Acute gastrointestinal illness in two Inuit communities: burden of illness in Rigolet and Iqaluit, Canada

Abstract

Food- and waterborne disease is thought to be high in some Canadian Indigenous communities; however, the burden of acute gastrointestinal illness (AGI) is not well understood due to limited availability and quality of surveillance data. This study estimated the burden of community-level self-reported AGI in the Inuit communities of Rigolet, Nunatsiavut, and Iqaluit, Nunavut, Canada. Cross-sectional retrospective surveys captured information on AGI and potential environmental risk factors. Multivariable logistic regression models identified potential AGI risk factors. The annual incidence of AGI ranged from 2·9-3·9 cases/person per year in Rigolet and Iqaluit. In Rigolet, increased spending on obtaining country foods, a homeless person in the house, not visiting a cabin recently, exposure to puppies, and alternative sources of drinking water were associated with increased odds of AGI. In Iqaluit, eating country fish often, exposure to cats, employment status of the person responsible for food preparation, not washing the countertop with soap after preparing meat, a homeless person in the house, and overcrowding were associated with increased odds of AGI. The results highlight the need for systematic data collection to better understand and support previously anecdotal indications of high AGI incidence, as well as insights into unique AGI environmental risk factors in Indigenous populations.

Foodborne and waterborne illness among Canadian Indigenous populations: A scoping review

“…Other traditional foods linked to illness included fermented salmon eggs (stink eggs) (7,16,(21)(22)(23) and fish (such as char, salmon and trout (5,7,21). Aside from raw meat consumption, the fermentation of traditional foods was the most common traditional preparation method involved in foodborne illness (7,16,(20)(21)(22)(23)25,26).…”

“…Of the six documents that reported some form of trend by male/female gender, half noted approximately equal distribution for botulism (16), E. coli (28) and hepatitis A (30,31). Overcrowding in homes was noted in four articles, particularly during winter (5,29,30,31). Two studies (8,29) reported that tight social networks in small remote communities may be another possible mode of transmission for foodborne illness.…”

“…Waterborne illness Table 1 identifies that about one-quarter of all studies addressed unsafe water practices in Indigenous communities associated with either water or foodborne illness (5,7,8,30,32). Three documents (5,7,8) mentioned the preference of Indigenous communities to drink alternative water sources such as bottled water and untreated brook water rather than tap water.…”

“…In Canada, it is estimated that foodborne illness affects about one in eight Canadians (four million cases) each year (3). However, the burden of foodborne illness is not distributed equally, as the risk of enteric illness is believed to be higher in many Indigenous communities compared to the national average (5). Likewise, these communities also face increased risk of waterborne illnesses, particularly due to environmental factors (6).…”

“…For example, the consumption of meat-such as seal, whale, walrus and caribou-in raw form is common among some Indigenous groups, which poses a health risk from pathogens normally destroyed by proper cooking (7). Non-adherence to boil water advisories in Canadian Indigenous communities can also affect the risk of contracting waterborne illness (5,8,9).…”