983

Sentence

denotes

In countries where there is overcrowding, poor nutrition, and poor environmental hygiene, cholera remains a very serious problem.

TextSentencer_T238

30984-31060

Sentence

denotes

People with blood group O are generally more susceptible to severe diseases.

TextSentencer_T238

30984-31060

Sentence

denotes

People with blood group O are generally more susceptible to severe diseases.

TextSentencer_T239

31061-31201

Sentence

denotes

Clostridium perfringens, Bacillus cereus, and Vibrio parahaemolyticus All these cause diarrhea through the consumption of contaminated food.

TextSentencer_T239

31061-31201

Sentence

denotes

Clostridium perfringens, Bacillus cereus, and Vibrio parahaemolyticus All these cause diarrhea through the consumption of contaminated food.

TextSentencer_T240

31202-31317

Sentence

denotes

The first two have the capacity to form spores and are found in terrestrial environments (the ground, for example).

TextSentencer_T240

31202-31317

Sentence

denotes

The first two have the capacity to form spores and are found in terrestrial environments (the ground, for example).

TextSentencer_T241

31318-31409

Sentence

denotes

V. parahaemolyticus is halophilic and is found in marine environments and seafood products.

TextSentencer_T241

31318-31409

Sentence

denotes

V. parahaemolyticus is halophilic and is found in marine environments and seafood products.

TextSentencer_T242

31410-31469

Sentence

denotes

Person-to-person transmission, if it exists, would be rare.

TextSentencer_T242

31410-31469

Sentence

denotes

Person-to-person transmission, if it exists, would be rare.

TextSentencer_T243

31470-31551

Sentence

denotes

Diarrheas caused by parasites usually have a more prolonged and insidious course.

TextSentencer_T243

31470-31551

Sentence

denotes

Diarrheas caused by parasites usually have a more prolonged and insidious course.

TextSentencer_T244

31552-31614

Sentence

denotes

Relapses and chronic forms are frequent and cause weight loss.

TextSentencer_T244

31552-31614

Sentence

denotes

Relapses and chronic forms are frequent and cause weight loss.

TextSentencer_T245

31615-31690

Sentence

denotes

They are usually resistant to the levels of chlorination in drinking water.

TextSentencer_T245

31615-31690

Sentence

denotes

They are usually resistant to the levels of chlorination in drinking water.

TextSentencer_T246

31691-31763

Sentence

denotes

Entamoeba histolytica is frequent in tropical and subtropical countries.

TextSentencer_T246

31691-31763

Sentence

denotes

Entamoeba histolytica is frequent in tropical and subtropical countries.

TextSentencer_T247

31764-31906

Sentence

denotes

Patients with diarrhea dispose of the parasite in trophozoit form, a form with little infectious potential due to its environmental fragility.

TextSentencer_T247

31764-31906

Sentence

denotes

Patients with diarrhea dispose of the parasite in trophozoit form, a form with little infectious potential due to its environmental fragility.

TextSentencer_T248

31907-32075

Sentence

denotes

In contrast, a significant number of infected people remain asymptomatic for months or years, eliminating cysts that have a greater infectious capacity than trophozoit.

TextSentencer_T248

31907-32075

Sentence

denotes

In contrast, a significant number of infected people remain asymptomatic for months or years, eliminating cysts that have a greater infectious capacity than trophozoit.

TextSentencer_T249

32076-32136

Sentence

denotes

Giardia lamblia is distributed by people all over the world.

TextSentencer_T249

32076-32136

Sentence

denotes

Giardia lamblia is distributed by people all over the world.

TextSentencer_T250

32137-32305

Sentence

denotes

Outbreaks caused by Giardia are relatively common in day-care centers, especially when there are poor hygienic conditions that facilitate person-to-person transmission.

TextSentencer_T250

32137-32305

Sentence

denotes

Outbreaks caused by Giardia are relatively common in day-care centers, especially when there are poor hygienic conditions that facilitate person-to-person transmission.

TextSentencer_T251

32306-32364

Sentence

denotes

Foods and water can also provide vehicles of transmission.

TextSentencer_T251

32306-32364

Sentence

denotes

Foods and water can also provide vehicles of transmission.

TextSentencer_T252

32365-32431

Sentence

denotes

The reservoir is human and, perhaps, some animals such as beavers.

TextSentencer_T252

32365-32431

Sentence

denotes

The reservoir is human and, perhaps, some animals such as beavers.

TextSentencer_T253

32432-32470

Sentence

denotes

People can remain carriers for months.

TextSentencer_T253

32432-32470

Sentence

denotes

People can remain carriers for months.

TextSentencer_T254

32471-32582

Sentence

denotes

Cryptosporidium parvum produces diarrhea in humans and can also affect systems other than the digestive system.

TextSentencer_T254

32471-32582

Sentence

denotes

Cryptosporidium parvum produces diarrhea in humans and can also affect systems other than the digestive system.

TextSentencer_T255

32583-32766

Sentence

denotes

They are parasites resistive to the levels of chlorination used to disinfect drinking water; therefore, hydric transmission outbreaks occur without requiring failures in chlorination.

TextSentencer_T255

32583-32766

Sentence

denotes

They are parasites resistive to the levels of chlorination used to disinfect drinking water; therefore, hydric transmission outbreaks occur without requiring failures in chlorination.

TextSentencer_T256

32767-32828

Sentence

denotes

Water filtration is a preventive method to avoid propagation.

TextSentencer_T256

32767-32828

Sentence

denotes

Water filtration is a preventive method to avoid propagation.

TextSentencer_T257

32829-32910

Sentence

denotes

It has a good survival capacity in the aquatic environment of continental waters.

TextSentencer_T257

32829-32910

Sentence

denotes

It has a good survival capacity in the aquatic environment of continental waters.

TextSentencer_T258

32911-33073

Sentence

denotes

It is responsible for 57% of gastroenteritis outbreaks related to swimming venues in the EU, although hyperchlorination can inactivate cysts present in the water.

TextSentencer_T258

32911-33073

Sentence

denotes

It is responsible for 57% of gastroenteritis outbreaks related to swimming venues in the EU, although hyperchlorination can inactivate cysts present in the water.

TextSentencer_T259

33074-33214

Sentence

denotes

It has been diagnosed with relative frequency throughout 2007 and 2008 in Ireland, England, and Belgium, and with less frequency in Germany.

TextSentencer_T259

33074-33214

Sentence

denotes

It has been diagnosed with relative frequency throughout 2007 and 2008 in Ireland, England, and Belgium, and with less frequency in Germany.

TextSentencer_T260

33215-33270

Sentence

denotes

There have been outbreaks from tap water contamination.

TextSentencer_T260

33215-33270

Sentence

denotes

There have been outbreaks from tap water contamination.

TextSentencer_T261

33271-33404

Sentence

denotes

Parasites such as Cyclospora cayetanensis, Balantidium coli, and Isospora belli have less importance than the ones mentioned earlier.

TextSentencer_T261

33271-33404

Sentence

denotes

Parasites such as Cyclospora cayetanensis, Balantidium coli, and Isospora belli have less importance than the ones mentioned earlier.

TextSentencer_T262

33405-33491

Sentence

denotes

There are even doubts about their capacity to produce symptomatic infection in humans.

TextSentencer_T262

33405-33491

Sentence

denotes

There are even doubts about their capacity to produce symptomatic infection in humans.

TextSentencer_T263

33492-33578

Sentence

denotes

There is a very diverse range of agents that cause, or can cause, diarrhea (Table 3) .

TextSentencer_T263

33492-33578

Sentence

denotes

There is a very diverse range of agents that cause, or can cause, diarrhea (Table 3) .

TextSentencer_T264

33579-33669

Sentence

denotes

They are characterized by short incubation periods following ingestion (minutes or hours).

TextSentencer_T264

33579-33669

Sentence

denotes

They are characterized by short incubation periods following ingestion (minutes or hours).

TextSentencer_T265

33670-33711

Sentence

denotes

They have a very broad clinical spectrum.

TextSentencer_T265

33670-33711

Sentence

denotes

They have a very broad clinical spectrum.

TextSentencer_T266

33712-33884

Sentence

denotes

Notable among the biotoxins is scombroid fish poisoning, which can take place after ingestion of certain scombroid fish (such as tuna and herring) in certain circumstances.

TextSentencer_T266

33712-33884

Sentence

denotes

Notable among the biotoxins is scombroid fish poisoning, which can take place after ingestion of certain scombroid fish (such as tuna and herring) in certain circumstances.

TextSentencer_T267

33885-33974

Sentence

denotes

The symptomology simulates an allergic reaction that presents itself in an epidemic form.

TextSentencer_T267

33885-33974

Sentence

denotes

The symptomology simulates an allergic reaction that presents itself in an epidemic form.

TextSentencer_T268

33975-34105

Sentence

denotes

Ciguatoxin, tetrodotoxin, and gempilotoxin are marine biotoxins that can produce very serious digestive and neurological symptoms.

TextSentencer_T268

33975-34105

Sentence

denotes

Ciguatoxin, tetrodotoxin, and gempilotoxin are marine biotoxins that can produce very serious digestive and neurological symptoms.

TextSentencer_T269

34106-34215

Sentence

denotes

Especially striking is gempilotoxin poisoning, in which diarrhea with orange colored feces has been observed.

TextSentencer_T269

34106-34215

Sentence

denotes

Especially striking is gempilotoxin poisoning, in which diarrhea with orange colored feces has been observed.

TextSentencer_T270

34216-34284

Sentence

denotes

Among vegetables, mushroom poisoning can cause serious consequences.

TextSentencer_T270

34216-34284

Sentence

denotes

Among vegetables, mushroom poisoning can cause serious consequences.

TextSentencer_T271

34285-34415

Sentence

denotes

Less well known is the diarrhea from Robinia pseudoacacia poisoning, which can be observed after chewing the bark of common trees.

TextSentencer_T271

34285-34415

Sentence

denotes

Less well known is the diarrhea from Robinia pseudoacacia poisoning, which can be observed after chewing the bark of common trees.

TextSentencer_T272

34416-34523

Sentence

denotes

As consequences of the intestinal infections, complications and long-term aftereffects are distinguishable.

TextSentencer_T272

34416-34523

Sentence

denotes

As consequences of the intestinal infections, complications and long-term aftereffects are distinguishable.

TextSentencer_T273

34524-34661

Sentence

denotes

The former occurs in the acute phase and the latter appears 3 weeks or 1 year after resolving the clinical profile, sometimes even later.

TextSentencer_T273

34524-34661

Sentence

denotes

The former occurs in the acute phase and the latter appears 3 weeks or 1 year after resolving the clinical profile, sometimes even later.

TextSentencer_T274

34662-34726

Sentence

denotes

Studies used by epidemiologists to investigate aftereffects are:

TextSentencer_T274

34662-34726

Sentence

denotes

Studies used by epidemiologists to investigate aftereffects are:

TextSentencer_T275

34727-34838

Sentence

denotes

• Point source outbreaks studies • Prospective cohort studies of sporadic cases • Retrospective cohort studies.

TextSentencer_T275

34727-34838

Sentence

denotes

• Point source outbreaks studies • Prospective cohort studies of sporadic cases • Retrospective cohort studies.

TextSentencer_T276

34839-35241

Sentence

denotes

The etiology of inflammatory bowel disease (IBD) is not known, but cohort studies carried out in the United Kingdom and Sweden indicate that previous bacterial intestinal infections by Salmonella, Campylobacter, or diarrheagenic E. coli and other agents of acute gastroenteritis double or triple the risk of suffering from some IBD variants, with incidences reaching almost 70 per 100 000 person-years.

TextSentencer_T276

34839-35241

Sentence

denotes

The etiology of inflammatory bowel disease (IBD) is not known, but cohort studies carried out in the United Kingdom and Sweden indicate that previous bacterial intestinal infections by Salmonella, Campylobacter, or diarrheagenic E. coli and other agents of acute gastroenteritis double or triple the risk of suffering from some IBD variants, with incidences reaching almost 70 per 100 000 person-years.

TextSentencer_T277

35242-35377

Sentence

denotes

Irritable bowel syndrome (IBS) can develop after infectious gastroenteritis by Campylobacter, Shigella, Salmonella, or E. coli O157:H7.

TextSentencer_T277

35242-35377

Sentence

denotes

Irritable bowel syndrome (IBS) can develop after infectious gastroenteritis by Campylobacter, Shigella, Salmonella, or E. coli O157:H7.

TextSentencer_T278

35378-35468

Sentence

denotes

By case-control studies, a statistically significant odds ratio of 4.8 has been estimated.

TextSentencer_T278

35378-35468

Sentence

denotes

By case-control studies, a statistically significant odds ratio of 4.8 has been estimated.

TextSentencer_T279

35469-35623

Sentence

denotes

It is believed that age (young), sex (feminine), psychological profile, severity, and duration of gastroenteritis are all risk factors in contracting IBS.

TextSentencer_T279

35469-35623

Sentence

denotes

It is believed that age (young), sex (feminine), psychological profile, severity, and duration of gastroenteritis are all risk factors in contracting IBS.

TextSentencer_T280

35624-35947

Sentence

denotes

The 2007 Leirisalo-Repo definition of reactive arthritis (ReA) is ''joint inflammation that develops soon after or during infection elsewhere in the body but in which the microorganism cannot be recovered from the joint.'' It usually occurs in the first 4 weeks after infection, is selflimiting, and affects a single joint.

TextSentencer_T280

35624-35947

Sentence

denotes

The 2007 Leirisalo-Repo definition of reactive arthritis (ReA) is ''joint inflammation that develops soon after or during infection elsewhere in the body but in which the microorganism cannot be recovered from the joint.'' It usually occurs in the first 4 weeks after infection, is selflimiting, and affects a single joint.

TextSentencer_T281

35948-36088

Sentence

denotes

Incidence varies according to the germ and its serotype, as well as the patient characteristics and case definition in each different study.

TextSentencer_T281

35948-36088

Sentence

denotes

Incidence varies according to the germ and its serotype, as well as the patient characteristics and case definition in each different study.

TextSentencer_T282

36089-36274

Sentence

denotes

Although the frequency of bacterial musculoskeletal symptoms after foodborne infection can reach up to 50% of affected patients, the incidences of ReA are positioned between 0% and 29%.

TextSentencer_T282

36089-36274

Sentence

denotes

Although the frequency of bacterial musculoskeletal symptoms after foodborne infection can reach up to 50% of affected patients, the incidences of ReA are positioned between 0% and 29%.

TextSentencer_T283

36275-36398

Sentence

denotes

Microorganisms related to ReA are enteric Salmonella, Shigella, Campylobacter, Yersinia, E. coli O157:H7, and C. difficile.

TextSentencer_T283

36275-36398

Sentence

denotes

Microorganisms related to ReA are enteric Salmonella, Shigella, Campylobacter, Yersinia, E. coli O157:H7, and C. difficile.

TextSentencer_T284

36399-36425

Sentence

denotes

Perhaps there may be more.

TextSentencer_T284

36399-36425

Sentence

denotes

Perhaps there may be more.

TextSentencer_T285

36426-36540

Sentence

denotes

Apparently women, adults (above 18 years), and those who have suffered more serious illnesses are at greater risk.

TextSentencer_T285

36426-36540

Sentence

denotes

Apparently women, adults (above 18 years), and those who have suffered more serious illnesses are at greater risk.

TextSentencer_T286

36541-36622

Sentence

denotes

The genetic marker HLA B27 would be associated more with severity than incidence.

TextSentencer_T286

36541-36622

Sentence

denotes

The genetic marker HLA B27 would be associated more with severity than incidence.

TextSentencer_T287

36623-36764

Sentence

denotes

The effect of taking antibiotics during the acute phase of intestinal infection is an object of discussion relating to the appearance of ReA.

TextSentencer_T287

36623-36764

Sentence

denotes

The effect of taking antibiotics during the acute phase of intestinal infection is an object of discussion relating to the appearance of ReA.

TextSentencer_T288

36765-36911

Sentence

denotes

Guillain-Barré syndrome (GBS) is an acute neuropathy of immune origin, which is associated with infections from Campylobacter and cytomegalovirus.

TextSentencer_T288

36765-36911

Sentence

denotes

Guillain-Barré syndrome (GBS) is an acute neuropathy of immune origin, which is associated with infections from Campylobacter and cytomegalovirus.

TextSentencer_T289

36912-37121

Sentence

denotes

Studies from the United Kingdom give an incidence of GBS, which takes place 1-3 weeks after infection, in 2 out of every 100 000 inhabitants, especially for some serotypes of Campylobacter such as O19 and O41.

TextSentencer_T289

36912-37121

Sentence

denotes

Studies from the United Kingdom give an incidence of GBS, which takes place 1-3 weeks after infection, in 2 out of every 100 000 inhabitants, especially for some serotypes of Campylobacter such as O19 and O41.

TextSentencer_T290

37122-37170

Sentence

denotes

Males are at greater risk of suffering from GBS.

TextSentencer_T290

37122-37170

Sentence

denotes

Males are at greater risk of suffering from GBS.

TextSentencer_T291

37171-37368

Sentence

denotes

After 4 years of monitoring, a greater risk of hypertension and problematic kidney function after exposure to C. jejuni and E. coli O157:H7 has been observed in hydric outbreaks of gastroenteritis.

TextSentencer_T291

37171-37368

Sentence

denotes

After 4 years of monitoring, a greater risk of hypertension and problematic kidney function after exposure to C. jejuni and E. coli O157:H7 has been observed in hydric outbreaks of gastroenteritis.

TextSentencer_T292

37369-37564

Sentence

denotes

Autoimmune diseases (Graves' disease, autoimmune tiroiditis, Kawasiki disease, Sjogren syndrome, and psoriasis) have been related to previous intestinal infections by Staphylococcus and Yersinia.

TextSentencer_T292

37369-37564

Sentence

denotes

Autoimmune diseases (Graves' disease, autoimmune tiroiditis, Kawasiki disease, Sjogren syndrome, and psoriasis) have been related to previous intestinal infections by Staphylococcus and Yersinia.

TextSentencer_T293

37565-37693

Sentence

denotes

The aftereffects of viral intestinal processes are less well known due to limitations of diagnosis in conventional laboratories.

TextSentencer_T293

37565-37693

Sentence

denotes

The aftereffects of viral intestinal processes are less well known due to limitations of diagnosis in conventional laboratories.

TextSentencer_T294

37694-37806

Sentence

denotes

Some of them are fibromyalgia or chronic fatigue syndrome (CFS), and chronic inflammatory muscle disease (CIMD).

TextSentencer_T294

37694-37806

Sentence

denotes

Some of them are fibromyalgia or chronic fatigue syndrome (CFS), and chronic inflammatory muscle disease (CIMD).

TextSentencer_T295

37807-37965

Sentence

denotes

Studies of stomach biopsies and the presence of enterovirus in skeletal muscles suggest the persistence of infection with viral replication in these patients.

TextSentencer_T295

37807-37965

Sentence

denotes

Studies of stomach biopsies and the presence of enterovirus in skeletal muscles suggest the persistence of infection with viral replication in these patients.

TextSentencer_T296

37966-38215

Sentence

denotes

Some cohort studies carried out in the United States suggest that children between 6 and 36 months of age infected by norovirus, sapovirus, or rotavirus are at greater risk of displaying persistent diarrhea in the 6 months following viral infection.

TextSentencer_T296

37966-38215

Sentence

denotes

Some cohort studies carried out in the United States suggest that children between 6 and 36 months of age infected by norovirus, sapovirus, or rotavirus are at greater risk of displaying persistent diarrhea in the 6 months following viral infection.

TextSentencer_T297

38216-38404

Sentence

denotes

Cross-sectional epidemiological studies and prospective studies in children have suggested the importance of enteric viral infections in the development of autoimmune celiac disease (ACD).

TextSentencer_T297

38216-38404

Sentence

denotes

Cross-sectional epidemiological studies and prospective studies in children have suggested the importance of enteric viral infections in the development of autoimmune celiac disease (ACD).

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