Population distribution and burden of acute gastrointestinal illness in British Columbia, Canada

BACKGROUND: In developed countries, gastrointestinal illness (GI) is typically mild and self-limiting, however, it has considerable economic impact due to high morbidity. METHODS: The magnitude and distribution of acute GI in British Columbia (BC), Canada was evaluated via a cross-sectional telephone survey of 4,612 randomly selected residents, conducted from June 2002 to June 2003. Respondents were asked if they had experienced vomiting or diarrhoea in the 28 days prior to the interview. RESULTS: A response rate of 44.3% was achieved. A monthly prevalence of 9.2% (95%CI 8.4 – 10.0), an incidence rate of 1.3 (95% CI 1.1–1.4) episodes of acute GI per person-year, and an average probability that an individual developed illness in the year of 71.6% (95% CI 68.0–74.8), weighted by population size were observed. The average duration of illness was 3.7 days, translating into 19.2 million days annually of acute GI in BC. CONCLUSION: The results corroborate those from previous Canadian and international studies, highlighting the substantial burden of acute GI

An outbreak of food poisoning among British tourists visiting Amsterdam, June 1992

Abstract niet beschikbaarAn outbreak of food poisoning with Clostridium perfringens occurred among 48 British tourists visiting Amsterdam, june 1992. Thirty-nine cases of illness (nausea, abdominal pain and diarrhoea occurred among 41 tourists who attended a meal on June 6, at an Amsterdam Chinese restaurant. No symptoms of illness were reported from 7 tourists that did not eat at the Chinese restaurant. An epidemiologic investigation was conducted by the Communicable Disease Surveillance Centre (CDSC), Colindale, London. CDSC reported this outbreak to the Foodborne Disease Coordinating Centre at the National Insitute of Public Health and Environmental Protection (RIVM), Bilthoven, the Netherlands. A full inspection of the restaurant had been carried out at once by the Amsterdam Inspectorate of Health Protection (KVW) and the staff was interviewed. It was necessary to take enforcement action by way of an Improvement Notice. Samples of the environment and various foods/ ingredients were taken for bacteriological examination. The Public Prosecutor will consider the advice of the KVW to undertake preventive measures. Clostridium perfringens-enterotoxin was detected in 6 out of 7 faecal samples taken from the British tourists. No such evidence was found in the food and environmental samples, taken 6 days after the meal at the restaurant. It was agreed that RIVM would translate the CDSC- questionnaire in order to extend the epidemiologic investigation if possible to a group of Dutch quests that visited the Chinese restaurant on June 6th. Although a tour-operator was initially willing to contact a group of 30 customers, they finally decided to deny all cooperation to the investigation. After a discussion with the Department of the Chief Medical Officer of Health (Division of Infectious Diseases), it was decided that there were no further means of action for the RIVM to identify the group of Dutch restaurant-quests.HIGB GH

Epidemiological and microbiological research of human gastro-enteritis in the districts Amsterdam and Helmond in 1987

In een onderzoek naar het voorkomen van gastro-enteritis in een dertigtal huisartsenpraktijken in Amsterdam en 11 in de regio Helmond door de desbetreffende Gezondheidsdiensten en Streeklaboratoria in samenwerking met het RIVM, werden in 1987 incidenties gevonden voor gastro-enteritis van respectievelijk 13 en 17 per 1000 personen per jaar. Het totale percentage positieve isolaties bij screening op Salmonella, Shigella, Campylobacter en darmparasieten bedroeg respectievelijk 29 en 34%. Opmerkelijk was het grote aandeel van de Campylobacters, nl. 17% in Amsterdam en 20% in Helmond. Van een deel van de fasemonsters uit Amsterdam werd zowel door het Streeklaboratorium van Amsterdam als door het RIVM parasitologisch onderzoek verricht. In 5% van deze monsters toonde Amsterdam parasieten aan, terwijl het RIVM in 16% de aanwezigheid van parasieten screenden. In geen enkel geval werden parasieten in faeces aangetoond door Amsterdam terwijl het monster door het RIVM als negatief werd afgegeven. Bij onderzoek van goed gefixeerd materiaal zou zelfs nog een hoger isolatiepercentage kunnen worden verwacht. Nader onderzoek in verband met de rol van parasieten bij gastro-enteritis is dan ook noodzakelijk.Abstract not availableGHI RIV

Methods for determining disease burden and calibrating national surveillance data in the United Kingdom: the second study of infectious intestinal disease in the community (IID2 study)

<p>Abstract</p> <p>Background</p> <p>Infectious intestinal disease (IID), usually presenting as diarrhoea and vomiting, is frequently preventable. Though often mild and self-limiting, its commonness makes IID an important public health problem. In the mid 1990s around 1 in 5 people in England suffered from IID a year, costing around £0.75 billion. No routine information source describes the UK's current community burden of IID. We present here the methods for a study to determine rates and aetiology of IID in the community, presenting to primary care and recorded in national surveillance statistics. We will also outline methods to determine whether or not incidence has declined since the mid-1990s.</p> <p>Methods/design</p> <p>The Second Study of Infectious Intestinal Disease in the Community (IID2 Study) comprises several separate but related studies. We use two methods to describe IID burden in the community - a retrospective telephone survey of self-reported illness and a prospective, all-age, population-based cohort study with weekly follow-up over a calendar year. Results from the two methods will be compared. To determine IID burden presenting to primary care we perform a prospective study of people presenting to their General Practitioner with symptoms of IID, in which we intervene in clinical and laboratory practice, and an audit of routine clinical and laboratory practice in primary care. We determine aetiology of IID using molecular methods for a wide range of gastrointestinal pathogens, in addition to conventional diagnostic microbiological techniques, and characterise isolates further through reference typing. Finally, we combine all our results to calibrate national surveillance data.</p> <p>Discussion</p> <p>Researchers disagree about the best method(s) to ascertain disease burden. Our study will allow an evaluation of methods to determine the community burden of IID by comparing the different approaches to estimate IID incidence in its linked components.</p

Immunity to Campylobacter: its role in risk assessment and epidemiology

Acquired immunity is an important factor in the epidemiology of campylobacteriosis in the developing world, apparently limiting symptomatic infection to children of less than two years. However, also in developed countries the highest incidence is observed in children under five years and the majority of Campylobacter infections are asymptomatic, which may be related to the effects of immunity and/or the ingested doses. Not accounting for immunity in epidemiological studies may lead to biased results due to the misclassification of Campylobacter-exposed but apparently healthy persons as unexposed. In risk assessment studies, health risks may be overestimated when immunity is neglected