Abstract
PurposeOutbreaks of Campylobacter infection are common, but studies exploring the clinical features of acute illness in the outbreak setting are scarce in existing literature. The main purpose of the present study was to investigate the clinical features of self-reported acute illness in gastroenteritis cases during a large waterborne Campylobacter outbreak in Askøy municipality, Norway, in 2019.MethodsA web-based self-administered questionnaire, and invitation to participate was sent by the municipality of Askøy as text message to mobile phones using the municipality’s warning system to the inhabitants during the ongoing outbreak.ResultsOut of 3624 participants, 749 (20.7%) were defined as cases, of which 177 (23.6%) reported severe gastroenteritis. The most common symptoms were loose stools (90.7%), abdominal pain (89.3%) and diarrhea (88.9%), whereas 63.8% reported fever, 50.2% joint pain and 14.2% bloody stools. Tiredness, a symptom non-specific to gastroenteritis, was the overall most common symptom (91.2%).ConclusionAbout one in four of the cases reported symptoms consistent with severe gastroenteritis. We found more joint pain and less bloody stools than reported in published studies of laboratory confirmed campylobacteriosis cases. Tiredness was common in the current study, although rarely described in previous literature of acute illness in the outbreak setting.
Highlights
Campylobacter spp. is considered the most common bacterial cause of gastroenteritis worldwide, as well as in Europe and Norway [1,2,3]
Common symptoms of gastroenteritis caused by Campylobacter include loose stools, diarrhea (≥ 3 loose stools in 24 h), nausea, vomiting, abdominal pain, bloody stools and fever, and the severity varies from mild and self-limiting symptoms to lethal disease [6,7,8,9,10,11,12,13,14]
For the outcome severe gastroenteritis vs non-severe gastroenteritis, we further explored the associations by estimating relative risks (RRs) with 95% confidence intervals using a modified Poisson regression model [32], adjusting for sex and age
Summary
Campylobacter spp. is considered the most common bacterial cause of gastroenteritis worldwide, as well as in Europe and Norway [1,2,3]. Several studies report symptoms and clinical features of campylobacteriosis, but these studies were predominantly published in the period from late 1970s to 2000, and based mainly on surveillance data or sporadic cases of laboratory confirmed infection [7,8,9,10,11,12, 15, 16]. Such cases represent a selected group that may differ from the total symptomatic population in the community [17, 18].
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