Epidemiology and Infection

Disease burden in The Netherlands due to infections with Shiga toxin-producing Escherichia coli O157

A. H. HAVELAAR a1c1, Y. T. H. P. VAN DUYNHOVEN a1, M. J. NAUTA a1, M. BOUWKNEGT a1, A. E. HEUVELINK a2, G. A. DE WIT a1, M. G. M. NIEUWENHUIZEN a3 and N. C. A. J. van de KAR a4
a1 National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
a2 Inspectorate for Health Protection and Veterinary Public Health, PO Box 202, 7200 AE Zutphen, The Netherlands
a3 Renine, Renal Replacement Registry of The Netherlands, PO Box 4097, 3006 AB Rotterdam, The Netherlands
a4 Department of Paediatric Nephrology, University Hospital Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands

Article author query
havelaar a   [PubMed][Google Scholar] 
van duynhoven y   [PubMed][Google Scholar] 
nauta m   [PubMed][Google Scholar] 
bouwknegt m   [PubMed][Google Scholar] 
heuvelink a   [PubMed][Google Scholar] 
de wit g   [PubMed][Google Scholar] 
nieuwenhuizen m   [PubMed][Google Scholar] 
van de kar n   [PubMed][Google Scholar] 


Surveys carried out between 1990 and 2000 indicated that the incidence of STEC O157-associated gastroenteritis in The Netherlands was 1250 cases/year (median), of which 180 visited a general practitioner, 40 are reported and 0·6 are fatal, mainly in the elderly. There are approximately 20 cases of STEC O157-associated haemolytic–uraemic syndrome (HUS) per year, mainly in children. There are 2·5 HUS patients per year who develop end-stage renal disease (ESRD). There are an estimated 2 HUS-related and 0·5 ESRD-related fatalities per year. The mean disease burden associated with STEC O157 in the Dutch population is 116 (90% confidence interval 85–160) Disability Adjusted Life Years (DALYs) per year. Mortality due to HUS (58 DALYs), and ESRD (21 DALYs) and dialysis due to ESRD (21 DALYs) constitute the main determinants of disease burden. Sensitivity analysis indicates that uncertainty associated with model assumptions did not have a major effect on these estimates.

(Accepted December 22 2003)

c1 Author for correspondence.