Epidemiology and Infection

A population-based estimate of the substantial burden of diarrhoeal disease in the United States; FoodNet, 1996–2003 1

T. F. JONES a1c1, M. B. McMILLIAN a1, E. SCALLAN a2, P. D. FRENZEN a3, A. B. CRONQUIST a4, S. THOMAS a5 and F. J. ANGULO a2
a1 Tennessee Department of Health, Nashville, TN, USA
a2 Centers for Disease Control and Prevention, Atlanta, GA, USA
a3 Economic Research Service, U.S. Department of Agriculture, Washington, DC, USA
a4 Colorado Department of Health, Denver, CO, USA
a5 Georgia Division of Public Health, Atlanta, GA, USA

Article author query
jones tf   [PubMed][Google Scholar] 
mcmillian mb   [PubMed][Google Scholar] 
scallan e   [PubMed][Google Scholar] 
frenzen pd   [PubMed][Google Scholar] 
cronquist ab   [PubMed][Google Scholar] 
thomas s   [PubMed][Google Scholar] 
angulo fj   [PubMed][Google Scholar] 


From 1996 to 2003, four 12-month population-based surveys were performed in FoodNet sites to determine the burden of diarrhoeal disease in the population. Acute diarrhoeal illness (ADI) was defined as [gt-or-equal, slanted]3 loose stools in 24 hours with impairment of daily activities or duration of diarrhoea >1 day. A total of 52840 interviews were completed. The overall weighted prevalence of ADI in the previous month was 5·1% (95% CI±0·3%), corresponding to 0·6 episodes of ADI per person per year. The average monthly prevalence of ADI was similar in each of the four survey cycles (range 4·5–5·2%). Rates of ADI were highest in those age <5 years. Of those with ADI, 33·8% (95% CI±2·7%) reported vomiting, 19·5% (95% CI±2·1%) visited a medical provider, and 7·8% (95% CI±1·4%) took antibiotics. Rates of ADI were remarkably consistent over time, and demonstrate the substantial burden placed on the health-care system.

(Accepted April 25 2006)
(Published Online August 8 2006)

c1 Communicable and Environmental Disease Services, Tennessee Department of Health, 4th Floor, Cordell Hull Bldg., 425 5th Ave. N., Nashville, TN 37247, USA. (Email: tim.f.jones@state.tn.us)


1 The views expressed in this paper are those of the authors, and may not be attributed to the Economic Research Service or the U.S. Department of Agriculture.