title: Stool submission data to help inform population-level incidence rates of enteric disease in a Canadian community.
abstract: Laboratory-based surveillance data is essential for monitoring trends in the incidence of enteric disease. Current Canadian human enteric surveillance systems report only confirmed cases of human enteric disease and are often unable to capture the number of negative test results. Data from 9116 hospital stool specimens from the Waterloo Region in Canada, with a mixed urban and rural population of about 500 000 were analysed to investigate the use of stool submission data and its role in reporting bias when determining the incidence of enteric disease. The proportion of stool specimens positive for Campylobacter spp. was highest in the 15-29 years age group, and in the 5-14 years age group for Salmonella spp. and E. coli O157:H7. By contrast, the age-specific incidence rates were highest for all three pathogens in the 0-4 years age group which also had the highest stool submission rate. This suggests that variations in age-specific stool submission rates are influencing current interpretation of surveillance data.
authors.affiliation: Department of Population Medicine,Ontario Veterinary College, University of Guelph,Guelph,ON,Canada.
authors.forename: K
authors.initials: K
authors.lastname: Franklin
authors.affiliation: Centre for Food-borne,Environmental and Zoonotic Infectious Diseases,Public Health Agency of Canada,Guelph,ON,Canada.
authors.forename: F
authors.initials: F
authors.lastname: Pollari
authors.affiliation: Centre for Food-borne,Environmental and Zoonotic Infectious Diseases,Public Health Agency of Canada,Guelph,ON,Canada.
authors.forename: B J
authors.initials: BJ
authors.lastname: Marshall
authors.affiliation: Laboratory for Foodborne Zoonoses,Public Health Agency of Canada,Guelph,ON,Canada.
authors.forename: K D M
authors.initials: KD
authors.lastname: Pintar
authors.affiliation: Centre for Food-borne,Environmental and Zoonotic Infectious Diseases,Public Health Agency of Canada,Guelph,ON,Canada.
authors.forename: A
authors.initials: A
authors.lastname: Nesbitt
authors.affiliation: Laboratory for Foodborne Zoonoses,Public Health Agency of Canada,Guelph,ON,Canada.
authors.forename: I
authors.initials: I
authors.lastname: Young
authors.affiliation: Department of Population Medicine,Ontario Veterinary College, University of Guelph,Guelph,ON,Canada.
authors.forename: S A
authors.initials: SA
authors.lastname: McEwen
authors.affiliation: Grand River Hospital Regional Microbiology Laboratory,Kitchener,ON,Canada.
authors.forename: J
authors.initials: J
authors.lastname: Vanderlaan
authors.affiliation: Department of Population Medicine,Ontario Veterinary College, University of Guelph,Guelph,ON,Canada.
authors.forename: A
authors.initials: A
authors.lastname: Papadopoulos
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002167:Campylobacter / Q000302:isolation & purification*; D002169:Campylobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D019453:Escherichia coli O157 / Q000302:isolation & purification*; D005243:Feces / Q000382:microbiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D012475:Salmonella / Q000302:isolation & purification*; D012480:Salmonella Infections / Q000453:epidemiology* / Q000382:microbiology; D012621:Seasons; D055815:Young Adult
keywords: surveillance