title: The incidence of acute gastrointestinal illness in Sweden.
abstract: OBJECTIVE
  The aim of this study was to estimate the self-reported domestic incidence of acute gastrointestinal illness in the Swedish population irrespective of route of transmission or type of pathogen causing the disease. Previous studies in Sweden have primarily focused on incidence of acute gastrointestinal illness related to consumption of contaminated food and drinking water.
  
  
  METHODS
  In May 2009, we sent a questionnaire to 4000 randomly selected persons aged 0-85 years, asking about the number of episodes of stomach disease during the last 12 months. To validate the data on symptoms, we compared the study results with anonymous queries submitted to a Swedish medical website.
  
  
  RESULTS
  The response rate was 64%. We estimated that a total number of 2744,778 acute gastrointestinal illness episodes (95% confidence intervals 2475,641-3013,915) occurred between 1 May 2008 and 30 April 2009. Comparing the number of reported episodes with web queries indicated that the low number of episodes during the first 6 months was an effect of seasonality rather than recall bias. Further, the result of the recall bias analysis suggested that the survey captured approximately 65% of the true number of episodes among the respondents.
  
  
  CONCLUSIONS
  The estimated number of Swedish acute gastrointestinal illness cases in this study is about five times higher than previous estimates this study provides valuable information on the incidence of gastrointestinal symptoms in Sweden, irrespective of route of transmission, indicating a high burden of acute gastrointestinal illness, especially among children, and large societal costs, primarily due to production losses.
authors.affiliation: Department of Knowledge Development, Public Health Agency of Sweden, Sweden.
authors.forename: Frida I
authors.initials: FI
authors.lastname: Hansdotter
authors.affiliation: Department of Computer and Information Science, Linköping University, Sweden.
authors.forename: Måns
authors.initials: M
authors.lastname: Magnusson
authors.affiliation: Department of Monitoring and Evaluation, Public Health Agency of Sweden, Sweden.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kühlmann-Berenzon
authors.affiliation: Department of Monitoring and Evaluation, Public Health Agency of Sweden, Sweden anette.hulth@folkhalsomyndigheten.se.
authors.forename: Anette
authors.initials: A
authors.lastname: Hulth
authors.affiliation: Institute for Food and Agricultural Economics, Lund University, Sweden.
authors.forename: Kristian
authors.initials: K
authors.lastname: Sundström
authors.affiliation: Formerly at Swedish Institute for Communicable Disease Control, Sweden.
authors.forename: Kjell-Olof
authors.initials: KO
authors.lastname: Hedlund
authors.affiliation: Formerly at Swedish Institute for Communicable Disease Control, Sweden.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Andersson
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D057566:Self Report; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Estimating disease incidence; acute gastrointestinal illness; diarrhoea; public health; recall bias; syndromic surveillance; web query-based surveillance