Epidemiology and Infection



A one-year intensified study of outbreaks of gastroenteritis in The Netherlands


Y. T. H. P. VAN DUYNHOVEN a1c1, C. M. DE JAGER a1, L. M. KORTBEEK a2, H. VENNEMA a2, M. P. G. KOOPMANS a2, F. VAN LEUSDEN a3, W. H. M. VAN DER POEL a3 and M. J. M. VAN DEN BROEK a4 on behalf of the eXplosie Project Team
a1 Centre for Infectious Disease Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
a2 Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
a3 Microbiological Laboratory for Health Protection, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
a4 The Food and Consumer Product Safety Authority/the Inspectorate for Health Protection and Veterinary Public Health, Zutphen, The Netherlands

Article author query
van duynhoven yt   [PubMed][Google Scholar] 
de jager cm   [PubMed][Google Scholar] 
kortbeek lm   [PubMed][Google Scholar] 
vennema h   [PubMed][Google Scholar] 
koopmans mp   [PubMed][Google Scholar] 
van leusden f   [PubMed][Google Scholar] 
van der poel wh   [PubMed][Google Scholar] 
van den broek mj   [PubMed][Google Scholar] 

Abstract

In 2002, in The Netherlands a national study of gastroenteritis outbreaks was performed. Epidemiological information was collected by the Public Health Services (PHS) and the Food Inspection Services (FIS) using standardized questionnaires. Stool samples were collected for diagnostic testing. For foodborne outbreaks, food samples were taken. In total, 281 gastroenteritis outbreaks were included, mainly from nursing homes and homes for the elderly (57%), restaurants (11%), hospitals (9%) and day-care centres (7%). Direct person-to-person spread was the predominant transmission route in all settings (overall 78%), except for restaurant outbreaks where food was suspected in almost 90% (overall in 21% of outbreaks). The most common pathogen was norovirus (54%), followed by Salmonella spp. (4%), rotavirus group A (2%), Campylobacter spp. (1%) and only incidentally others. In conclusion, most outbreaks were reported from health and residential institutions, with norovirus as the dominant agent. Control should aim at reducing person-to-person spread. In foodborne outbreaks norovirus was common, due to contamination of food by food handlers. Salmonella, as the second foodborne pathogen, was mainly associated with raw shell eggs. These results stress the continuous need for food safety education, complementary to governmental regulation.

(Accepted June 25 2004)


Correspondence:
c1 Dr Y. T. H. P. van Duynhoven, Senior Epidemiologist, National Institute of Public Health and the Environment, Centre for Infectious Disease Epidemiology, PO Box 1, 3720 BA, Bilthoven, The Netherlands. (Email: y.van.duynhoven@rivm.nl)


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