Diarrheal Disease

Diarrheal Disease

Diarrhea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual). Frequent passing of formed stools is not diarrhea, nor is the passing of loose, "pasty" stools by breastfed babies. Diarrhea is usually a symptom of an infection in the intestinal tract, which can be caused by a variety of bacterial, viral and parasitic organisms. Infection is spread through contaminated food or drinking-water, or from person-to-person as a result of poor hygiene Diarrhea that lasts several days can leave the body without the water and salts that are necessary for survival. Most people who die from diarrhea actually die from severe dehydration and fluid loss1.


Diarrhea affects about 1.7 billion children worldwide and kills 525,000 children every year. Diarrhea is also the leading cause of malnutrition in children under five years old. Children who are malnourished or have impaired immunity are most at risk of life-threatening diarrhea1.

Dehydration is the most severe threat posed by diarrhea. During a diarrheal episode, water and electrolytes (sodium, chloride, potassium and bicarbonate) are lost through liquid stools, vomit, sweat, urine and breathing. Dehydration occurs when these losses are not replaced. Death can follow severe dehydration if body fluids and electrolytes are not replenished, either through the use of oral rehydration salts (ORS) solution, or through an intravenous drip.


In 2004, diarrhoeal disease was the third leading cause of death in low-income countries, causing 6.9% of deaths overall. In developing countries, children under three years old experience on average three episodes of diarrhoea every year. Each episode deprives the child of the nutrition necessary for growth. As a result, diarrhoea is a major cause of malnutrition, and malnourished children are more likely to fall ill from diarrhoea.


There are three clinical types of diarrhoea:

  • Acute watery diarrhoea – lasts several hours or days, and includes cholera.
  • Acute bloody diarrhoea – also called dysentery.
  • Persistent diarrhoea – lasts 14 days or longer.

The degree of dehydration is rated on a scale of three.

  • Early dehydration – no signs or symptoms.
  • Moderate dehydration:
    • thirst
    • restless or irritable behaviour
    • decreased skin elasticity
    • sunken eyes
  • Severe dehydration:
    • symptoms become more severe
    • shock, with diminished consciousness, lack of urine output, cool, moist extremities, a rapid and feeble pulse, low or undetectable blood pressure, and pale skin.


Key measures to prevent diarrhea include1:

  • access to safe drinking-water
  • improved sanitation
  • exclusive breastfeeding for the first six months of life
  • good personal and food hygiene
  • health education about how infections spread
  • rotavirus vaccination.

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