Background. Large-scale, prospective studies of infectious intestinal disease (IID) in developed countries are uncommon. Two studies of IID incidence and etiology have been conducted in the United Kingdom: the Infectious Intestinal Disease Study in England (IID1) in 1993-1996 and the Second Study of Infectious Intestinal Disease in the Community (IID2) in 2008-2009. We examined changes in etiology and diagnostic yield of IID cases over 15 years. Methods. Fecal samples submitted by IID cases were examined for a range of bacterial, viral, and protozoal pathogens using traditional and molecular microbiological Methods. We calculated the percentage of specimens positive for each organism based on traditional methods and on traditional and molecular methods combined. We compared the distributions of organisms in the 2 studies. Results. For pathogens investigated in both studies, 40% of fecal samples submitted by cases in IID2 were positive compared with 28% in IID1. Viruses were most frequent among community cases in IID2. Campylobacter was the most common bacterial pathogen among cases presenting to healthcare. Major differences between the 2 studies were increases in the detection of norovirus and sapovirus and a decline Salmonella. Conclusions. Most fecal specimens were negative for the pathogens tested in both studies, so new strategies are needed to close the diagnostic gap. Among known pathogens, effective control of norovirus, rotavirus, and Campylobacter remain high priorities. The reduction in nontyphoidal salmonellosis demonstrates the success of Europe-wide control strategies, notably an industry-led Salmonella control program in poultry in the United Kingdom.
|Number of pages||12|
|Journal||Clinical Infectious Diseases|
|Publication status||Published - 1 May 2012|
Bibliographical noteFunding Information:
Financial support. This work was supported by the United Kingdom Food Standards Agency and the Department of Health [grant number B18021]; the Department of Health; the Scottish Primary Care Research Network; National Health Service (NHS) Greater Glasgow and Clyde; NHS Grampian; NHS Tayside; the Welsh Assembly Government (Wales Office of Research and Development) and, in Northern Ireland, the Health and Social Care (HSC) Public Health Agency (HSC Research and Development). The IID1 study was supported by the Medical Research Council and the Department of Health in England. Potential conflicts of interest. All authors: No reported conflicts.