Acute intestinal infections in Europe. A review of reported cases

Acute intestinal infections still constitute one of the leading causes of death in the world and a major cause of morbidity in Europe. Unfortunately, most European countries do not have an information system oriented towards acute intestinal infection surveillance. The present work is an analysis of cases of typhoid fever, Salmonellosis, Shigellosis, foodborne infections, and acute gastroenteritis reported from January 1980 to December 1985. Data from 24 of the 33 countries belonging to WHO Regional Office for Europe (EURO-WHO) were considered. Data for 1980 and 1981 were taken from World Health Organization statistics, while data for 1982-85 were taken from bulletins sent to EURO-WHO and WHOCCHDS by individual countries. Data was entered in an IBM 4341 computer system and a data base was organized using a general purpose inquiry language (IBM's APLDI). Rates per 100,000 were calculated using as a denominator 1983 WHO official population figures. The quality of the data is a great problem, as the only available sources of information are official national reports which underestimate the actual incidence of diseases. For typhoid fever, Mediterranean countries show much higher incidences than the rest of Europe, although a decreasing trend can be seen for all European countries. We estimate that the data for typhoid fever, Salmonellosis and Shigellosis are reliable, while reports of foodborne infections and acute gastroenteritis represent only a very small percentage of the actual number of cases.