Management of Food-Related Diarrhea Outbreak in the Emergency Department: Lessons Learned from the German STEC O104:H4 Epidemic
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Management of Food-Related Diarrhea Outbreak in the Emergency Department: Lessons Learned from the German STEC O104:H4 Epidemic. / Sayk, Friedhelm; Asselborn, Niels Henrik; Eisemann, Nora; Katalinic, Alexander; Metzner, Jörg; Wolfrum, Sebastian; Fellermann, Klaus; Knobloch, Johannes; Nitschke, Martin.
in: BIOMED RES INT , Jahrgang 2015, 2015, S. 480680.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Management of Food-Related Diarrhea Outbreak in the Emergency Department: Lessons Learned from the German STEC O104:H4 Epidemic
AU - Sayk, Friedhelm
AU - Asselborn, Niels Henrik
AU - Eisemann, Nora
AU - Katalinic, Alexander
AU - Metzner, Jörg
AU - Wolfrum, Sebastian
AU - Fellermann, Klaus
AU - Knobloch, Johannes
AU - Nitschke, Martin
PY - 2015
Y1 - 2015
N2 - Emergency department (ED) management of the German STEC O104:H4 outbreak in 2011 was not limited to patients being truly infected with STEC. In parallel to spread of alarming news in public media, patients suffering from diarrhea due to other reasons fearfully presented, equally. We retrospectively characterized these two cohorts for anamnestic, clinical, and laboratory findings at their first ED contact. From 15th of May to July 2011, 302 adult patients with diarrheal complaint presented at the EDs of two tertiary hospitals in Lubeck, northern Germany. Fecal testing for STEC was obtained in 245 (81%) patients: 105 were STEC-positive and 140 were STEC-negative. Anamnestic characteristics (defecation rate, visible bloody diarrhea, and lower abdominal pain), abdominal tenderness, and some laboratory findings were significantly different between both cohorts but not reliable to exclude STEC. In >90% of STEC-positive patients diarrheal symptoms had started in May, reflecting the retrospective nationwide peak of infections, whereas the majority of STEC-negative patients became symptomatic in June 2011. During the German STEC O104:H4 outbreak a definite distinction at initial ED contact between STEC-positive versus STEC-negative patients by clinical judgment alone was not reliable. Fecal testing in the ED, however, might survey the outbreak of foodborne infections with the utmost precision.
AB - Emergency department (ED) management of the German STEC O104:H4 outbreak in 2011 was not limited to patients being truly infected with STEC. In parallel to spread of alarming news in public media, patients suffering from diarrhea due to other reasons fearfully presented, equally. We retrospectively characterized these two cohorts for anamnestic, clinical, and laboratory findings at their first ED contact. From 15th of May to July 2011, 302 adult patients with diarrheal complaint presented at the EDs of two tertiary hospitals in Lubeck, northern Germany. Fecal testing for STEC was obtained in 245 (81%) patients: 105 were STEC-positive and 140 were STEC-negative. Anamnestic characteristics (defecation rate, visible bloody diarrhea, and lower abdominal pain), abdominal tenderness, and some laboratory findings were significantly different between both cohorts but not reliable to exclude STEC. In >90% of STEC-positive patients diarrheal symptoms had started in May, reflecting the retrospective nationwide peak of infections, whereas the majority of STEC-negative patients became symptomatic in June 2011. During the German STEC O104:H4 outbreak a definite distinction at initial ED contact between STEC-positive versus STEC-negative patients by clinical judgment alone was not reliable. Fecal testing in the ED, however, might survey the outbreak of foodborne infections with the utmost precision.
KW - Adult
KW - Diarrhea
KW - Disease Outbreaks
KW - Emergency Service, Hospital
KW - Escherichia coli Infections
KW - Female
KW - Food Microbiology
KW - Germany
KW - Humans
KW - Male
KW - Middle Aged
KW - Shiga-Toxigenic Escherichia coli
KW - Journal Article
U2 - 10.1155/2015/480680
DO - 10.1155/2015/480680
M3 - SCORING: Journal article
C2 - 26539499
VL - 2015
SP - 480680
JO - BIOMED RES INT
JF - BIOMED RES INT
SN - 2314-6133
ER -