Epidemiology of enteric disease in C-EnterNet's pilot site - Waterloo region, Ontario, 1990 to 2004.
OBJECTIVE
The objective of the present study was to describe the epidemiology of reportable enteric illness in Ontario's Waterloo region, including comparing calculated incidence rates with published rates, and adjusting for under-reporting to determine the number of community cases, where published data were available.


METHODS
Descriptive analyses were performed on reportable disease data for 13 enteric diseases collected in the Waterloo region from 1990 to 2004. Poisson and negative binomial regression analyses were used to investigate differences in incidence rates among age, sex, the 15 years of data and seasons. Disease-specific incidence rates were calculated and compared with the literature, where possible. Under-reporting ratios from the literature were applied to estimate the number of cases of campylobacteriosis, nontyphoidal salmonellosis and verotoxigenic Escherichia coli infection at the community level.


RESULTS
Over the study period, the average annual age- and sex-adjusted incidence rates per 100,000 population were highest for campylobacteriosis (49.69 cases), followed by giardiasis (31.87 cases) and nontyphoidal salmonellosis (25.97 cases). The incidence of most enteric illnesses peaked in the summer. The highest incidence occurred in young children, followed by adults in their 20s. Diarrhea (85.4%) was the most frequently reported symptom, food (57.4%) was the most commonly reported probable source, and home (41.7%) and travel (37.0%) were the two most frequently reported risk settings.


CONCLUSIONS
Enteric illness was a significant health burden in the Waterloo region from 1990 to 2004. Because reportable disease data are subject to under-reporting, it is likely that the true burden is greater than estimated in the present study.
Keegan
Victoria A
VA
Department of Population Medicine, University of Guelph;
Majowicz
Shannon E
SE
Pearl
David L
DL
Marshall
Barbara J
BJ
Sittler
Nancy
N
Knowles
Lewinda
L
Wilson
Jeffery B
JB
Bull World Health Organ. 1999;77(8):651-66
10516787
CMAJ. 2005 May 24;172(11):1438
15911855
Can Commun Dis Rep. 2006 Oct 1;32(19):211-25
17076030
Can J Public Health. 2004 Nov-Dec;95(6):446-50
15622795
Emerg Infect Dis. 2003 May;9(5):539-44
12737736
BMC Infect Dis. 2005 Mar 07;5:11
15752427
Emerg Infect Dis. 1999 Sep-Oct;5(5):607-25
10511517
Can Commun Dis Rep. 1997 Nov 1;23(21):161-6
9397602
Am J Public Health. 2003 Dec;93(12):2118-23
14652344
Epidemiol Infect. 2004 Aug;132(4):607-17
15310162
Can J Public Health. 2004 Jul-Aug;95(4):309-13
15362478
Appl Environ Microbiol. 2004 Jun;70(6):3742-4
15184182
Can J Public Health. 2001 Jan-Feb;92(1):62-6
11257995
J Food Prot. 2003 Jun;66(6):953-61
12800994
BMC Public Health. 2008 Oct 24;8:370
18950509
Can J Public Health. 2001 Sep-Oct;92(5):361-5
11702490
Public Health Rep. 2002 Jan-Feb;117(1):69-77
12297684
BMC Infect Dis. 2005 Sep 16;5:72
16168061
Emerg Infect Dis. 1997 Oct-Dec;3(4):503-10
9368787
Can J Public Health. 1998 Jul-Aug;89(4):253-7
9735519
Can J Infect Dis Med Microbiol. 2006 Jul;17(4):229-34
18382633
Can Commun Dis Rep. 2005 May 15;31(10):105-10
15895505
J Travel Med. 2005 Jul-Aug;12(4):197-204
16086894
Int J Epidemiol. 2005 Apr;34(2):454-60
15659464
Can J Public Health. 2005 May-Jun;96(3):178-81
15913079
BMJ. 1999 Apr 17;318(7190):1046-50
10205103
BMC Health Serv Res. 2006 Feb 15;6:10
16480500
Am J Trop Med Hyg. 1999 Sep;61(3):500-4
10497998
Emerg Infect Dis. 2002 Mar;8(3):237-44
11927019
Ann Intern Med. 1999 Feb 2;130(3):210-20
10049199
Emerg Infect Dis. 2005 Mar;11(3):361-4
15757548
West J Med. 1983 Aug;139(2):177-8
6636729