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Characteristics of Campylobacter, Salmonella Infections and Acute Gastroenteritis in Older Adults in Australia, Canada, and the United States.

Background
The early detection of enteric infections in older adults is challenging because typical signs and symptoms of disease may be less common, absent, or overlooked. Understanding illness characteristics of enteric infections among older adults could improve the timeliness and accuracy of clinical diagnoses, thereby improving patient outcomes and increasing cases reported to surveillance.


Methods
This study describes illness characteristics (percentage reporting bloody diarrhea, fever, vomiting, abdominal pain, percentage hospitalized, duration of hospitalization, and duration of illness) among older adults (≥65 years) with acute gastroenteritis and culture-confirmed Campylobacter and nontyphoidal Salmonella infections in Australia, Canada, and the United States, and compares these characteristics with those among younger adults (25-64 years) and children (<5 years, 5-24 years).


Results
A significant negative correlation was found between all symptoms and increasing age group, except for bloody diarrhea in cases of acute gastroenteritis. Adults ≥85 years old reported bloody diarrhea in only 9% of nontyphoidal Salmonella and 4% of Campylobacter infections, compared with 59% and 55% among children aged <5 years. Conversely, a greater percentage of older adults (≥65) than younger persons (<5, 5-24, 25-64) reported being hospitalized, with an increasing linear relationship in age groups 65 years and older.


Conclusions
Although older adults are more likely to have severe illness and be hospitalized, this study found that the proportion of persons reporting symptoms typically associated with enteric infections decreases with age. These findings have implications for clinical recognition and treatment of gastrointestinal illness, as well as for public health research.