Epidemiology and Infection

Research Article

Problems in the diagnosis of foodborne infection in general practice

S. Palmera1, H. Houstona2, B. Lervya3, D. Ribeiroa4 and P. Thomasa5

a1 PHLS Communicable Disease Surveillance Centre (Welsh Unit), Abton House, Wedal Road, Roath, Cardiff CF4 3QX

a2 The Health Centre, Plasmawr Road, Fairwater, Cardiff CF5 3JT, and Department of General Practice, UWCM

a3 Llys Meddyg, The Surgery, Sway Road, Morriston, Swansea and School of Postgraduate Studies, Swansea SA6 6NL

a4 Public Health Laboratory, University Hospital of Wales, Heath Park, Cardiff CF4 4XW

a5 Department of Medical Microbiology, Singleton Hospital, Sgeti, Abertawe, Swansea SA2 8QA

Summary

The incidence of acute gastroenteritis and self suspected food poisoning in general practice populations was compared with consultation rates in four group practices during a 3-month winter period and a 2-month autumn period. The average monthly consultation rate for acute gastroenteritis and self suspected food poisoning was 0·3 % and 0·06 % respectively. However, over the same period, on average, an estimated 7% of the practice population per month reported an acute gastroenteritis illness, and 0·7% suspected a food poisoning illness. Only about one in 26 people who suffer an acute episode of gastroenteritis consult their general practitioner (GP). In two practices, faecal samples were sought from all patient cases; the isolation rate for salmonellas was 2% (3/191) and for campylobacters it was 12% (23/191). In the other two practices following routine management, the isolation rate for salmonellas was 9% (6/64) and for campylobacters it was 2% (1/64). Isolation of faecal pathogens was not associated with patients' suspicion of food poisoning. A history of eating out in the week before onset was associated with a significantly increased yield of salmonellas and campylobacters.

(Accepted July 17 1996)

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