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Original article
Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice
  1. Clarence C Tam1,
  2. Laura C Rodrigues1,
  3. Laura Viviani1,
  4. Julie P Dodds2,
  5. Meirion R Evans3,
  6. Paul R Hunter4,
  7. Jim J Gray5,
  8. Louise H Letley2,
  9. Greta Rait2,
  10. David S Tompkins6,
  11. Sarah J O'Brien7 On behalf of the IID2 Study Executive Committee*
  1. 1Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
  2. 2Medical Research Council General Practice Research Framework and University College London, London, UK
  3. 3Department of Primary Care and Public Health, Cardiff University, Cardiff, UK
  4. 4School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK
  5. 5Department of Gastrointestinal, Emerging & Zoonotic Infections, Health Protection Agency Centre for Infections, London, UK
  6. 6Regional Microbiology Network, Health Protection Agency Yorkshire and the Humber, Leeds Laboratory, Leeds, UK
  7. 7School of Translational Medicine, University of Manchester and Manchester Academic Health Science Centre, Manchester, UK
  1. Correspondence to Dr Clarence C Tam, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; clarence.tam{at}lshtm.ac.uk

Abstract

Objectives To estimate, overall and by organism, the incidence of infectious intestinal disease (IID) in the community, presenting to general practice (GP) and reported to national surveillance.

Design Prospective, community cohort study and prospective study of GP presentation conducted between April 2008 and August 2009.

Setting Eighty-eight GPs across the UK recruited from the Medical Research Council General Practice Research Framework and the Primary Care Research Networks.

Participants 6836 participants registered with the 88 participating practices in the community study; 991 patients with UK-acquired IID presenting to one of 37 practices taking part in the GP presentation study.

Main outcome measures IID rates in the community, presenting to GP and reported to national surveillance, overall and by organism; annual IID cases and GP consultations by organism.

Results The overall rate of IID in the community was 274 cases per 1000 person-years (95% CI 254 to 296); the rate of GP consultations was 17.7 per 1000 person-years (95% CI 14.4 to 21.8). There were 147 community cases and 10 GP consultations for every case reported to national surveillance. Norovirus was the most common organism, with incidence rates of 47 community cases per 1000 person-years and 2.1 GP consultations per 1000 person-years. Campylobacter was the most common bacterial pathogen, with a rate of 9.3 cases per 1000 person-years in the community, and 1.3 GP consultations per 1000 person-years. We estimate that there are up to 17 million sporadic, community cases of IID and 1 million GP consultations annually in the UK. Of these, norovirus accounts for 3 million cases and 130 000 GP consultations, and Campylobacter is responsible for 500 000 cases and 80 000 GP consultations.

Conclusions IID poses a substantial community and healthcare burden in the UK. Control efforts must focus particularly on reducing the burden due to Campylobacter and enteric viruses.

  • Campylobacter
  • diarrhoeal disease
  • epidemiology
  • infectious diarrhoea
  • salmonella

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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Footnotes

  • Data from the IID2 study will be archived and made available publicly in due course.

  • * Members are: Bob Adak, Eric Bolton, Paul Cook (Chair), John Cowden, Meirion Evans, Jim Gray, Paul Hunter, Louise Letley, Jim McLauchlin, Keith Neal, Sarah O'Brien, Greta Rait, Laura Rodrigues, Gillian Smith, Brian Smyth and David Tompkins.

  • Funding This study was funded by the Food Standards Agency and sponsored by University of Manchester. Neither the funder nor the sponsor were involved in the analysis, interpretation or decision to submit for publication.

  • Correction notice This article has been corrected since it was published Online First. In the results section of the abstract, the following sentence has been corrected as follows: “Campylobacter was the most common bacterial pathogen, with a rate of 9.3 cases per 1000 person-years in the community, and 1.3 GP consultations per 1000 person-years.”

  • Competing interests All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author).

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the North West MREC, Stockport PCT, Gateway House, Piccadilly South, Manchester M60 7LP, UK.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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