Table 3.

Clinical Symptoms and Severity of Illness for Inpatient AGE cases, Overall and by Single and Multiple Pathogensa

AGE (n = 724)C. difficile (n = 120)Norovirus (n = 27)Campylobacter spp. (n = 22)Shigella/ EIEC (n = 10)Salmonella spp. (n = 10)Rotavirus (n = 11)Multiple co-pathogens (n = 20)
Frequency of clinical symptoms, n (%)
 Fever164/718 (23)19/118 (16)4/27 (15)6/22 (27)5/10 (50)2/10 (20)3/11 (27)5/20 (25)
 Diarrhead680/723 (94)118/120 (98)27/27 (100)22/22 (100)10/10 (100)10/10 (100)11/11 (100)19/19 (100)
 Vomiting378/724 (52)56/120 (47)23/27 (85)7/22 (32)5/10 (50)1/10 (10)8/11 (73)12/20 (60)
 Only diarrhea346/723 (48)64/120 (53)4/27 (15)15/22 (68)5/10 (50)9/10 (90)3/11 (27)8/19 (42)
 Only vomiting43/723 (6)2/120 (2)000000
Duration of clinical symptoms in days, median (range; IQR)
 Fever at enrollment2 (1–10; 1–4)3 (1–8; 2–4)1 (1–1; 1–1)3 (3–5; 3–3)2 (1–4; 2–2)2 (1–2; 1–2)1 (1–1; 1–1)2 (1–8; 1–4)
 Diarrhea in 24 hours, episodes5 (1–48; 4–8)5 (1–30; 3–7)5 (2–40; 4–15)8 (3–30; 5–20)7 (4–20; 4–10)13 (4–30; 8–20)10 (4–20; 5–15)5 (2–20; 4–10)
 Vomiting in 24 hours, episodes3 (1–118; 2–6)3 (1–118; 2–6)4 (1–20; 2–11)2 (1–7; 1–3)3 (1–4; 1–3)4 (4–4; 4–4)3 (1–15; 2–12)2 (1–11; 2–5)
 Illness at enrollment4 (1–10; 3–6)4 (1–10; 3–7)3 (1–10; 2–5)4 (1–10; 4–6)5 (2–9; 4–7)5 (3–10; 4–5)4 (2–7; 4–5)4 (2–10; 3–5)
 Illness at follow-up7 (1–15; 4–9)7 (1–14; 4–9)6 (1–12; 3–7)8 (1–15; 6–9)7 (2–11; 4–10)7 (3–10; 7–10)7 (2–12; 6–9)5 (2–15; 4–7)
 Diarrhea at enrollment4 (1–10; 2–5)4 (1–10; 2–6)2 (1–10; 2–5)4 (1–10; 3–6)5 (2–9; 3–6)5 (3–10; 4–5)4 (1–7; 2–5)3 (1–10; 2–5)
 Diarrhea at follow-up6 (1–15; 4–8)6 (1–14; 4–8)4 (1–10; 2–7)7 (1–15; 6–9)6 (2–11; 4–9)7 (3–10; 7–10)7 (1–12; 6–8)5 (1–15; 3–6)
 Vomiting at enrollment2 (1–10; 1–4)2 (1–9; 1–4)1 (1–6; 1–3)1 (1–7; 1–2)2 (1–4; 2–4)4 (4–4; 4–4)3 (1–3; 2–3)2 (1–6; 2–3)
 Vomiting at follow-up3 (1–13; 2–5)3 (1–10; 2–6)2 (1–10; 1–5)3 (1–7; 2–4)4 (1–6; 2–4)6 (6–6; 6–6)3 (3–6; 3–4)3 (1–8; 2–4)
Severity of illness
Modified Vesikari Score (MVS), median (range)b11 (4–19)10 (4–18)13 (8–17)11 (7–17)12 (10–16)11 (8–17)12 (9–18)12 (7–16)
 Mild MVS, n (%)38 (6)4 (4)000000
 Moderate MVS, n (%)293 (42)56 (49)7 (27)8 (36)2 (20)5 (50)3 (27)9 (47)
 Severe MVS, n (%)362 (52)54 (47)19 (73)14 (63)8 (80)5 (50)8 (73)10 (53)
ICU stay, n (%)89/724 (12)20/120 (17)2/27 (7)1/22 (5)2/10 (20)01/11 (9)3/20 (15)
Duration of ICU stay in days, median (range; IQR)3 (1–38; 2–6)2 (1–11; 2–6)11 (10–12; 10–12)2 (2–2; 2–2)3 (1–4; 1–4)02 (2–2; 2–2)3 (3–4; 3–4)
Duration of hospital stay in days, median (range; IQR)5 (1–196; 3–10)6 (2–72; 3–16)4 (1–66; 2–8)4 (2–26; 3–7)3 (1–26; 3–5)4 (2–8; 3–6)4 (2–38; 2–6)5 (1–28; 3–8)
 Duration of hospital stay for community-onset cases4 (1–95; 3–7)5 (2–72; 3–8)3 (1–13; 2–7)4 (2–8; 3–6)3 (1–26; 3–5)4 (2–8; 3–6)4 (2–38; 2–6)5 (1–20; 3–7)
 Duration of hospital stay for hospital-onset cases15 (1–196; 9–24)20 (5–51; 11–24)36 (6–66; 6–66)26 (26–26; 26–26)00018 (8–28; 8–28)
23 hour stay, n (%)86/724 (12)12/120 (10)6/27 (22)2/22 (9)1/10 (10)01/11 (9)3/20 (15)
Death, n (%)c17/723 (2)3/120 (3)1/27 (4)00000
AGE (n = 724)C. difficile (n = 120)Norovirus (n = 27)Campylobacter spp. (n = 22)Shigella/ EIEC (n = 10)Salmonella spp. (n = 10)Rotavirus (n = 11)Multiple co-pathogens (n = 20)
Frequency of clinical symptoms, n (%)
 Fever164/718 (23)19/118 (16)4/27 (15)6/22 (27)5/10 (50)2/10 (20)3/11 (27)5/20 (25)
 Diarrhead680/723 (94)118/120 (98)27/27 (100)22/22 (100)10/10 (100)10/10 (100)11/11 (100)19/19 (100)
 Vomiting378/724 (52)56/120 (47)23/27 (85)7/22 (32)5/10 (50)1/10 (10)8/11 (73)12/20 (60)
 Only diarrhea346/723 (48)64/120 (53)4/27 (15)15/22 (68)5/10 (50)9/10 (90)3/11 (27)8/19 (42)
 Only vomiting43/723 (6)2/120 (2)000000
Duration of clinical symptoms in days, median (range; IQR)
 Fever at enrollment2 (1–10; 1–4)3 (1–8; 2–4)1 (1–1; 1–1)3 (3–5; 3–3)2 (1–4; 2–2)2 (1–2; 1–2)1 (1–1; 1–1)2 (1–8; 1–4)
 Diarrhea in 24 hours, episodes5 (1–48; 4–8)5 (1–30; 3–7)5 (2–40; 4–15)8 (3–30; 5–20)7 (4–20; 4–10)13 (4–30; 8–20)10 (4–20; 5–15)5 (2–20; 4–10)
 Vomiting in 24 hours, episodes3 (1–118; 2–6)3 (1–118; 2–6)4 (1–20; 2–11)2 (1–7; 1–3)3 (1–4; 1–3)4 (4–4; 4–4)3 (1–15; 2–12)2 (1–11; 2–5)
 Illness at enrollment4 (1–10; 3–6)4 (1–10; 3–7)3 (1–10; 2–5)4 (1–10; 4–6)5 (2–9; 4–7)5 (3–10; 4–5)4 (2–7; 4–5)4 (2–10; 3–5)
 Illness at follow-up7 (1–15; 4–9)7 (1–14; 4–9)6 (1–12; 3–7)8 (1–15; 6–9)7 (2–11; 4–10)7 (3–10; 7–10)7 (2–12; 6–9)5 (2–15; 4–7)
 Diarrhea at enrollment4 (1–10; 2–5)4 (1–10; 2–6)2 (1–10; 2–5)4 (1–10; 3–6)5 (2–9; 3–6)5 (3–10; 4–5)4 (1–7; 2–5)3 (1–10; 2–5)
 Diarrhea at follow-up6 (1–15; 4–8)6 (1–14; 4–8)4 (1–10; 2–7)7 (1–15; 6–9)6 (2–11; 4–9)7 (3–10; 7–10)7 (1–12; 6–8)5 (1–15; 3–6)
 Vomiting at enrollment2 (1–10; 1–4)2 (1–9; 1–4)1 (1–6; 1–3)1 (1–7; 1–2)2 (1–4; 2–4)4 (4–4; 4–4)3 (1–3; 2–3)2 (1–6; 2–3)
 Vomiting at follow-up3 (1–13; 2–5)3 (1–10; 2–6)2 (1–10; 1–5)3 (1–7; 2–4)4 (1–6; 2–4)6 (6–6; 6–6)3 (3–6; 3–4)3 (1–8; 2–4)
Severity of illness
Modified Vesikari Score (MVS), median (range)b11 (4–19)10 (4–18)13 (8–17)11 (7–17)12 (10–16)11 (8–17)12 (9–18)12 (7–16)
 Mild MVS, n (%)38 (6)4 (4)000000
 Moderate MVS, n (%)293 (42)56 (49)7 (27)8 (36)2 (20)5 (50)3 (27)9 (47)
 Severe MVS, n (%)362 (52)54 (47)19 (73)14 (63)8 (80)5 (50)8 (73)10 (53)
ICU stay, n (%)89/724 (12)20/120 (17)2/27 (7)1/22 (5)2/10 (20)01/11 (9)3/20 (15)
Duration of ICU stay in days, median (range; IQR)3 (1–38; 2–6)2 (1–11; 2–6)11 (10–12; 10–12)2 (2–2; 2–2)3 (1–4; 1–4)02 (2–2; 2–2)3 (3–4; 3–4)
Duration of hospital stay in days, median (range; IQR)5 (1–196; 3–10)6 (2–72; 3–16)4 (1–66; 2–8)4 (2–26; 3–7)3 (1–26; 3–5)4 (2–8; 3–6)4 (2–38; 2–6)5 (1–28; 3–8)
 Duration of hospital stay for community-onset cases4 (1–95; 3–7)5 (2–72; 3–8)3 (1–13; 2–7)4 (2–8; 3–6)3 (1–26; 3–5)4 (2–8; 3–6)4 (2–38; 2–6)5 (1–20; 3–7)
 Duration of hospital stay for hospital-onset cases15 (1–196; 9–24)20 (5–51; 11–24)36 (6–66; 6–66)26 (26–26; 26–26)00018 (8–28; 8–28)
23 hour stay, n (%)86/724 (12)12/120 (10)6/27 (22)2/22 (9)1/10 (10)01/11 (9)3/20 (15)
Death, n (%)c17/723 (2)3/120 (3)1/27 (4)00000

aPathogen-specific columns include AGE cases with single pathogen detections, independent of the other 5 pathogens in the table. Any co-detection (≥2) between the six pathogens are included in the multiple co-pathogens column.

bIf cases were missing data for certain measurements, a Vesikari score was not assigned, pathogen (% missing): AGE (4%), Norovirus (3%), C. difficile (6%), Salmonella (8%). Modified Vesikari scoring was defined as follows: Mild (0–6), Moderate (7–10), Severe (≥11). See supplementary appendix for scoring components.

cAmong these deaths, 14 occurred while hospitalized. Three deaths occurred within 1–12 days following discharge; one died in inpatient hospice, one died within 24 hours of transferring to inpatient palliative care, and one died after discharge. Deaths following discharge were ascertained when attempting the follow-up interview at 3–5 weeks post-enrollment.

Campylobacter spp. includes jejuni, coli, and upsaliensis. EIEC=Enteroinvasive E. coli

dDiarrhea was defined as 3 or more loose stools within a 24 hour period

Table 3.

Clinical Symptoms and Severity of Illness for Inpatient AGE cases, Overall and by Single and Multiple Pathogensa

AGE (n = 724)C. difficile (n = 120)Norovirus (n = 27)Campylobacter spp. (n = 22)Shigella/ EIEC (n = 10)Salmonella spp. (n = 10)Rotavirus (n = 11)Multiple co-pathogens (n = 20)
Frequency of clinical symptoms, n (%)
 Fever164/718 (23)19/118 (16)4/27 (15)6/22 (27)5/10 (50)2/10 (20)3/11 (27)5/20 (25)
 Diarrhead680/723 (94)118/120 (98)27/27 (100)22/22 (100)10/10 (100)10/10 (100)11/11 (100)19/19 (100)
 Vomiting378/724 (52)56/120 (47)23/27 (85)7/22 (32)5/10 (50)1/10 (10)8/11 (73)12/20 (60)
 Only diarrhea346/723 (48)64/120 (53)4/27 (15)15/22 (68)5/10 (50)9/10 (90)3/11 (27)8/19 (42)
 Only vomiting43/723 (6)2/120 (2)000000
Duration of clinical symptoms in days, median (range; IQR)
 Fever at enrollment2 (1–10; 1–4)3 (1–8; 2–4)1 (1–1; 1–1)3 (3–5; 3–3)2 (1–4; 2–2)2 (1–2; 1–2)1 (1–1; 1–1)2 (1–8; 1–4)
 Diarrhea in 24 hours, episodes5 (1–48; 4–8)5 (1–30; 3–7)5 (2–40; 4–15)8 (3–30; 5–20)7 (4–20; 4–10)13 (4–30; 8–20)10 (4–20; 5–15)5 (2–20; 4–10)
 Vomiting in 24 hours, episodes3 (1–118; 2–6)3 (1–118; 2–6)4 (1–20; 2–11)2 (1–7; 1–3)3 (1–4; 1–3)4 (4–4; 4–4)3 (1–15; 2–12)2 (1–11; 2–5)
 Illness at enrollment4 (1–10; 3–6)4 (1–10; 3–7)3 (1–10; 2–5)4 (1–10; 4–6)5 (2–9; 4–7)5 (3–10; 4–5)4 (2–7; 4–5)4 (2–10; 3–5)
 Illness at follow-up7 (1–15; 4–9)7 (1–14; 4–9)6 (1–12; 3–7)8 (1–15; 6–9)7 (2–11; 4–10)7 (3–10; 7–10)7 (2–12; 6–9)5 (2–15; 4–7)
 Diarrhea at enrollment4 (1–10; 2–5)4 (1–10; 2–6)2 (1–10; 2–5)4 (1–10; 3–6)5 (2–9; 3–6)5 (3–10; 4–5)4 (1–7; 2–5)3 (1–10; 2–5)
 Diarrhea at follow-up6 (1–15; 4–8)6 (1–14; 4–8)4 (1–10; 2–7)7 (1–15; 6–9)6 (2–11; 4–9)7 (3–10; 7–10)7 (1–12; 6–8)5 (1–15; 3–6)
 Vomiting at enrollment2 (1–10; 1–4)2 (1–9; 1–4)1 (1–6; 1–3)1 (1–7; 1–2)2 (1–4; 2–4)4 (4–4; 4–4)3 (1–3; 2–3)2 (1–6; 2–3)
 Vomiting at follow-up3 (1–13; 2–5)3 (1–10; 2–6)2 (1–10; 1–5)3 (1–7; 2–4)4 (1–6; 2–4)6 (6–6; 6–6)3 (3–6; 3–4)3 (1–8; 2–4)
Severity of illness
Modified Vesikari Score (MVS), median (range)b11 (4–19)10 (4–18)13 (8–17)11 (7–17)12 (10–16)11 (8–17)12 (9–18)12 (7–16)
 Mild MVS, n (%)38 (6)4 (4)000000
 Moderate MVS, n (%)293 (42)56 (49)7 (27)8 (36)2 (20)5 (50)3 (27)9 (47)
 Severe MVS, n (%)362 (52)54 (47)19 (73)14 (63)8 (80)5 (50)8 (73)10 (53)
ICU stay, n (%)89/724 (12)20/120 (17)2/27 (7)1/22 (5)2/10 (20)01/11 (9)3/20 (15)
Duration of ICU stay in days, median (range; IQR)3 (1–38; 2–6)2 (1–11; 2–6)11 (10–12; 10–12)2 (2–2; 2–2)3 (1–4; 1–4)02 (2–2; 2–2)3 (3–4; 3–4)
Duration of hospital stay in days, median (range; IQR)5 (1–196; 3–10)6 (2–72; 3–16)4 (1–66; 2–8)4 (2–26; 3–7)3 (1–26; 3–5)4 (2–8; 3–6)4 (2–38; 2–6)5 (1–28; 3–8)
 Duration of hospital stay for community-onset cases4 (1–95; 3–7)5 (2–72; 3–8)3 (1–13; 2–7)4 (2–8; 3–6)3 (1–26; 3–5)4 (2–8; 3–6)4 (2–38; 2–6)5 (1–20; 3–7)
 Duration of hospital stay for hospital-onset cases15 (1–196; 9–24)20 (5–51; 11–24)36 (6–66; 6–66)26 (26–26; 26–26)00018 (8–28; 8–28)
23 hour stay, n (%)86/724 (12)12/120 (10)6/27 (22)2/22 (9)1/10 (10)01/11 (9)3/20 (15)
Death, n (%)c17/723 (2)3/120 (3)1/27 (4)00000
AGE (n = 724)C. difficile (n = 120)Norovirus (n = 27)Campylobacter spp. (n = 22)Shigella/ EIEC (n = 10)Salmonella spp. (n = 10)Rotavirus (n = 11)Multiple co-pathogens (n = 20)
Frequency of clinical symptoms, n (%)
 Fever164/718 (23)19/118 (16)4/27 (15)6/22 (27)5/10 (50)2/10 (20)3/11 (27)5/20 (25)
 Diarrhead680/723 (94)118/120 (98)27/27 (100)22/22 (100)10/10 (100)10/10 (100)11/11 (100)19/19 (100)
 Vomiting378/724 (52)56/120 (47)23/27 (85)7/22 (32)5/10 (50)1/10 (10)8/11 (73)12/20 (60)
 Only diarrhea346/723 (48)64/120 (53)4/27 (15)15/22 (68)5/10 (50)9/10 (90)3/11 (27)8/19 (42)
 Only vomiting43/723 (6)2/120 (2)000000
Duration of clinical symptoms in days, median (range; IQR)
 Fever at enrollment2 (1–10; 1–4)3 (1–8; 2–4)1 (1–1; 1–1)3 (3–5; 3–3)2 (1–4; 2–2)2 (1–2; 1–2)1 (1–1; 1–1)2 (1–8; 1–4)
 Diarrhea in 24 hours, episodes5 (1–48; 4–8)5 (1–30; 3–7)5 (2–40; 4–15)8 (3–30; 5–20)7 (4–20; 4–10)13 (4–30; 8–20)10 (4–20; 5–15)5 (2–20; 4–10)
 Vomiting in 24 hours, episodes3 (1–118; 2–6)3 (1–118; 2–6)4 (1–20; 2–11)2 (1–7; 1–3)3 (1–4; 1–3)4 (4–4; 4–4)3 (1–15; 2–12)2 (1–11; 2–5)
 Illness at enrollment4 (1–10; 3–6)4 (1–10; 3–7)3 (1–10; 2–5)4 (1–10; 4–6)5 (2–9; 4–7)5 (3–10; 4–5)4 (2–7; 4–5)4 (2–10; 3–5)
 Illness at follow-up7 (1–15; 4–9)7 (1–14; 4–9)6 (1–12; 3–7)8 (1–15; 6–9)7 (2–11; 4–10)7 (3–10; 7–10)7 (2–12; 6–9)5 (2–15; 4–7)
 Diarrhea at enrollment4 (1–10; 2–5)4 (1–10; 2–6)2 (1–10; 2–5)4 (1–10; 3–6)5 (2–9; 3–6)5 (3–10; 4–5)4 (1–7; 2–5)3 (1–10; 2–5)
 Diarrhea at follow-up6 (1–15; 4–8)6 (1–14; 4–8)4 (1–10; 2–7)7 (1–15; 6–9)6 (2–11; 4–9)7 (3–10; 7–10)7 (1–12; 6–8)5 (1–15; 3–6)
 Vomiting at enrollment2 (1–10; 1–4)2 (1–9; 1–4)1 (1–6; 1–3)1 (1–7; 1–2)2 (1–4; 2–4)4 (4–4; 4–4)3 (1–3; 2–3)2 (1–6; 2–3)
 Vomiting at follow-up3 (1–13; 2–5)3 (1–10; 2–6)2 (1–10; 1–5)3 (1–7; 2–4)4 (1–6; 2–4)6 (6–6; 6–6)3 (3–6; 3–4)3 (1–8; 2–4)
Severity of illness
Modified Vesikari Score (MVS), median (range)b11 (4–19)10 (4–18)13 (8–17)11 (7–17)12 (10–16)11 (8–17)12 (9–18)12 (7–16)
 Mild MVS, n (%)38 (6)4 (4)000000
 Moderate MVS, n (%)293 (42)56 (49)7 (27)8 (36)2 (20)5 (50)3 (27)9 (47)
 Severe MVS, n (%)362 (52)54 (47)19 (73)14 (63)8 (80)5 (50)8 (73)10 (53)
ICU stay, n (%)89/724 (12)20/120 (17)2/27 (7)1/22 (5)2/10 (20)01/11 (9)3/20 (15)
Duration of ICU stay in days, median (range; IQR)3 (1–38; 2–6)2 (1–11; 2–6)11 (10–12; 10–12)2 (2–2; 2–2)3 (1–4; 1–4)02 (2–2; 2–2)3 (3–4; 3–4)
Duration of hospital stay in days, median (range; IQR)5 (1–196; 3–10)6 (2–72; 3–16)4 (1–66; 2–8)4 (2–26; 3–7)3 (1–26; 3–5)4 (2–8; 3–6)4 (2–38; 2–6)5 (1–28; 3–8)
 Duration of hospital stay for community-onset cases4 (1–95; 3–7)5 (2–72; 3–8)3 (1–13; 2–7)4 (2–8; 3–6)3 (1–26; 3–5)4 (2–8; 3–6)4 (2–38; 2–6)5 (1–20; 3–7)
 Duration of hospital stay for hospital-onset cases15 (1–196; 9–24)20 (5–51; 11–24)36 (6–66; 6–66)26 (26–26; 26–26)00018 (8–28; 8–28)
23 hour stay, n (%)86/724 (12)12/120 (10)6/27 (22)2/22 (9)1/10 (10)01/11 (9)3/20 (15)
Death, n (%)c17/723 (2)3/120 (3)1/27 (4)00000

aPathogen-specific columns include AGE cases with single pathogen detections, independent of the other 5 pathogens in the table. Any co-detection (≥2) between the six pathogens are included in the multiple co-pathogens column.

bIf cases were missing data for certain measurements, a Vesikari score was not assigned, pathogen (% missing): AGE (4%), Norovirus (3%), C. difficile (6%), Salmonella (8%). Modified Vesikari scoring was defined as follows: Mild (0–6), Moderate (7–10), Severe (≥11). See supplementary appendix for scoring components.

cAmong these deaths, 14 occurred while hospitalized. Three deaths occurred within 1–12 days following discharge; one died in inpatient hospice, one died within 24 hours of transferring to inpatient palliative care, and one died after discharge. Deaths following discharge were ascertained when attempting the follow-up interview at 3–5 weeks post-enrollment.

Campylobacter spp. includes jejuni, coli, and upsaliensis. EIEC=Enteroinvasive E. coli

dDiarrhea was defined as 3 or more loose stools within a 24 hour period

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