Abstract
Less than half of stool samples from people symptomatic with infectious intestinal disease (IID) will identify a causative organism. A secondary data analysis was undertaken to explore whether symptomology alone could be used to make inferences about causative organisms. Data were utilised from the Second Study of Infectious Intestinal Disease in the Community. A total of 844 cases were analysed. Few symptoms differentiated individual pathogens, but grouping pathogens together showed that viral IID was more likely when symptom onset was in winter (odds ratio (OR) 2.08, 95% confidence interval (CI) 1.16-3.75) or spring (OR 1.92, 95% CI 1.11-3.33), the patient was aged under 5 years (OR 3.63, 95% CI 2.24-6.03) and there was loss of appetite (OR 2.19, 95% CI 1.29-3.72). The odds of bacterial IID were higher with diarrhoea in the absence of vomiting (OR 3.54, 95% CI 2.37-5.32), diarrhoea which persisted for >3 days (OR 2.69, 95% CI 1.82-3.99), bloody diarrhoea (OR 4.17, 95% CI 1.63-11.83) and fever (OR 1.67, 95% CI 1.11-2.53). Symptom profiles could be of value to help guide clinicians and public health professionals in the management of IID, in the absence of microbiological confirmation.
Highlights
Infectious intestinal disease (IID) is characterised by the acute onset of diarrhoea and/or vomiting in otherwise healthy people caused by an infectious, transmissible organism [1]
The odds of a viral cause of illness were higher when symptom onset was in winter or spring, the patient was under 5 years of age and there was loss of appetite
This study has identified that people with IID who reported symptoms of diarrhoea in the absence of vomiting, diarrhoea lasting for more 3 days, bloody diarrhoea and fever were at increased odds of having a bacterial pathogen
Summary
Infectious intestinal disease (IID) is characterised by the acute onset of diarrhoea and/or vomiting in otherwise healthy people caused by an infectious, transmissible organism [1]. The likelihood of identifying a causative organism has been found to be affected by factors such as age, sex, occupation, the absence of specific symptoms such as vomiting, and the timing of the stool sample in relation to symptom onset [1]. Other factors such as the volume of the sample, the performance of the microbiological test and local organism testing policies may impact on the isolation of organisms [6, 7]
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