Gastrointestinal infections presenting in general practice in Scotland

To determine the incidence of gastrointestinal infections (GII) presenting to general practitioners (GPs) in Scotland, To record the demographic and clinical characteristics of persons presenting with GII, To determine the proportion and characteristics of GII investigated in the laboratory, To report on the microbiological aetiology of the GII.

Descriptive epidemiological study.

Twenty three general practices in Scotland serving a total practice population of 152,471.

Patients consulting their GPs for a 'gastrointestinal infection' which met the study case definition.

These are presented for the 3872 patient consultations for GII between April 1996 and December 31st 1997 which met the survey case definition. The crude annual rate of new consultations recorded was 1.7 per 100 person years. The crude monthly consultation rate for new cases ranged between 11 and 18 per 10,000 patients. GPs notified 9% of the cases as 'food poisoning'. A request for microbiological testing of samples at the local laboratory for clinical reasons was documented for 34% of cases with diarrhoea. The study laboratory received faecal samples by post from 66% of these cases. About one in five of the samples tested revealed evidence of infection with a common gastrointestinal pathogen. The pathogens most frequently reported were Campylobacter sp and Salmonella sp.

The incidence of consultations for GII in Scotland is similar to that recorded in a recent survey in England. The very low notification rate by GPs means that statutory notification by telephone or post is a poor basis for early warning of outbreaks. It is recommended that a pilot study of electronic notification using the NHS net is set up.