de Jong Birgitta, Ekdahl Karl
Department of Epidemiology, Swedish Institute for Infectious Disease Control (SMI), Solna, Sweden.
BMC Public Health. 2006 Jan 10;6:4. doi: 10.1186/1471-2458-6-4.
Salmonella is an infectious agents causing numerous cases of illness each year, and thereby having significant economic impact. Using returning Swedish travellers we estimated the burden of salmonellosis in different European countries.
From the Swedish database on notifiable communicable diseases 15,864 cases with travel-associated salmonellosis acquired in Europe from 1997-2003 were retrieved. These cases were compared to a dataset from the same years on 14,171 randomly selected Swedish residents, with a history of recent overnight travel in Europe. Distribution of salmonellosis in returning travellers and the distribution of Salmonella Enteritidis was analysed for different member states in the European Union, associated and candidate countries. The risk of being notified with a salmonella infection after return from each European country/region was calculated, and compared with official reporting data rom these countries. Using Norway as reference country, we could 1) construct comparable incidence estimates and 2) calculate the "under-reporting" in each country compared to Norway.
The highest burden of salmonellosis was estimated for Bulgaria (2741/100,000), followed by Turkey with 2344/100,000 and Malta with 2141/100,000. S. Enteritidis is the dominating serotype, 66.9 % of all cases and phage type 4 accounts for 37.5 % of the S. Enteritidis cases.
Using returning tourists as a sentinel population can provide a useful base for comparison of disease burdens in different countries/regions. Focusing prevention of salmonellosis to prevention of egg and poultry associated S. Enteritidis infection will have a major impact from a public health perspective and will significantly lower the burden of disease in most European countries.
沙门氏菌是一种每年导致众多疾病病例的感染源，从而产生重大经济影响。我们利用回国的瑞典旅行者来估算不同欧洲国家的沙门氏菌病负担。
从瑞典法定传染病数据库中检索出1997年至2003年在欧洲感染的15864例与旅行相关的沙门氏菌病病例。将这些病例与同一年份的14171名随机选择的有近期在欧洲过夜旅行史的瑞典居民数据集进行比较。分析了欧盟、相关国家和候选国家中回国旅行者的沙门氏菌病分布以及肠炎沙门氏菌的分布。计算了从每个欧洲国家/地区回国后被通报感染沙门氏菌的风险，并与这些国家的官方报告数据进行比较。以挪威作为参照国家，我们能够1）构建可比的发病率估算值，以及2）计算每个国家与挪威相比的“漏报率”。
估计保加利亚的沙门氏菌病负担最高（2741/100,000），其次是土耳其，为2344/100,000，马耳他为2141/100,000。肠炎沙门氏菌是主要血清型，占所有病例的66.9%，其中噬菌体4型占肠炎沙门氏菌病例的37.5%。
将回国游客作为监测人群可为比较不同国家/地区的疾病负担提供有用的基础。从公共卫生角度来看，将沙门氏菌病的预防重点放在预防与蛋类和家禽相关的肠炎沙门氏菌感染上，将对大多数欧洲国家产生重大影响，并将显著降低疾病负担。
