Question

Case
Complaint:
Five children from the same school presented with abdominal pain and diarrhea (streaked with blood) over a period of 3 days. Upon investigation it was found that those children had recently been in birthday party. Fecal specimen was collected and sent to microbiology lab. Lab report showed presence of pus cells on direct microscopy and non motile bacteria on motility test.

Clinical History: The children are usually healthy. They take no regular medications

- Identify a virus cause diarrhea with possibility of developing flaccid paralysis?

a) Polioviruses
b) rotavirus

With an explanation of the reason

Answer 1

b) Rotavirus causes acute diarrhoea with flaccid paralysis. It is a highly contagious virus.

It activates the enteric nervous system , nerves that control the movement of intestines and it's fluid absorption. The activated nerves stimulate the lining of intestinal epithelial cells and increase its watery secretion causing diarrhoea.

Reason for Rotavirus causing flaccid paralysis is :

Children with diarrhoea caused by Rotavirus, may be associated with febrile or afebrile seizures. This afebrile seizure leads to neurological complications like acute flaccid paralysis. This paralysis is excluded by RT- PCR (Reverse transcriptase polymerase chain reaction) from it's differential diagnosis of AFP by polio virus. Other tests like ELISA, Latex agglutination, viral nucleic acids in stool samples are used to detect the presence of rota virus.

Here polio is excluded as the incidence of diarrhoea due to polio virus is comparatively low than that caused due to rota virus.