Respiratory symptoms and the case definition of gastroenteritis: an international analysis of the potential impact on burden estimates

Estimates of the burden of foodborne disease rely on attributing a proportion of syndromic gastroenteritis to foodborne transmission. Persons with syndromic diarrhoea/vomiting can also present with concurrent respiratory symptoms that could be due to respiratory infections, gastrointestinal infectio...

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Bibliographic Details
Published in:Epidemiology and infection 2010-01, Vol.138 (1), p.117-124
Main Authors: HALL, G., McDONALD, L., MAJOWICZ, S. E., SCALLAN, E., KIRK, M., SOCKETT, P., ANGULO, F. J.
Format: Article
Language:English
Subjects:
Acute gastroenteritis
Adolescent
Adult
Age Distribution
Australia - epidemiology
Biological and medical sciences
Canada - epidemiology
Child
Child, Preschool
Chronic illnesses
Diarrhea
diarrhoea
Diseases
Epidemiology
Epidemiology. Vaccinations
Estimates
Female
Fever
Foodborne Diseases - complications
Foodborne Diseases - diagnosis
Foodborne Diseases - epidemiology
Gastroenteritis
Gastroenteritis - complications
Gastroenteritis - diagnosis
Gastroenteritis - epidemiology
General aspects
Headache
Humans
Incidence
Infections
Infectious diseases
Lung Diseases - complications
Lung Diseases - diagnosis
Lung Diseases - epidemiology
Male
Medical sciences
Methods and Modelling
Polls & surveys
Population
population study
Population Surveillance - methods
Regression analysis
Respiratory symptoms
Sex Distribution
Symptoms
United States - epidemiology
Vomiting
Young Adult
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Description
Summary:Estimates of the burden of foodborne disease rely on attributing a proportion of syndromic gastroenteritis to foodborne transmission. Persons with syndromic diarrhoea/vomiting can also present with concurrent respiratory symptoms that could be due to respiratory infections, gastrointestinal infections, or both. This distinction is important when estimating the foodborne disease burden but has rarely been considered. Using data from population surveys from Australia, Canada and the USA we describe the effect of excluding persons with respiratory and associated symptoms from the case definition of gastroenteritis. Excluding persons first with respiratory symptoms, or second with respiratory symptoms plus fever and headache, resulted in a decrease in the weighted estimates of acute gastroenteritis of about 10–50% depending on the exclusion criteria. This has the potential to have a very significant impact on estimates of the burden of foodborne infections using syndromic case definitions of acute gastroenteritis.
ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268809990112