Canadian Field Epidemiology Program, Public Health Agency of Canada, 120 Colonnade Rd, Ottawa, ON, Canada.
BMC Public Health. 2012 Nov 12;12:970. doi: 10.1186/1471-2458-12-970.
Gastrointestinal illnesses (GI) continue to pose a substantial burden in terms of morbidity and economic impact in Canada. We describe the epidemiology of reportable GI in Ontario by characterizing the incidence of each reportable GI, as well as associated demographics, clinical outcomes, seasonality, risk settings, and likely sources of infection.
Reports on laboratory confirmed cases of amebiasis, botulism, campylobacteriosis, cryptosporidiosis, cyclosporiasis, giardiasis, hepatitis A, listeriosis, paratyphoid fever, salmonellosis, shigellosis, typhoid fever, illness due to verotoxin-producing Escherichia coli (VTEC-illness), and yersiniosis, from January 1, 2007 to December 31, 2009 were obtained from Ontario's passive reportable disease surveillance system. Cases were classified by history of relevant travel, association with outbreaks, and likely source of infection, obtained through follow-up of reported cases by local health authorities.
There were 29,897 GI reported by health authorities in Ontario from 2007 to 2009. The most frequently reported diseases were campylobacteriosis (10,916 cases or 36.5% of all GI illnesses) and salmonellosis (7,514 cases, 25.1%). Overall, 26.9% of GI cases reported travel outside of Ontario during the relevant incubation period. Children four years of age and younger had the highest incidence rate for most GI, and significantly more (54.8%, p<0.001) cases occurred among males than females. The most commonly reported sources of infections were food (54.2%), animals (19.8%), and contact with ill persons (16.9%). Private homes (45.5%) and food premises (29.7%) were the most commonly reported exposure settings. Domestic cases of campylobacteriosis, cryptosporidiosis, giardiasis, salmonellosis, and VTEC-illness showed seasonal patterns with incidence peaking in the summer months.
Reportable GI continues to be a burden in Ontario. Since more than one in four GI cases experienced in Ontario were acquired outside of the province, international travel is an important risk factor for most GI. Because private homes are the most commonly reported risk settings and the main suspect sources of infection are food, animal contact and ill persons, these findings support the continued need for public health food safety programs, public education on safe handling of food and animals, and proper hand hygiene practices.
在加拿大，胃肠道疾病（GI）在发病率和经济影响方面仍然构成重大负担。我们通过描述安大略省报告的胃肠道疾病的流行病学情况，来确定每种报告疾病的发病率，以及相关的人口统计学、临床结果、季节性、风险环境和可能的感染源。
从 2007 年 1 月 1 日至 2009 年 12 月 31 日，从安大略省被动报告疾病监测系统中获取了有关阿米巴病、肉毒中毒、弯曲杆菌病、隐孢子虫病、环孢子虫病、贾第虫病、甲型肝炎、李斯特菌病、副伤寒、沙门氏菌病、志贺菌病、伤寒、产肠毒素性大肠杆菌（VTEC-疾病）和耶尔森菌病的实验室确诊病例的报告。通过当地卫生当局对报告病例的随访，根据相关旅行史、与暴发的关联以及可能的感染源对病例进行分类。
2007 年至 2009 年期间，安大略省卫生当局共报告了 29897 例胃肠道疾病。报告发病率最高的疾病是弯曲杆菌病（10916 例，占所有胃肠道疾病的 36.5%）和沙门氏菌病（7514 例，占 25.1%）。总体而言，26.9%的胃肠道疾病报告在相关潜伏期内有安大略省以外的旅行史。4 岁及以下儿童的大多数胃肠道疾病发病率最高，且男性病例明显多于女性（54.8%，p<0.001）。最常报告的感染源是食物（54.2%）、动物（19.8%）和接触病人（16.9%）。私人住宅（45.5%）和食品场所（29.7%）是最常报告的暴露场所。弯曲杆菌病、隐孢子虫病、贾第虫病、沙门氏菌病和 VTEC-疾病的国内病例呈季节性模式，发病率在夏季达到高峰。
报告的胃肠道疾病在安大略省仍然是一个负担。由于安大略省超过四分之一的胃肠道疾病是在省内以外地区获得的，国际旅行是大多数胃肠道疾病的一个重要危险因素。由于私人住宅是最常报告的风险环境，感染的主要可疑来源是食物、动物接触和病人，因此这些发现支持继续需要公共卫生食品安全计划、关于安全处理食物和动物的公众教育以及正确的手部卫生习惯。
