Overseas outbreaks of infectious intestinal disease identified in Scotland, 2003 to 2007.
BACKGROUND
This article presents information on all potential outbreaks of infectious intestinal disease (IID) identified by Health Protection Scotland (HPS) involving residents of Scotland. Unlike other systems, this alert system covers potential outbreaks of IID rather than apparently sporadic cases and covers all gastrointestinal pathogens, all visited countries, and all groups of travelers.


METHODS
HPS collects information on all potential outbreaks of IID in residents of Scotland where infection is believed to have been acquired abroad and disseminates this to all public health teams in Scotland so other linked cases can be identified. Where possible HPS also disseminates the details to the national surveillance center in the country where infection is believed to have been acquired, enabling them to facilitate any investigations or control measures they believe necessary. The rate of outbreaks associated with travel to particular countries was determined using the number of visits reported for residents of Scotland from Travel Trends data from the Office of National Statistics.


RESULTS
Between 2003 and 2007, 319 such potential outbreaks were identified. Spain was the most frequently identified country reflecting the fact that it was also the most frequently visited country; the rate per 100,000 visits to Spain was 1.4, very similar to the overall rate for all countries of 1.3, while the highest rate of 46.7 per 100,000 visitors was associated with travel to Egypt. Salmonella sp was the most frequently identified pathogen within which Salmonella enteritidis was the most frequently identified serotype.


CONCLUSIONS
The system provides a rapid alert mechanism for potential outbreaks of IID outside Scotland, allowing their investigation and control as appropriate and demonstrates the risks of outbreaks associated with different countries and pathogens.
Smith-Palmer
Alison
A
Gastrointestinal Disease and Zoonoses, Health Protection Scotland, Glasgow, UK. Alison.SmithPalmer@hps.scot.nhs.uk
Cowden
John M
JM
D003458:Cryptosporidium / Q000302:isolation & purification; D004196:Disease Outbreaks; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology; D004926:Escherichia coli / Q000302:isolation & purification; D005060:Europe; D005843:Geography; D005872:Giardia / Q000302:isolation & purification; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology* / Q000382:microbiology*; D012475:Salmonella / Q000302:isolation & purification; D012606:Scotland / Q000453:epidemiology; D018571:Sentinel Surveillance; D012760:Shigella / Q000302:isolation & purification; D013030:Spain; D011795:Surveys and Questionnaires; D014195:Travel