Abstract
Symptom profiles have previously been identified for infectious intestinal disease (IID) which distinguish bacterial from viral organisms. However, there is evidence that the seasonality, severity, and duration of IID may differ between children, adults and elderly. A secondary data analysis was undertaken to explore whether symptom profiles for bacterial and viral IID vary across different age groups. Data from 844 cases of IID were divided into three age categories: <16 years, 16–65 years and >65 years. Multivariable logistic regression modelling was used to compare the significance of different symptoms across the three age groups. The odds of bacterial IID in children were increased by onset in the summer, diarrhoea in the absence of vomiting and fever. These symptoms were also associated with lower odds of a viral pathogen. In adults, diarrhoea but no vomiting, bloody diarrhoea and diarrhoea lasting more than 3 days were associated with increased odds of a bacterial organism, whilst onset in the winter or spring and a loss of appetite were associated with viral IID. In the elderly, diarrhoea in the absence of vomiting and diarrhoea lasting more than 3 days were associated with higher odds of bacterial IID and lower odds of a viral cause. Only diarrhoea in the absence of vomiting emerged as a key symptom across all three age groups. Variation in symptom profiles by age has implications for clinicians, public health specialists and epidemiologists who use symptoms to guide presumptive diagnoses in the absence of microbiological confirmation.
| Original language | English |
|---|---|
| Article number | e0269676 |
| Journal | PLoS ONE |
| Volume | 17 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 30 Jun 2022 |
Bibliographical note
Funding Information: This research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with University of East Anglia, University of Oxford and the Quadram Institute [Grant number NIHR HPRU 2012-10038]. Anna Donaldson is a PhD student based at the University of Liverpool and Public Health England. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or Public Health England. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Open Access: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Publisher Copyright: © 2022 Donaldson et al.
Citation: Donaldson AL, Harris JP, Vivancos R, O’Brien SJ (2022) Symptom profiling for infectious intestinal disease (IID): Do symptom profiles alter with age? PLoS ONE 17(6): e0269676.
DOI: https://doi.org/10.1371/journal.pone.0269676
