Clinical Features of Gastroenteritis During a Large Waterborne Campylobacter Outbreak in Askøy, Norway

Overview

Journal Infection

Date 2021 Jul 3

PMID 34215942

Citations 1

Authors

Knut Erik Emberland

K-A Wensaas

S Litleskare

A Iversen

K Hanevik

N Langeland

G Rortveit

Affiliations

Soon will be listed here.

Abstract

Purpose: Outbreaks 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.

Methods: A 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.

Results: Out 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%).

Conclusion: About 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.

Citing Articles

The impact on primary care of a large waterborne campylobacter outbreak in Norway: a controlled observational study.

Iversen A, Rortveit G, Wensaas K, Gulla C Scand J Prim Health Care. 2024; 42(1):187-194.

PMID: 38189827 PMC: 10851797. DOI: 10.1080/02813432.2023.2299116.

References

Sandberg M, Nygard K, Meldal H, Valle P, Kruse H, Skjerve E . Incidence trend and risk factors for campylobacter infections in humans in Norway. BMC Public Health. 2006; 6:179. PMC: 1550237. DOI: 10.1186/1471-2458-6-179. View

MacDonald E, White R, Mexia R, Bruun T, Kapperud G, Lange H . Risk Factors for Sporadic Domestically Acquired Campylobacter Infections in Norway 2010-2011: A National Prospective Case-Control Study. PLoS One. 2015; 10(10):e0139636. PMC: 4592224. DOI: 10.1371/journal.pone.0139636. View

Blaser M, Berkowitz I, LaForce F, CRAVENS J, Reller L, Wang W . Campylobacter enteritis: clinical and epidemiologic features. Ann Intern Med. 1979; 91(2):179-85. DOI: 10.7326/0003-4819-91-2-179. View

Butzler J . Campylobacter, from obscurity to celebrity. Clin Microbiol Infect. 2004; 10(10):868-76. DOI: 10.1111/j.1469-0691.2004.00983.x. View

de Wit M, Koopmans M, Kortbeek L, van Leeuwen N, Bartelds A, Van Duynhoven Y . Gastroenteritis in sentinel general practices,The Netherlands. Emerg Infect Dis. 2001; 7(1):82-91. PMC: 2631671. DOI: 10.3201/eid0701.010113. View

Kapperud G, Lassen J, Ostroff S, Aasen S . Clinical features of sporadic Campylobacter infections in Norway. Scand J Infect Dis. 1992; 24(6):741-9. DOI: 10.3109/00365549209062459. View

McKendrick M, Geddes A, Gearty J . Campylobacter enteritis: a study of clinical features and rectal mucosal changes. Scand J Infect Dis. 1982; 14(1):35-8. DOI: 10.3109/inf.1982.14.issue-1.07. View

Tribble D, Baqar S, Scott D, Oplinger M, Trespalacios F, Rollins D . Assessment of the duration of protection in Campylobacter jejuni experimental infection in humans. Infect Immun. 2010; 78(4):1750-9. PMC: 2849408. DOI: 10.1128/IAI.01021-09. View

White A, Ciampa N, Chen Y, Kirk M, Nesbitt A, Bruce B . Characteristics of Campylobacter and Salmonella Infections and Acute Gastroenteritis in Older Adults in Australia, Canada, and the United States. Clin Infect Dis. 2019; 69(9):1545-1552. PMC: 6606397. DOI: 10.1093/cid/ciy1142. View

10.

Thielman N, Guerrant R . Clinical practice. Acute infectious diarrhea. N Engl J Med. 2004; 350(1):38-47. DOI: 10.1056/NEJMcp031534. View

11.

Tam C, Rodrigues L, Viviani L, Dodds J, Evans M, Hunter P . Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice. Gut. 2011; 61(1):69-77. PMC: 3230829. DOI: 10.1136/gut.2011.238386. View

12.

Blaser M . Epidemiologic and clinical features of Campylobacter jejuni infections. J Infect Dis. 1997; 176 Suppl 2:S103-5. DOI: 10.1086/513780. View

13.

Marshall J, Thabane M, Garg A, Clark W, Salvadori M, Collins S . Incidence and epidemiology of irritable bowel syndrome after a large waterborne outbreak of bacterial dysentery. Gastroenterology. 2006; 131(2):445-50. DOI: 10.1053/j.gastro.2006.05.053. View

14.

Uotila T, Korpela M, Vuento R, Laine J, Lumio J, Kuusi M . Joint symptoms after a faecal culture positive Campylobacter infection associated with a waterborne gastroenteritis outbreak: a questionnaire study. Scand J Rheumatol. 2014; 43(6):524-6. DOI: 10.3109/03009742.2014.920916. View

15.

Wouters M, Van Wanrooy S, Nguyen A, Dooley J, Aguilera-Lizarraga J, Van Brabant W . Psychological comorbidity increases the risk for postinfectious IBS partly by enhanced susceptibility to develop infectious gastroenteritis. Gut. 2015; 65(8):1279-88. DOI: 10.1136/gutjnl-2015-309460. View

16.

Ruiz-Palacios G . The health burden of Campylobacter infection and the impact of antimicrobial resistance: playing chicken. Clin Infect Dis. 2007; 44(5):701-3. DOI: 10.1086/509936. View

17.

Ternhag A, Asikainen T, Giesecke J, Ekdahl K . A meta-analysis on the effects of antibiotic treatment on duration of symptoms caused by infection with Campylobacter species. Clin Infect Dis. 2007; 44(5):696-700. DOI: 10.1086/509924. View

18.

Mortensen N, Jonasson S, Lavesson I, Emberland K, Litleskare S, Wensaas K . Characteristics of hospitalized patients during a large waterborne outbreak of Campylobacter jejuni in Norway. PLoS One. 2021; 16(3):e0248464. PMC: 7987138. DOI: 10.1371/journal.pone.0248464. View

19.

Wensaas K, Langeland N, Hanevik K, Morch K, Eide G, Rortveit G . Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study. Gut. 2011; 61(2):214-9. DOI: 10.1136/gutjnl-2011-300220. View

20.

Litleskare S, Rortveit G, Eide G, Hanevik K, Langeland N, Wensaas K . Prevalence of Irritable Bowel Syndrome and Chronic Fatigue 10 Years After Giardia Infection. Clin Gastroenterol Hepatol. 2018; 16(7):1064-1072.e4. DOI: 10.1016/j.cgh.2018.01.022. View