Infectious intestinal disease (IID), with associated high morbidity and considerable mortality worldwide, causes a wide spectrum of illness. This ranges from mild discomfort to illness with severe complications. The economic burden from direct and indirect costs may be high. It is acquired by oral ingestion of micro-organisms which are transmitted from person to person; via food or water or through contact with animals or contaminated objects. Viruses are the commonest cause in developed countries. In Malta, medical practitioners and laboratories are the main source of data on IID. However, under-reporting is a problem. In order to fill in the lacunae in information on the disease burden, population-based-studies are required. Along with other countries, Malta has embarked on a number of studies to describe and quantify under-reporting of IID. This may assist in strengthening the surveillance system which, in combination with other measures, should result in an improvement of the control of IID.peer-reviewe