Enteric disease: a major health concern in Canada
Despite efforts to reduce the presence of dangerous pathogens in Canadian food and water, Salmonella, E. coli, Campylobacter, Yersinia, Listeria, Shigella, Vibrio, Cryptosporidium, Cyclospora, Giardia,Norovirus, Rotavirus and others continue to cause enteric disease in Canada .
Several factors point to the importance of infectious enteric disease surveillance:
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each year, there are roughly 1.3 cases of enteric disease per capita
in Canada, costing an average of $115 per capita1.
This roughly translates to a $50 billion burden on Canada's economy
every year
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In industrialized countries, an estimated 15% to 30% of people with
a case of enteric disease consult a physician. 3 In
Canada , an estimated 20% of enteric cases consult a physicain 1.
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In Ontario , about 1 in 313 cases of enteric disease are reported
to the province through passive disease notification surveillance. 1
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The majority of cases of enteric disease are mild and require
only a day or two of reduced activities; however, these cases pose
a significant burden due to lost productivity and other related
costs . Other cases are severe and can result in hospitalization,
serious chronic conditions or death.
- Roughly 4% of enteric disease cases in industrialized countries
will result in hospitalization 3. Assuming a Canadian population
of 32 270 507, this represents 1 290 820 hospitalizations per year
in this country.
Significance of under-reporting
Traditional passive surveillance systems have resulted in the under-reporting
of enteric disease in Canada , because of their reliance on physicians,
laboratories and others to submit case information through provincial and
national reporting chains. As evidenced by a recent report of the National
Studies on Acute Gastrointestinal Illness (NSAGI) group of the Public Health
Agency of Canada, only 1 of 313 cases of enteric disease was reported to
the Province of Ontario .
- 1 positive case
reported to province
- 1.24 positive cases reported
locally
- 1.56 stools test positive
- 14 stools tested
- 15 submit stool
- 19
stool samples requested
- 73 visit physician
- 313 cases of enteric illness in the community
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C-EnterNet's comprehensive, integrated and systematic surveillance framework will improve reporting from the laboratory level, and from below the laboratory level, through episodic surveillance activities. This work is important
- to understand the true burden of enteric disease in Canada ;
- to assess the value of intervention programs; and
- to accurately and effectively inform policy on food and water safety for Canadians.
References
- Majowicz, S.E., et al., 2004. Magnitude and distribution of acute, self-reported gastrointestinal illness in a Canadian community. Epidemiol. Infect. 132(4): 607-17
- Majowicz, S.E., et al., 2005. Estimating under-reporting for infectious gastrointestinal illness in Ontario . Canadian Journal of Public Health. 96(3): 178-181.
- Wheeler, J.G. et al., 1999. Study of Infectious intestinal disease in England : rates in the community, presenting to general practice, and reported to national surveillance. The Infectious Intestinal Disease Executive. BMJ, 318(7190):1046-50.
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