Etiology of gastroenteritis in sentinel general practices in the Netherlands

Data from a general practice-based, case-control study on gastroenteritis a nd the pathogens related to this disease were used to study the association between specific pathogens and the infected patients' ages and symptoms. F or comparison, the occurrence of these pathogens in control patients, strat ified by age, also is presented. In children with gastroenteritis who were <5 years of age, rotavirus (in 21% of patients) and Norwalk-like virus (NLV ; in 15%) were the most common pathogens. Among patients who were 5-14 year s of age, Campylobacter species (in 16% of patients) and Giardia lamblia (i n 10%) were the most common pathogens. In the older patients, Campylobacter species was also the most common pathogen (8% to 15% of patients). In addi tion, several symptoms in case patients were associated with specific patho gens. Blood in the stool was associated with infection with Campylobacter s pecies. In patients with fever, Salmonella species, Campylobacter species, and rotavirus were detected relatively often. Vomiting was associated with NLV and rotavirus. This is the first study in The Netherlands and one of th e first studies in the world that has investigated a broad range of pathoge ns recovered from an unselected population of patients who had consulted ge neral practitioners because of gastroenteritis.