The Second Study of Infectious Intestinal Disease in the Community (IID2)

Lead Research Organisation: Medical Research Council

Abstract

In 2000 the Government set up the Food Standards Agency. Its mission was to reduce food borne disease by 20% in 5 years. There is no single official information source that tells us how many people in the community suffer from D&V. The official statistics that exist tell only part of the story and may be inaccurate.We want to find out exactly how many people have IID during a year, how many people go to their doctor when they have symptoms and what germs are causing the symptoms. We are hence undertaking a national study about infectious intestinal disease (IID), also known as diarrhoea and vomiting (D&V), gastroenteritis, food poisoning or gastric flu. This study will provide information on whether the Food Standards Agencys targets have been met and will be used by the Food Standards Agency to work out whether more is needed to clean up our food supply.

Technical Summary

Background: The Food Standard Agency (FSA) set a target for a 20% reduction in food borne disease by 2005. This study will assess the relationship between disease burden in the community and official statistics and whether they match the figures published a decade ago.

Study Aims: To estimate the number of cases of infectious intestinal disease (IID) in the community and the number of people contracting IID who present to their General Practitioners (GPs). To compare these numbers and the aetiologies with those reported to the national surveillance systems.

Methods: Prospective cohort and studies examining presentations to general practices are planned. These are currently being piloted prior to setting up the pilot main study which will include:
a) Cohort study: People registered with general practices will be randomly drawn from 84 practices and will be followed-up for one year. Respondents will get weekly email and post card queries about presence of IID symptoms and those with symptoms will complete a questionnaire and provide a stool sample.

b) GP presentation study: 42 practices will invite all patients presenting with a new episode of IID to complete a web-based questionnaire and provide a stool sample.

c) An Enumeration study: To be conducted in practices not participating in the GP presentation study. This will involve a note search of all individuals presenting to the GP during the study period with symptoms of diarrhoea and vomiting.

d) Validation study: To be conducted in the 42 GP "presentation study practices". This will involve an audit of individuals presenting to their GP with symptoms of diarrhoea and vomiting during the 12 month period of the study to determine who should have been included in the GP presentation study but were not.
The study is funded by the Food Standards Agency and is a collaboration between GPRF, University of Manchester, LSHTM, HPA, Cardiff University, University of Nottingham, University of Glasgow, NHS Direct and University of East Anglia.

Publications

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Chattaway MA (2013) Investigating the link between the presence of enteroaggregative Escherichia coli and infectious intestinal disease in the United Kingdom, 1993 to 1996 and 2008 to 2009. in Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

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O'Brien SJ (2013) The "decline and fall" of nontyphoidal salmonella in the United kingdom. in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

 
Description Acting Together on Campylobacter - Accelerated Solutions Event
Geographic Reach National 
Policy Influence Type Participation in a national consultation
Impact This Accelerated Solutions Event (ASE) was designed to develop effective interventions against Campylobacter in the Food Chain. The output has directly influenced the Campylobacter Risk Management plan developed by the Food Standards Agency with a view to decreasing the human toll of Campylobacter infection by reducing contamination on poultry carcases.
URL https://www.food.gov.uk/news-updates/campaigns/campylobacter/actnow
 
Description Citation in Annual Science Report 2013/14
Geographic Reach National 
Policy Influence Type Citation in other policy documents
URL http://www.food.gov.uk/sites/default/files/annual-%20science-report-2013-14.pdf
 
Description Citation in FSA Chief Scientific Advisor's Science Report March 2015
Geographic Reach National 
Policy Influence Type Citation in other policy documents
URL http://www.food.gov.uk/sites/default/files/csa-report-issue-one-foodborne-viruses.pdf
 
Description Citation in the Food Standards Agency Science and Evidence Strategy 2010-15 April 2013 update
Geographic Reach National 
Policy Influence Type Citation in other policy documents
 
Description NIHR Health Protection Research Unit Competition
Amount £3,816,917 (GBP)
Funding ID HPRU-2012-10038 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 03/2014 
End 04/2019
 
Description Tender: Estimating Quality Adjusted Life Years and Willingness to Pay Values for Microbiological Foodborne Disease (Phase 2)
Amount £279,015 (GBP)
Funding ID FS102087 
Organisation Food Standards Agency (FSA) 
Sector Public
Country United Kingdom
Start 11/2015 
End 12/2016
 
Description UK Food Standards Agency Electronic Tender System
Amount £264,743 (GBP)
Funding ID FS231043 (B18021) 
Organisation Food Standards Agency (FSA) 
Sector Public
Country United Kingdom
Start 07/2011 
End 01/2014
 
Description United Kingdom Food Standards Agency Electronic Tender System
Amount £2,101,482 (GBP)
Funding ID FS101040 
Organisation Food Standards Agency (FSA) 
Sector Public
Country United Kingdom
Start 01/2014 
End 05/2017
 
Description Wellcome Trust/Department of Health Health Innovation Challenge Fund
Amount £4,240,745 (GBP)
Funding ID HICF-T5-354 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 04/2013 
End 03/2016
 
Title IID2 Study Dataset 
Description We have archived the original datasets from the IID2 Studies at the UK Data Service. These have been provided under an open access agreement. 
Type Of Material Database/Collection of data 
Year Produced 2015 
Provided To Others? Yes  
Impact Data from the IID2 Study fed into the WHO global burden of foodborne disease estimates published at the end of 2015 in a collection in PLoS Medicine. The WHO Foodborne Disease Epidemiology Reference Group (FERG) used data from the study to help to develop the European Regional estimates. 
 
Description Food Safety Inspection Service Webinar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact I was invited to deliver a webinar on the findings of the IID2 study by the USDA Food Safety Inspection Service, which took place on April 3rd 2013.

The audience comprised over 60 scientists from across the US including from USDA ARS and FSIS, CDC and the FDA. It has generated a lot of e-mail correspondence since.
Year(s) Of Engagement Activity 2013
 
Description Food Safety Week 2014 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact The purpose of the meeting was to brief journalists about the Food Standards Agency's Food Safety Week campaign on Campylobacter and to demonstrate to journalists how to cook chicken properly. It took place at the Good Housekeeping Institute, where the cookery demonstration also took place. As well as the journalists who attended in person there was also a Google Drop-in event so that people who could not attend in person could still take part and ask questions. The event sparked a lot of discussion about not washing chicken before cooking it and few of the journalists realised how serious an illness Campylobacter could be or how many people were affected in a year. There was a lot of coverage of the event in the national press.

Participation in the event prompted more media interviews and briefings.
Year(s) Of Engagement Activity 2014
URL https://www.food.gov.uk/news-updates/campaigns/campylobacter/fsw-2014/fsw-2014