Acute diarrhea in adults consulting a general practitioner in France during winter: incidence, clinical characteristics, management and risk factors

BMC Infectious Diseases

Thomas Hanslik⁴  Alessandra Falchi⁷  Thierry Blanchon⁵  Cécile Souty⁵  Jean Arrighi⁶  Laurent Varesi⁸  Nathalie Jourdan-Da Silva¹  Roxane Chikhi-Brachet³  Katia Ambert-Balay²  Véronique Vaillant¹  Jean Pierre Amoros⁶  Christophe Arena⁶ 

[1] Department of Infectious Diseases, Institut de Veille Sanitaire (InVS) (French Institute for Public Health Surveillance), Saint-Maurice, France;National Reference Center for Enteric Viruses, Laboratory of Virology, CHU of Dijon, Dijon, France;French National Agency for Research on AIDS and Viral Hepatitis, Paris, France;UFR des Sciences de la Santé Simone-Veil, Université de Versailles - Saint-Quentin-en-Yvelines, Versailles, F-78280, France;Sorbonne Universités, UPMC Univ Paris 06, UMRS 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, F-75013, France;Regional Observatory of Health of Corsica, Ajaccio, France;INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, F-75013, France;Laboratory of Virology, EA7310, University of Corsica, Corte, France

关键词: Rotavirus;    Norovirus;    Gastroenteritis;    Surveillance;    Adults;    General practice;    Diarrhea;   

Others  :  1122136
DOI  :  10.1186/s12879-014-0574-4

 received in 2014-07-03, accepted in 2014-10-17,  发布年份 2014

【 摘 要 】

Background

Data 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.

Methods

The 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.

Results

During 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.

Conclusions

During 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.

【 授权许可】

   
2014 Arena et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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