Table 3.
Clinical Symptoms and Severity of Illness for Inpatient AGE cases, Overall and by Single and Multiple Pathogensa
| AGE (n = 724) | C. difficile(n = 120) | Norovirus (n = 27) | Campylobacter spp. (n = 22) | Shigella/EIEC (n = 10) | Salmonella spp. (n = 10) | Rotavirus (n = 11) | Multiple co-pathogens (n = 20) | |
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| Frequency of clinical symptoms, n (%) | ||||||||
| Fever | 164/718 (23) | 19/118 (16) | 4/27 (15) | 6/22 (27) | 5/10 (50) | 2/10 (20) | 3/11 (27) | 5/20 (25) |
| Diarrhead | 680/723 (94) | 118/120 (98) | 27/27 (100) | 22/22 (100) | 10/10 (100) | 10/10 (100) | 11/11 (100) | 19/19 (100) |
| Vomiting | 378/724 (52) | 56/120 (47) | 23/27 (85) | 7/22 (32) | 5/10 (50) | 1/10 (10) | 8/11 (73) | 12/20 (60) |
| Only diarrhea | 346/723 (48) | 64/120 (53) | 4/27 (15) | 15/22 (68) | 5/10 (50) | 9/10 (90) | 3/11 (27) | 8/19 (42) |
| Only vomiting | 43/723 (6) | 2/120 (2) | 0 | 0 | 0 | 0 | 0 | 0 |
| Duration of clinical symptoms in days, median (range; IQR) | ||||||||
| Fever at enrollment | 2 (1–10; 1–4) | 3 (1–8; 2–4) | 1 (1–1; 1–1) | 3 (3–5; 3–3) | 2 (1–4; 2–2) | 2 (1–2; 1–2) | 1 (1–1; 1–1) | 2 (1–8; 1–4) |
| Diarrhea in 24 hours, episodes | 5 (1–48; 4–8) | 5 (1–30; 3–7) | 5 (2–40; 4–15) | 8 (3–30; 5–20) | 7 (4–20; 4–10) | 13 (4–30; 8–20) | 10 (4–20; 5–15) | 5 (2–20; 4–10) |
| Vomiting in 24 hours, episodes | 3 (1–118; 2–6) | 3 (1–118; 2–6) | 4 (1–20; 2–11) | 2 (1–7; 1–3) | 3 (1–4; 1–3) | 4 (4–4; 4–4) | 3 (1–15; 2–12) | 2 (1–11; 2–5) |
| Illness at enrollment | 4 (1–10; 3–6) | 4 (1–10; 3–7) | 3 (1–10; 2–5) | 4 (1–10; 4–6) | 5 (2–9; 4–7) | 5 (3–10; 4–5) | 4 (2–7; 4–5) | 4 (2–10; 3–5) |
| Illness at follow-up | 7 (1–15; 4–9) | 7 (1–14; 4–9) | 6 (1–12; 3–7) | 8 (1–15; 6–9) | 7 (2–11; 4–10) | 7 (3–10; 7–10) | 7 (2–12; 6–9) | 5 (2–15; 4–7) |
| Diarrhea at enrollment | 4 (1–10; 2–5) | 4 (1–10; 2–6) | 2 (1–10; 2–5) | 4 (1–10; 3–6) | 5 (2–9; 3–6) | 5 (3–10; 4–5) | 4 (1–7; 2–5) | 3 (1–10; 2–5) |
| Diarrhea at follow-up | 6 (1–15; 4–8) | 6 (1–14; 4–8) | 4 (1–10; 2–7) | 7 (1–15; 6–9) | 6 (2–11; 4–9) | 7 (3–10; 7–10) | 7 (1–12; 6–8) | 5 (1–15; 3–6) |
| Vomiting at enrollment | 2 (1–10; 1–4) | 2 (1–9; 1–4) | 1 (1–6; 1–3) | 1 (1–7; 1–2) | 2 (1–4; 2–4) | 4 (4–4; 4–4) | 3 (1–3; 2–3) | 2 (1–6; 2–3) |
| Vomiting at follow-up | 3 (1–13; 2–5) | 3 (1–10; 2–6) | 2 (1–10; 1–5) | 3 (1–7; 2–4) | 4 (1–6; 2–4) | 6 (6–6; 6–6) | 3 (3–6; 3–4) | 3 (1–8; 2–4) |
| Severity of illness | ||||||||
| Modified Vesikari Score (MVS), median (range)b | 11 (4–19) | 10 (4–18) | 13 (8–17) | 11 (7–17) | 12 (10–16) | 11 (8–17) | 12 (9–18) | 12 (7–16) |
| Mild MVS, n (%) | 38 (6) | 4 (4) | 0 | 0 | 0 | 0 | 0 | 0 |
| Moderate MVS, n (%) | 293 (42) | 56 (49) | 7 (27) | 8 (36) | 2 (20) | 5 (50) | 3 (27) | 9 (47) |
| Severe MVS, n (%) | 362 (52) | 54 (47) | 19 (73) | 14 (63) | 8 (80) | 5 (50) | 8 (73) | 10 (53) |
| ICU stay, n (%) | 89/724 (12) | 20/120 (17) | 2/27 (7) | 1/22 (5) | 2/10 (20) | 0 | 1/11 (9) | 3/20 (15) |
| Duration of ICU stay in days, median (range; IQR) | 3 (1–38; 2–6) | 2 (1–11; 2–6) | 11 (10–12; 10–12) | 2 (2–2; 2–2) | 3 (1–4; 1–4) | 0 | 2 (2–2; 2–2) | 3 (3–4; 3–4) |
| Duration of hospital stay in days, median (range; IQR) | 5 (1–196; 3–10) | 6 (2–72; 3–16) | 4 (1–66; 2–8) | 4 (2–26; 3–7) | 3 (1–26; 3–5) | 4 (2–8; 3–6) | 4 (2–38; 2–6) | 5 (1–28; 3–8) |
| Duration of hospital stay for community-onset cases | 4 (1–95; 3–7) | 5 (2–72; 3–8) | 3 (1–13; 2–7) | 4 (2–8; 3–6) | 3 (1–26; 3–5) | 4 (2–8; 3–6) | 4 (2–38; 2–6) | 5 (1–20; 3–7) |
| Duration of hospital stay for hospital-onset cases | 15 (1–196; 9–24) | 20 (5–51; 11–24) | 36 (6–66; 6–66) | 26 (26–26; 26–26) | 0 | 0 | 0 | 18 (8–28; 8–28) |
| 23 hour stay, n (%) | 86/724 (12) | 12/120 (10) | 6/27 (22) | 2/22 (9) | 1/10 (10) | 0 | 1/11 (9) | 3/20 (15) |
| Death, n (%)c | 17/723 (2) | 3/120 (3) | 1/27 (4) | 0 | 0 | 0 | 0 | 0 |
Pathogen-specific columns include AGE cases with single pathogen detections, independent of the other 5 pathogens in the table. Any co-detection (≥2) between the six pathogens are included in the multiple co-pathogens column.
If cases were missing data for certain measurements, a Vesikari score was not assigned, pathogen (% missing): AGE (4%), Norovirus (3%), C. difficile (6%), Salmonella (8%). Modified Vesikari scoring was defined as follows: Mild (0–6), Moderate (7–10), Severe (≥11). See supplementary appendix for scoring components.
Among these deaths, 14 occurred while hospitalized. Three deaths occurred within 1–12 days following discharge; one died in inpatient hospice, one died within 24 hours of transferring to inpatient palliative care, and one died after discharge. Deaths following discharge were ascertained when attempting the follow-up interview at 3–5 weeks post-enrollment.
Campylobacter spp. includes jejuni, coli, and upsaliensis. EIEC=Enteroinvasive E. coli
Diarrhea was defined as 3 or more loose stools within a 24 hour period