Sensor, a population-based cohort study on gastroenteritis in the Netherlands: Incidence and etiology

A prospective population-based cohort study with a nested case-control stud y was conducted to estimate the incidence of gastroenteritis and the associ ated pathogens in the general Dutch population. Follow-up of two consecutiv e cohorts was performed by weekly reporting cards from December 1998 to Dec ember 1999. Cases and controls in the case-control study supplied a questio nnaire and stool samples. The standardized gastroenteritis incidence was 28 3 per 1,000 person-years. The incidence rose with increasing level of educa tion and was higher for persons with a history of diarrhea and for young ch ildren. Bacterial pathogens accounted for 5% of cases, bacterial toxins for 9%, parasites for 6%, and viral pathogens for 21%, with Norwalk-like virus (NLV) as the leading pathogen in 11% of cases. The gastroenteritis inciden ce was higher than that reported for England, but lower than for the United States. In community cases, viral pathogens are the leading cause of gastr oenteritis, with NLV being the number one cause of illness in all age group s but one. In many countries, preventive measures are implemented to decrea se bacterial infections. However, additional prevention of viral infections , especially NLV, might significantly decrease the number of gastroenteriti s cases in the community.