Estimating the Burden of Acute Gastroenteritis and Foodborne Illness Caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus by Using Population-Based Telephone Survey Data, Miyagi Prefecture, Japan, 2005 to 2006

Abstract

Most cases of acute gastroenteritis and foodborne disease are not ascertained by public health surveillance because the ill person does not always seek medical care and submit a stool sample for testing, and the laboratory does not always test for or identify the causative organism. We estimated the total burden of acute gastroenteritis in Miyagi Prefecture, Japan, using data from two 2-week cross-sectional, population-based telephone surveys conducted in 2006 and 2007. To estimate the number of acute gastroenteritis illnesses caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus in Miyagi Prefecture, we determined the number of cases for each pathogen from active laboratory-based surveillance during 2005 to 2006 and adjusted for seeking of medical care and submission of stool specimens by using data from the population-based telephone surveys. Monte Carlo simulation was used to incorporate uncertainty. The prevalence of acute gastroenteritis in the preceding 4 weeks was 3.3% (70 of 2,126) and 3.5% (74 of 2,121) in the winter and summer months, yielding an estimated 44,200 episodes of acute gastroenteritis each year in this region. Among people with acute gastroenteritis, the physician consultation rate was 32.0%, and 10.9% of persons who sought care submitted a stool sample. The estimated numbers of Campylobacter-, Salmonella-, and V. parahaemolyticus -associated episodes of acute gastroenteritis were 1,512, 209, and 100 per 100,000 population per year, respectively, in this region. These estimates are significantly higher than the number of reported cases in surveillance in this region. Cases ascertained from active surveillance were also underrepresented in the present passive surveillance, suggesting that complementary surveillance systems, such as laboratory-based active surveillance in sentinel sites, are needed to monitor food safety in Japan.

Management of suspected infectious diarrhoea by English GPs: are they right?

“…In a Japanese study GPs submitted stool samples from about 10% of patients consulting with diarrhoea. 7 A reason for the higher submission rate by English GPs may be that only patients with more severe or prolonged cases of diarrhoea consult; the IID study found that, although IID incidence in the community had increased since 1990, consultations to GPs had halved. 3 Bloody diarrhoea, diagnosis of AIDS, and duration of diarrhoea were the most common indications for sending a stool specimen in US and Canadian surveys of clinician practice; 5,6 and similar numbers (44% and 25%) to those in the present study sent a specimen in their last case of diarrhoea.…”

Global Epidemiology of Campylobacter Infection

“…Differences in the incidence and number of cases reported from different countries or regions within the same country may vary substantially ( Fig. 2) (25,26). It is likely that these variations arise, in part, from differences in the sensitivity of detection methodologies and the area, population, and scope of the case profile studied, as well as differences in the standard and stringency of biocontrol protocols, surveillance bias, food practices, and availability of natural reservoirs for Campylobacter species in these regions.…”

Prevalence and Antimicrobial Resistance of <i>Campylobacter</i> Isolates from Beef Cattle and Pigs in Japan

“…Taking into account the unreported cases, it was estimated that incidences of foodborne illness associated with Campylobacter in Japan would be approximately 1,545,000 cases within a population of 127.8 million as of 2005 [9]. Campylobacter has been designated as a prioritized hazard in food safety risk management by the Japanese Ministry of Agriculture, Forestry and Fisheries.…”