Abstract
BackgroundData describing the epidemiology and management of viral acute diarrhea (AD) in adults are scant. The objective of this study was to identify the incidence, clinical characteristics, management and risk factors of winter viral AD in adults.MethodsThe incidence of AD in adults during two consecutive winters (from December 2010 to April 2011 and from December 2011 to April 2012) was estimated from the French Sentinelles network. During these two winters, a subset of Sentinelles general practitioners (GPs) identified and included adult patients who presented with AD and who filled out a questionnaire and returned a stool specimen for virological examination. All stool specimens were tested for astrovirus, group A rotavirus, human enteric adenovirus, and norovirus of genogroup I and genogroup II. Age- and sex-matched controls were included to permit a case–control analysis with the aim of identifying risk factors for viral AD.ResultsDuring the studied winters, the average incidence of AD in adults was estimated to be 3,158 per 100,000 French adults (95% CI [2,321 – 3,997]). The most reported clinical signs were abdominal pain (91.1%), watery diarrhea (88.5%), and nausea (83.3%). GPs prescribed a treatment in 95% of the patients with AD, and 80% of the working patients with AD could not go to work. Stool examinations were positive for at least one enteric virus in 65% (95% CI [57 – 73]) of patients with AD with a predominance of noroviruses (49%). Having been in contact with a person who has suffered from AD in the last 7 days, whether within or outside the household, and having a job (or being a student) were risk factors significantly associated with acquiring viral AD.ConclusionsDuring the winter, AD of viral origin is a frequent disease in adults, and noroviruses are most often the cause. No preventable risk factor was identified other than contact with a person with AD. Thus, at the present time, reinforcement of education related to hand hygiene remains the only way to reduce the burden of disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0574-4) contains supplementary material, which is available to authorized users.
Highlights
Data describing the epidemiology and management of viral acute diarrhea (AD) in adults are scant
Incidence rates in general practice During the two winters studied, 370 general practitioner (GP) participated in the electronic surveillance, and 10,415 AD cases were reported
The median age of adult patients seen by the Sentinelles GPs over the two consecutive winters was 37 years (IQ = [27 – 52]) and 36 years (IQ = [27 – 51]), respectively; the proportion of men was 46.2% and 45.4% over the two winters, respectively
Summary
Data describing the epidemiology and management of viral acute diarrhea (AD) in adults are scant. During the 1995–1996 winter, risk factors shown to be associated with AD in France included contact with a person with AD, living with a child ≤2 years of age, and recent treatment with oral penicillin or cephalosporin [5]. In the Netherlands, hand hygiene and contact with a sick person were identified as risk factors for viral gastroenteritis related to caliciviruses and group A rotavirus infections, but approximately 90% of the included patients were
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