Although severe gastrointestinal illness and related hospitalization is more common in older adults, the number of individuals who report symptoms associated with enteric infections decreases with age, according to a study published in Clinical Infectious Diseases.

A team of researchers in the United States, Canada, and Australia used data from surveillance and epidemiologic studies to determine age-specific clinical characteristics among subjects with laboratory-confirmed Campylobacter infection, nontyphoidal Salmonella infections, and acute gastroenteritis.

Illness characteristics, including percentage reporting bloody diarrhea, fever, vomiting, abdominal pain, number of hospitalizations, duration of hospitalization, and duration of illness, among adults ≥65 years of age were compared with younger adults aged 25 to 64 years, children aged <5 years, and subjects aged 5 to 24 years.

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The investigators reported a significant negative correlation among age groups and all symptoms, excluding bloody diarrhea, among patients with acute gastroenteritis; only 9% and 4% of adults aged ≥85 years with nontyphoidal Salmonella and Campylobacter infections, respectively, reported bloody diarrhea compared with 59% and 55% of children <5 years with nontyphoidal Salmonella and Campylobacter infections, respectively.

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In contrast, the proportion of adults aged ≥65 years who reported being hospitalized was greater than in all younger groups.

“As the population ages, it is important to understand the clinical presentation of gastrointestinal illness in older adults to prioritize early recognition and rapid treatment to prevent hospitalizations and poor outcomes,” the authors wrote. “This study highlights the importance and challenges of early clinical detection of gastrointestinal illness in older adults and the need for research on age-specific risk factors, symptoms, and severity indicators associated with gastrointestinal illness.”


White AE, Ciampa N, Chen Y, et al. Characteristics of Campylobacter, Salmonella infections and acute gastroenteritis in older adults in Australia, Canada, and the United States [published online January 2, 2019]. Clin Infect Dis. doi:10.1093/cid/ciy1142