BMJ 1999;319:258 ( 24 July )

Letters

Community study of infectious intestinal disease in England

    Study underestimated morbidity due to specific pathogens
    Authors' reply

Study underestimated morbidity due to specific pathogens

The first 150 words of the full text of this article appear below.

EDITOR---Wheeler et al's paper estimates the burden of symptomatic infectious intestinal disease in the United Kingdom.1 One aspect of their findings was the high proportion (55%) of community episodes in which no pathogen was identified. I would suggest that this study severely underestimates the prevalence of certain intestinal pathogens. For example, the authors calculate the incidence of cryptosporidium infection in their community study to be only 0.81 (95% confidence interval 0.26 to 2.5) per 1000 person years.

Another approach to determining the incidence of an infectious disease is to determine the prevalence of antibodies in the community and then calculate the annual attack rate required to give that degree of antibody positivity. If an individual is assumed to remain antibody positive for life after an infection then this attack rate is given by a simple formula: cases/100 person years=% seropositive/average life expectancy.

Few studies of cryptosporidium antibodies have been carried out . . . [Full text of this article]
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Relevant Article

Study of infectious intestinal disease in England: rates in the community, presenting to general practice, and reported to national surveillance
Jeremy G Wheeler, Dinesh Sethi, John M Cowden, Patrick G Wall, Laura C Rodrigues, David S Tompkins, Michael J Hudson, and Paul J Roderick
BMJ 1999 318: 1046-1050. [Abstract] [Full Text] [PDF]

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