Seasonal Gastroenteritis and Malabsorption at an American Military Base in the Philippines

Abstract

Dean and G. W. Parker. Seasonal gastroenteritis and malabsorption at an American military base in the Philippines. II. Malabsorption following the acute illness. Am J Epidemiol 95: 128-139, 1972.-In two epidemics of gastroenteritis at Clark Air Base in the Philippines, intestinal malabsorption was documented during the acute illness and for varying periods thereafter. The acute illness subsided in 1-5 days, but in 22% of 234 patients it was followed by prolonged symptoms of fatigue, nausea, abdominal discomfort, loose stools and weight loss. Xylose absorption was frequently abnormal during the first few days of illness, but lactose tolerance, intestinal lactase and sucrase levels, and intestinal morphology usually were normal. After the first week, tests of intestinal function usually were abnormal in patients with persistent symptoms and also, with a lesser frequency, in those who had become asymptomatic after the acute illness. The prolonged illness resembled tropical sprue and appeared to respond to therapy with tetracycline and folic acid. No epidemiologic differences were found between patients who recovered quickly from the acute gastroenteritis and those who had prolonged symptoms except that the latter group was slightly older. A single cause, of unknown nature, apparently produces annual seasonal epidemics with a spectrum of symptoms and signs ranging from acute gastroenteritis to mild tropical sprue. The epidemics at Clark Air Base provide a unique opportunity to study the etiology of tropical sprue and its relationship to acute gastroenteritis.

Opportunistic pathogens relative to physicochemical factors in water storage tanks

“…Even though algae in a freshwater environment are considered to be less toxic than cyanobacteria, the presence of both in freshwater storage tanks may have a significant effect on human health. Gastroenteritis and malabsorption on an airbase in the Philippines affected a large number of residents who suffered from diarrhoea, abdominal cramps and vomiting, which may be attributed to the presence of algae and microbes (Dean & Jones 1972). The presence of algae, cyanobacteria, bacteria and fungi in water tanks may be one of the factors contributing to gastrointestinal illnesses (Morin et al 1999;Payment 1999;Volk & LeChevallier 2000;Oberholster & Botha 2007).…”

Seasonal Gastroenteritis and Malabsorption at an American Military Base in the Philippines

“…rheal disease of unknown cause occur annually in the months from March through At Clark Air Base in central Luzon, Republic of the Philippines, epidemics of diar-July. The 1969 epidemic began in March and ended by late July, affecting an estimated 5,000-6,000 Americans of the 36,000 attached to the base (1). About 1,300 sought medical attention.…”

“…This report describes the microbiologic investigations and human volunteer studies. Epidemiologic and clinical studies are recorded elsewhere (1,2).…”

“…Essentially all the known infectious causes of diarrhea epidemics have been looked for in this study, and none found to be responsible for the epidemic. There is no epidemiologic evidence for staphylococcal or clostridial food poisoning or for organic or inorganic chemical poisoning (1). The possibility remains that a causative microorganism is either producing a toxin or multiplying in the host intestine or both.…”

Sprue in the Middle East: five case reports

“…It is recognized that a temporary phase of malabsorption may occur following acute gastrointestinal infections in Australian (King and Joske, 1960), Pakistani (Lindenbaum, 1965), and British patients (Montgomery, Beale, Sammons, and Schneider, 1973 Swanson, 1968;Mathan and Baker, 1970;O'Brien and England, 1971). This tends to support the concept that an unknown transmissible agent is the initiating factor in tropical sprue Dean and Jones, 1972), while folate and vitamin B12 deficiency play a part in perpetuation of the disease (Foroozan and Trier, 1967;O'Brien an-d England, 1971;Lindenbaum and Pezzimenti, 1972;Hermos, Adams, and Liu, 1972). Contamination of the jejunum by colonic bacteria may be a further perpetuating factor, but the role of this bacterial overgrowth is not completely understood Mollin and Booth, 1971).…”