Problems in the diagnosis of foodborne infection in general practice

Abstract

SUMMARYThe incidence of acute gastroenteritis and self suspected food poisoning in general practice populations was compared with consultation rates in four group practices during a 3-month winter period and a 2-month autumn period. The average monthly consultation rate for acute gastroenteritis and self suspected food poisoning was 0 3 % and 0-06 % respectively. However, over the same period, on average, an estimated 7 % of the practice population per month reported an acute gastroenteritis illness, and 0 7 % suspected a food poisoning illness. Only about one in 26 people who suffer an acute episode of gastroenteritis consult their general practitioner (GP). In two practices, faecal samples were sought from all patient cases; the isolation rate for salmonellas was 2% (3/191) and for campylobacters it was 12% (23/191). In the other two practices following routine management, the isolation rate for salmonellas was 9 % (6/64) and for campylobacters it was 2% (1/64). Isolation of faecal pathogens was not associated with patients' suspicion of food poisoning. A history of eating out in the week before onset was associated with a significantly increased yield of salmonellas and campylobacters.

Factors Associated with Seeking Medical Care and Submitting a Stool Sample in Estimating the Burden of Foodborne Illness

“…In this study, 20% of respondents with an acute diarrheal illness reported seeking medical care. This rate is similar to those reported in Australia, Canada, and Ireland (Scallan et al, 2005), but higher than that reported for the Netherlands (de Wit et al, 2000; and England and Wales (Palmer et al, 1996).…”

Self-Reported Diarrhea in a Control Group: A Strong Association with Reporting of Low-Pressure Events in Tap Water

“…These 4 persons were excluded from this analysis. Thus, the incidence of diarrhea in our control group was 86 cases per 100 person-years, which is in line with previous retrospective studies in the United Kingdom [3][4][5]. Statistical analysis in this study was identical to that used for the larger case-control study: the x 2 test or Fisher's exact test were used for univariable analysis, and logistic regression analysis was used for multivariable analysis [8].…”

Reported waterborne outbreaks of gastrointestinal disease in Australia are predominantly associated with recreational exposure

“…Such variations in outbreak reports from different jurisdictions highlights that differing effort and experience among surveillance personnel may lead to nonuniformities in outbreak identification and classification. 12,13 Outbreaks of gastroenteritis may be difficult for health authorities to recognise, as illness is often mild and selflimiting.…”