The impact on primary care of a large waterborne campylobacter outbreak in Norway: a controlled observational study

Abstract

Objective: Document the impact of an outbreak of gastroenteritis on local primary health careservices, compared to a control period. Design: controlled observational study with data from the outbreak and a control period. Dataobtained from electronic medical records (eMR) of general practitioners (GPs) and the out-of-hours (OOh) service. telephone data from the OOh service’s telephone records. Setting: campylobacteriosis outbreak in askøy municipality, Norway in 2019. Over 2000 individualswere infected. Subjects: Patients in contact with GPs and the OOh service during the outbreak and a controlperiod. Main outcome measures: Patient contacts with GPs and the OOh service during the outbreakand a control period. Results: there was a 36% increase in contacts during the outbreak compared to the controlperiod (4798 vs. 3528), with the OOh service handling 78% of outbreak-related contacts. telephoneadvice was the dominant method for managing the increase in contacts to primary care, both inOOh services and daytime general practice (OR 3.73 ci: [3.24–4.28]). children aged 0–4 years hadincreased use of primary care during the outbreak (OR 1.51 ci: [1.28–1.78]). GPs referred 25% andOOh services referred 75% of 70 hospitalized cases. Conclusion: the OOh service handled most of the patients during the outbreak, with supportfrom daytime general practice. the outbreak caused a shift towards telephone advice as a meansof providing care. Young children significantly increased their use of primary care during theoutbreak.