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Gastrointestinal infections: guidance, data and analysis

The characteristics, diagnosis, management and epidemiology of gastrointestinal infections.

Published 1 July 2014
Last updated 22 April 2020 — see all updates

• From: Public Health England

Infectious intestinal diseases affect 1 in 5 people in the UK each year and symptoms are not confined to diarrhoea and vomiting.

Public Health England (PHE) monitors trends in infection and outbreaks, drawing on data from:

• PHE reference laboratories
• the national laboratory reporting scheme
• consultants in communicable disease control (CCDCs)
• environmental health officers (EHOs)
• microbiologists

For trends in zoonotic infection in humans and animals, see Zoonoses in the UK.

Update during coronavirus (COVID-19) pandemic:

Gastrointestinal infections cause an estimated 17 million cases in the UK each year. Bacterial gastroenteritis is particularly common in summer months and outbreaks of zoonotic infections, such as campylobacteriosis, salmonellosis and Shiga toxin-producing E. coli (STEC) occur every year.

Although a vast majority of cases of gastroenteritis cause self- limiting diarrhoea, symptoms such as fever and diarrhoea can be mistaken for COVID-19. Certain gastrointestinal infections like STEC can cause serious complications such as haemolytic uraemic syndrome (HUS), and Listeria monocytogenes infections can be fatal in severely immunocompromised patients.

During the coronavirus (COVID-19) pandemic, the UK Government advice to stay at home and social distancing strategies have changed patterns of shopping, cooking and food consumption in the population. It is therefore important to be highly vigilant of complicated cases of gastroenteritis in the coming months.

Diagnosis

Gastrointestinal bacteria reference unit (GBRU) is the reference laboratory for a range of gastrointestinal pathogens.

During COVID-19 the following critical services will continue:

1. Detection of STEC from stool specimens and confirmation of STEC isolates using PCR.

2. Detection of Clostridium botulinum and botulinum toxin from food, stool, serum and tissues.

3. Confirmation of identity and typing of Salmonella, Shigella, STEC and Listeria spp using whole genome sequencing.

Clinicians and laboratories are advised to continue submitting isolates and appropriate clinical samples to the GBRU for detection, identification and typing of bacterial pathogens.

• GBRU: reference and diagnostic services
  • 14 May 2020
  • Guidance

Management

• Gastrointestinal infections: guidance for public health management
  • 31 January 2020
  • Guidance
• Amoebiasis: public health operational guidelines
  • 23 November 2017
  • Guidance
• Preventing person-to-person gastrointestinal infections
  • 10 April 2004
  • Guidance
• Farm visits: avoiding infection
  • 27 February 2019
  • Guidance
• Hygiene and catering at large events: follow-up study
  • 10 July 2013
  • Research and analysis
• Swim healthy
  • 24 June 2019
  • Guidance
• Care homes: infection prevention and control
  • 18 February 2013
  • Guidance
• Shigellosis: public health management and questionnaire
  • 30 November 2017
  • Guidance
• Typhoid and paratyphoid: public health operational guidelines
  • 19 May 2017
  • Guidance
• Ready-to-eat foods: microbiological safety assessment guidelines
  • 1 November 2009
  • Guidance
• Norovirus: managing infection in cruise ships
  • 1 July 2007
  • Guidance
• Shiga toxin-producing Escherichia coli: public health management
  • 8 August 2018
  • Guidance

Epidemiology

• Common gastrointestinal infections in England and Wales: laboratory reports in 2014
  • 9 January 2015
  • Research and analysis
• Less common gastrointestinal infections in England and Wales: laboratory reports in 2014
  • 9 January 2015
  • Research and analysis
• Foodborne illness in humans: general outbreaks in England and Wales in 2014
  • 12 December 2014
  • Research and analysis
• Gastrointestinal illness: outbreak investigation following a mass-participation River Thames swim
  • 1 May 2013
  • Research and analysis

Surveillance

• Foodborne and non-foodborne gastrointestinal outbreaks surveillance
  • 26 March 2015
  • Guidance

Published 1 July 2014
Last updated 22 April 2020 + show all updates

1. 22 April 2020

   Added guidance about gastrointestinal infections and GBRU reference and diagnostic services during the COVID-19 pandemic.

2. 31 January 2020

   Added: 'Gastrointestinal infections: guidance for public health management'.

3. 6 August 2018

   Added 'Shiga toxin- producing Escherichia coli (STEC): public health management and questionnaire' in 'Management' section.

4. 13 December 2017

   Added 'Shigellosis: public health management and questionnaire'.

5. 24 November 2017

   Added 'Amoebiasis: public health operational guidelines' under management section.

6. 21 February 2017

   Added new section for surveillance.

7. 1 July 2014

   First published.