title: Methods for determining disease burden and calibrating national surveillance data in the United Kingdom: the second study of infectious intestinal disease in the community (IID2 study).
abstract: BACKGROUND
  Infectious intestinal disease (IID), usually presenting as diarrhoea and vomiting, is frequently preventable. Though often mild and self-limiting, its commonness makes IID an important public health problem. In the mid 1990s around 1 in 5 people in England suffered from IID a year, costing around pound0.75 billion. No routine information source describes the UK's current community burden of IID. We present here the methods for a study to determine rates and aetiology of IID in the community, presenting to primary care and recorded in national surveillance statistics. We will also outline methods to determine whether or not incidence has declined since the mid-1990s.
  
  
  METHODS
  The Second Study of Infectious Intestinal Disease in the Community (IID2 Study) comprises several separate but related studies. We use two methods to describe IID burden in the community - a retrospective telephone survey of self-reported illness and a prospective, all-age, population-based cohort study with weekly follow-up over a calendar year. Results from the two methods will be compared. To determine IID burden presenting to primary care we perform a prospective study of people presenting to their General Practitioner with symptoms of IID, in which we intervene in clinical and laboratory practice, and an audit of routine clinical and laboratory practice in primary care. We determine aetiology of IID using molecular methods for a wide range of gastrointestinal pathogens, in addition to conventional diagnostic microbiological techniques, and characterise isolates further through reference typing. Finally, we combine all our results to calibrate national surveillance data.
  
  
  CONCLUSIONS
  Researchers disagree about the best method(s) to ascertain disease burden. Our study will allow an evaluation of methods to determine the community burden of IID by comparing the different approaches to estimate IID incidence in its linked components.
authors.affiliation: School of Translational Medicine, University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester, M13 9PL, UK. sarah.o'brien@manchester.ac.uk
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: O'Brien
authors.forename: Greta
authors.initials: G
authors.lastname: Rait
authors.forename: Paul R
authors.initials: PR
authors.lastname: Hunter
authors.forename: James J
authors.initials: JJ
authors.lastname: Gray
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Bolton
authors.forename: David S
authors.initials: DS
authors.lastname: Tompkins
authors.forename: Jim
authors.initials: J
authors.lastname: McLauchlin
authors.forename: Louise H
authors.initials: LH
authors.lastname: Letley
authors.forename: Goutam K
authors.initials: GK
authors.lastname: Adak
authors.forename: John M
authors.initials: JM
authors.lastname: Cowden
authors.forename: Meirion R
authors.initials: MR
authors.lastname: Evans
authors.forename: Keith R
authors.initials: KR
authors.lastname: Neal
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Smith
authors.forename: Brian
authors.initials: B
authors.lastname: Smyth
authors.forename: Clarence C
authors.initials: CC
authors.lastname: Tam
authors.forename: Laura C
authors.initials: LC
authors.lastname: Rodrigues
mesh_terms: D002138:Calibration; D015331:Cohort Studies; D003141:Communicable Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D017281:Cost of Illness; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007410:Intestinal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D016012:Poisson Distribution; D011159:Population Surveillance; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology
references.citation: J Virol. 2002 Jul;76(13):6596-601
references.pmid: 12050372
references.citation: N Engl J Med. 1994 Jul 21;331(3):161-7
references.pmid: 7818640
references.citation: Clin Infect Dis. 2004 Apr 15;38 Suppl 3:S219-26
references.pmid: 15095193
references.citation: Epidemiol Infect. 2002 Aug;129(1):9-17
references.pmid: 12211601
references.citation: J Microbiol Methods. 2003 Jan;52(1):123-31
references.pmid: 12401234
references.citation: Lett Appl Microbiol. 1993 Jan;16(1):32-5
references.pmid: 7763354
references.citation: J Safety Res. 2006;37(5):487-92
references.pmid: 17126366
references.citation: J Travel Med. 2000 Sep-Oct;7(5):259-66
references.pmid: 11231210
references.citation: Med Care. 1980 Jan;18(1):73-95
references.pmid: 6986517
references.citation: J Med Virol. 2006 Oct;78(10):1347-53
references.pmid: 16927293
references.citation: J Clin Virol. 2009 Mar;44(3):242-5
references.pmid: 19179107
references.citation: BMJ. 2000 Jul 1;321(7252):24-7
references.pmid: 10875830
references.citation: J Clin Microbiol. 2009 Nov;47(11):3729-31
references.pmid: 19741082
references.citation: J Clin Microbiol. 2003 Apr;41(4):1548-57
references.pmid: 12682144
references.citation: Eur J Clin Microbiol Infect Dis. 2007 May;26(5):311-23
references.pmid: 17447091
references.citation: BMJ. 1990 Apr 28;300(6732):1092
references.pmid: 2344534
references.citation: Epidemiol Infect. 2008 Jul;136(7):886-94
references.pmid: 17686196
references.citation: Pediatr Pulmonol. 1996 Apr;21(4):203-10
references.pmid: 9121848
references.citation: FEMS Microbiol Lett. 2003 Dec 12;229(2):237-41
references.pmid: 14680705
references.citation: J Virol Methods. 1996 May;59(1-2):73-82
references.pmid: 8793832
references.citation: Nucleic Acids Res. 1990 Apr 25;18(8):2195
references.pmid: 2336409
references.citation: J Nurs Scholarsh. 2001;33(1):27-32
references.pmid: 11253577
references.citation: J Clin Microbiol. 2003 Jul;41(7):2884-93
references.pmid: 12843017
references.citation: Diagn Mol Pathol. 2005 Jun;14(2):90-6
references.pmid: 15905692
references.citation: Lett Appl Microbiol. 2004;38(3):217-22
references.pmid: 14962043
references.citation: Foodborne Pathog Dis. 2008 Oct;5(5):629-39
references.pmid: 18681798
references.citation: J Clin Microbiol. 2010 Feb;48(2):606-8
references.pmid: 20032256
references.citation: Am J Public Health. 1982 Jun;72(6):567-73
references.pmid: 7072873
references.citation: Epidemiol Infect. 2002 Jun;128(3):433-8
references.pmid: 12113487
references.citation: J Clin Microbiol. 1999 Oct;37(10):3153-8
references.pmid: 10488169
references.citation: Epidemiol Infect. 1994 Jun;112(3):481-7
references.pmid: 8005214
references.citation: J Med Virol. 1997 Jun;52(2):173-8
references.pmid: 9179765
references.citation: Drug Alcohol Rev. 2003 Jun;22(2):221-5
references.pmid: 12850908
references.citation: Eur J Clin Microbiol Infect Dis. 2003 Jan;22(1):16-20
references.pmid: 12582739
references.citation: BMJ. 1999 Apr 17;318(7190):1046-50
references.pmid: 10205103
references.citation: J Med Microbiol. 2003 Aug;52(Pt 8):681-683
references.pmid: 12867562
references.citation: J Clin Microbiol. 1993 Nov;31(11):3007-12
references.pmid: 8263187
references.citation: Am J Epidemiol. 2001 Oct 1;154(7):666-74
references.pmid: 11581101
references.citation: J Water Health. 2006;4 Suppl 2:31-69
references.pmid: 16895085
references.citation: Epidemiol Infect. 2008 Jan;136(1):23-33
references.pmid: 17313697
references.citation: BMC Infect Dis. 2009 May 14;9:63
references.pmid: 19442278
references.citation: J Clin Microbiol. 2010 Mar;48(3):889-93
references.pmid: 20071552
references.citation: Fam Pract. 2009 Oct;26(5):391-7
references.pmid: 19549623
references.citation: Int J Food Microbiol. 2007 Nov 30;120(1-2):110-9
references.pmid: 17604864
references.citation: Commun Dis Intell Q Rep. 2003;27(2):209-43
references.pmid: 12926736