New GP study highlights the burden of acute gastroenteritis to general practice

19, January 2005. A Survey of General Practitioners’ has revealed that acute infectious gastroenteritis (GE) is one of the most common conditions seen by GP’s on the island of Ireland. The new study facilitated by safefood, the Food Safety Promotion Board entitled ‘Acute Gastroenteritis North and South’ found that GE accounts for 4.5% of all consultations per day on the island of Ireland. This makes acute gastroenteritis one of the commonest conditions seen in general practice. 

This study follows on from the population survey published in 2003 which analysed the incidence of GE from the patients perspective. Both survey’s were commissioned by safefood, the Food Safety Promotion Board in partnership with public health and academic bodies North and South.

This particular study designed to assess the impact of acute GE in General Practice and GP’s attitudes and practices with regard to the clinical management of their patients. The project also aimed to understand GP’s views on surveillance and notification of cases of GE as well as their interface with the public health system. The overall aim of these two studies is to develop better awareness and training among General Practitioners in the area of food safety and infectious intestinal illnesses.

GPs were almost unanimous in their approach to treatment with 93% claiming that they would advise patients to take extra fluids along with continued feeding especially for children, elderly and vulnerable patients. There was no consensus on the use of anti-diarrhoeal agents with GPs in the North less likely to prescribe them, compared with colleagues in the South.
 
To aid the diagnosis of acute GE during consultation with their patients, GPs looked at issues such as the level of exposure to unsafe foods, recent foreign travel and contact with other ill persons - all factors in the spread of infectious disease. It was unlikely though that the GP would question if the patient was a food handler or healthcare worker.

A significant issue highlighted in the South of Ireland was the lack of a clinical specimen collection service as applies in the North. 40% of GPs in the South, particularly in rural areas, compared with 16.7% of GPs in the North regularly faced problems with collection services and GPs often personally deliver samples to the laboratory or rely on the postal service.

Commenting on the report, Dr Margaret Fitzgerald, Chairperson of the steering committee said, “Acute gastroenteritis is a common illness in the community affecting over 8,000 patients every day North and South. Our study found that it is also a significant condition in General Practice with on average each GP seeing seven cases per week. The results will help to measure the true burden of the disease in primary care. Again the report highlighted where GPs could interact with their patients on prevention, hygiene, hand-washing, exclusion from work and safe food preparation in the prevention of acute GE. Another area highlighted is the need to develop transport for clinical specimens including stools in the South.

The study highlighted the need for improved liaison between general practice and public health in the area of infectious diseases. ‘A number of factors in the GPs management of patients with acute GE, were not fully understood including, exposure history, stool checks, treatment and advice, health education, high risk groups, notification and reporting to public health”, Dr Fitzgerald continued.

safefood is working in consultation with GPs in developing training material and guidelines in the management of food borne infections.

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For further information please contact

Amy Pilgrim or Sharon Murphy, WHPR, Tel: 01 669 0030
087 261 3300 (Amy) or 087 608 1316 (Sharon)

or

Fiona Gilligan, safefood, Tel: 01 448 0600

Editors Notes

The 2002 study entitled ‘Acute Gastroenteritis in Ireland, North and South’ found that there were 8,800 new cases of GE per day on the island of Ireland. 3100 of these claimed to have consulted with their GP.