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The second study of infectious intestinal disease in the community (IID2 Study)

Project Code: B18021;
Publication:

Food Standards Agency (2000). A report of infectious intestinal disease in England. London: The Stationary Office
O’Brien SJ, Rait G, Hunter PR el al. (2010 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). BMC Med Res Methodol. May 5; 10:39
Tam, C.C., Rodrigues, L.C., Viviani, L., Dodds, J.P., Evans, M.R., Hunter, P.R., Gray, J.J., Letley, L.H., Rait, G., Tompkins, D.S. & O'Brien, S.J. (2012) Longitudinal study of infectious intestinal disease in the UK (IID2 Study): incidence in the community and presenting to general practice. Gut 61(1), 69-77 doi: 10.1136/gut.2011.238386
Tam, C.C., O'Brien, S.J., Tompkins, D.S., Bolton, F.J., Berry, L., Dodds, J., Choudhury, D., Halstead, F., Iturriza-Gómara, M., Mather, K., Rait, G., Ridge, A., Rodrigues, L.C., Wain, J., Wood, B., Gray, J.J. & the IID2 Study Executive Committee (2012) Changes in causes of acute gastroenteritis in the United Kingdom over 15 years: microbiologic findings from two prospective, population-based studies of infectious intestinal disease. Clin. Infect. Dis. (2012) 54(9),1275-1286, doi: 10.1093/cid/cis028
Nawaz S, Allen DJ, Aladin F, Gallimore C, Iturriza-Gómara M (2012) Human Bocaviruses Are Not Significantly Associated with Gastroenteritis: Results of Retesting Archive DNA from a Case Control Study in the UK. PLoS ONE 7(7): e41346. doi:10.1371/journal.pone.0041346
Royal College of General Practitioners (RCGP) Weekly Returns Service

06/09/2011

University of Manchester
O'Brien, S

The key findings of the IID2 Study are provided below:

UK situation
• The incidence of IID in the community in the UK is substantial, with around 25% of the population suffering from an episode of IID in a year – equivalent to 17 million cases annually. Around 2% of the population visit their GP for symptoms of IID each year – an estimated 1 million consultations annually.
• Approximately 50% of people with IID reported absence from school or work because of their symptoms. The FSA has calculated that this represents nearly 19 million days lost (over 11 million days lost in people of working age).
• The most commonly identified microorganisms found in stool samples from those with IID were norovirus, sapovirus, Campylobacter spp. and rotavirus.
• For every case of IID in the UK reported to national surveillance there were around 10 GP consultations and 147 cases in the community.
• Only 1 specimen tested positive for Clostridium difficile (<1%), suggesting that this microorganism which is usually associated with healthcare settings is not found very often in the community.

Situation in England compared to mid-1990s
• The incidence of IID in the community in England was 43% higher in 2008-09 (IID2) than in 1993-96 (IID1) whilst the number of people visiting their GP about IID was 50% lower.
• Reporting of IID to national statistics had improved since the mid-1990s for those presenting their symptoms to their GP. This suggests that GPs are more likely to take a stool sample and/or there have been improvements in recording episodes of IID for those using primary healthcare services. However, fewer people are visiting their GPs due to an episode of IID. As a result more cases in the community now go unrecognised and are therefore unreported.
• A very small proportion of people with IID (~2%) contacted NHS Direct. Contact with NHS Direct was insufficient to account for the observed drop in rates of consultation to GP.
• The rate of IID estimated from the Telephone Survey of self-reported illness were between 2 and 5 times higher than the Cohort Study depending on the recall period (28 days and 7 days respectively). Data from other studies in the project and from external sources suggested that the Cohort Study provided more reliable estimates and so this was used to determine IID rates in the community.

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