Pathogens causing community gastroenteritis in Australia.

BACKGROUND AND AIM: Many individuals with gastrointestinal symptoms do not seek medical attention and so there is little known about the pathogens involved in most cases of community gastroenteritis. We aimed to identify the pathogens responsible for community gastroenteritis and to examine the associated symptoms. METHODS: In a prospective study of 2811 subjects over 15 months, fecal pathogens were examined following highly credible gastroenteritis (HCG) events. The population consisted of family units of at least two children (< or =15 years-old) and two adults each. Fecal samples were tested for a range of bacterial, viral and protozoal pathogens. Gastroenteric episode duration and symptoms such as vomiting, nausea and diarrhea were measured. RESULTS: One or more pathogens were identified in 198 of a total 791 specimens collected. Pathogens detected most often were Norovirus virus (10.7%), pathogenic E. coli (6.7%), Campylobacter spp. (3.0%) and Giardia sp. (2.5%). Children were more prone than adults to all the pathogens tested, except E. coli. Children infected with Campylobacter were 8.3 times more likely (95% CI: 2.7-25.4) to have a longer duration of diarrhea than children with Norovirus (P < 0.001). Similarly, children infected with E. coli had increased persistence of diarrhea compared to Norovirus (OR = 3.5; 95% CI: 1.3-9.5; P = 0.02). Infection with Norovirus in children meant greater persistence of vomiting symptoms than infection with Campylobacter (P = 0.005), E. coli (P = 0.03), or if no pathogen was identified (P = 0.004). Adults usually vomited for fewer days than children while duration of diarrhea was similar to children. CONCLUSIONS: Many of the pathogens responsible for cases of gastroenteritis in the Australian community are likely to go undetected by current surveillance systems and routine clinical practice.

Food safety in family homes in Melbourne, Australia.

Poor food handling practices in the home are a likely cause of gastroenteritis. This study examined how often reported practices in Australian homes met public health food safety recommendations. During 1998 in Melbourne, Australia, food handling and food storage questionnaires were completed by an adult member in 524 and 515 families, respectively. Each family consisted of at least two adults and two children. Respondents were surveyed regarding washing of hands, cutting boards, and fresh produce; use of kitchen cloths; egg storage; where cooked foods were cooled; the duration before refrigeration of cooked foods; where food types were positioned in the refrigerator; and the method of thawing chicken. Nearly every household reported handling food in a way that could cause food to become contaminated. Overall, 99.0% of respondents reported some form of mishandling, which encompassed 70.3% who handled food preparation surfaces poorly, 46.6% who did not wash their hands appropriately or in a timely manner, 41.7% who mishandled raw foods, and 70.1% who mishandled cooked foods. Food was inappropriately located in the refrigerator by 81.2%, and chicken was thawed using unsafe means by 76.3% of respondents. People preparing food in the home need to be reminded of the increased risk of disease that can arise from poor food handling practices.

A community-based study of respiratory episodes in Melbourne, Australia.

OBJECTIVE: To provide recent data regarding the epidemiology of community-based respiratory infections in Australia. METHODS: A longitudinal study between 1997-99 involving collection of a health diary from 600 families in Melbourne. RESULTS: More than 80% of study participants reported at least one respiratory episode over 15 months. An average of 2.2 respiratory episodes per person per year was reported, with a mean episode duration of 6.3 days. On average, subjects were symptomatic for 4.2% of the study days. Compared with other age groups, children aged less than two years were most likely to have at least one respiratory episode, a greater number of episodes per person and the longest episode duration (6.8 days). Approximately, one in three (28.7%) respiratory episodes were associated with a doctor's visit, and one in four (23%) necessitated time off school or work. Exposure to other people with respiratory symptoms was commonly reported. CONCLUSIONS: Respiratory infections are common, cause a significant amount of morbidity, and are major contributors to the total community health burden. IMPLICATIONS: The direct and indirect costs of respiratory infections to the community are substantial.