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Characteristics of hospitalized patients during a large waterborne outbreak of Campylobacter jejuni in Norway.

ABSTRACT: Very few reports describe all hospitalized patients with campylobacteriosis in the setting of a single waterborne outbreak. This study describes the demographics, comorbidities, clinical features, microbiology, treatment and complications of 67 hospitalized children and adults during a large waterborne outbreak of Campylobacter jejuni in Askoy, Norway in 2019, where more than 2000 people in a community became ill. We investigated factors that contributed to hospitalization and treatment choices. Data were collected from electronic patient records during and after the outbreak. Fifty adults and seventeen children were included with a biphasic age distribution peaking in toddlers and middle-aged adults. Most children, 14 out of 17, were below 4 years of age. Diarrhea was the most commonly reported symptom (99%), whereas few patients (9%) reported bloody stools. Comorbidities were frequent in adults (63%) and included cardiovascular disease, pre-existing gastrointestinal disease or chronic renal failure. Comorbidities in children (47%) were dominated by pulmonary and gastrointestinal diseases. Adult patients appeared more severely ill than children with longer duration of stay, higher levels of serum creatinine and CRP and rehydration therapy. Ninety-two percent of adult patients were treated with intravenous fluid as compared with 12% of children. Almost half of the admitted children received antibiotics. Two patients died, including a toddler. Both had significant complicating factors. The demographic and clinical findings presented may be useful for health care planning and patient management in Campylobacter outbreaks both in primary health care and in hospitals.

SUBMITTER: Mortensen N

PROVIDER: S-EPMC7987138 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:From 2007 to 2009, The Netherlands experienced a major Q fever epidemic, with higher hospitalization rates than the 2-5% reported in the literature for acute Q fever pneumonia and hepatitis. We describe epidemiological and clinical features of hospitalized acute Q fever patients and compared patients presenting with Q fever pneumonia with patients admitted for other forms of community-acquired pneumonia (CAP). We also examined whether proximity to infected ruminant farms was a risk factor for hospitalization.A retrospective cohort study was conducted for all patients diagnosed and hospitalized with acute Q fever between 2007 and 2009 in one general hospital situated in the high incidence area in the south of The Netherlands. Pneumonia severity scores (PSI and CURB-65) of acute Q fever pneumonia patients (defined as infiltrate on a chest x-ray) were compared with data from CAP patients. Hepatitis was defined as a >twofold the reference value for alanine aminotransferase and for bilirubin.Among the 183 hospitalized acute Q fever patients, 86.0% had pneumonia. Elevated liver enzymes (alanine aminotransferase) were found in 32.3% of patients, although hepatitis was not observed in any of them. The most frequent clinical signs upon presentation were fever, cough and dyspnoea. The median duration of admission was five days. Acute Q fever pneumonia patients were younger, had less co-morbidity, and lower PSI and CURB-65 scores than other CAP patients. Anecdotal information from attending physicians suggests that some patients were admitted because of severe subjective dyspnoea, which was not included in the scoring systems. Proximity to an infected ruminant farm was not associated with hospitalization.Hospitalized Dutch acute Q fever patients mostly presented with fever and pneumonia. Patients with acute Q fever pneumonia were hospitalized despite low PSI and CURB-65 scores, presumably because subjective dyspnoea was not included in the scoring systems.

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Characteristics of hospitalized patients during a large waterborne outbreak of Campylobacter jejuni in Norway.

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