Gastroenteritis in a Taipei emergency department: Aetiology and risk factors

A matched case-control study was used to determine pathogens and risk factors associated with gastroenteritis in a Taipei Emergency Department. Viruses (40.0%) were the leading cause of gastroenteritis, with noroviruses the most prevalent (33.2%). Bacteria were found in 26.0% of all cases, mostly suspected diarrheagenic E. coli (22.2%), followed by Salmonella spp. (5.4%) and Vibrio parahaemolyticus (4.2%). Giardia lamblia was identified in 16.4% of all cases. Statistical significance was noted for seven risk factors: taking antacids before gastroenteritis (OR=3.91; 95% CI, 2.13, 7.15), other household members with gastroenteritis (OR=5.18; 95% CI, 2.09, 12.85), attending a banquet (OR=1.93; 95% CI, 1.25, 2.98), eating out (OR=2.35; 95% CI, 1.30, 4.23), drinking bottled water (OR=1.72; 95% CI, 1.07, 2.75), eating honey peaches (OR=3.26; 95% CI, 1.24, 8.58), and eating raw oysters (OR=3.24; 95% CI, 1.02, 10.28). Eating out was identified as the highest risk behavior, as measured by population attributable risk fraction (PAR) (50.9%). Respective PAR values for drinking bottled water, attending a banquet and taking antacids before illness were 19.7%, 19.6% and 17.6%. Of these, additional research on bottled water appears to be the highest priority, because this is the first time it has been identified as a risk factor for gastroenteritis.