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12-03-2013 | Public health | Article

Underreporting of orphan zoonotic disease in the UK

Abstract

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medwireNews: "Orphan" zoonotic diseases might be underdiagnosed and underreported in the UK, with awareness of these diseases likely to be greater in rural areas than in urban centers, suggests a review.

"Orphan zoonotic diseases may not be immediately recognized due to symptoms, which have similarity to other more common illness presentations," write Katherine Halsby (Health Protection Agency, London, UK) and colleagues. "This means that the true health burden of these diseases is likely to be greater than that reported here."

Even when diseases are recognized and treated, they might not be reported to the regulatory authorities, add the authors.

When it comes to Lyme disease, for example, general practitioners are not required to utilize laboratory support to reach a clinical diagnosis of erythema migrans. As a result, these cases will not always appear in the laboratory reporting systems of the British Infection Association.

Halsby and colleagues note in Zoonosis and Public Health that cases of Lyme disease have increased in the UK from 691 in 2005 to 1093 in 2009. They note heightened disease awareness, tourism in rural areas, an expanded tick habitat due to climate change, and more overseas travel as a few explanations for the increase in rate.

Hydatid disease is extremely rare in the UK with an overall rate of 0.03 cases per 100,000 individuals and there wer no reported cases in Scotland or Northern Ireland between 2005 and 2009. By contrast, toxoplasmosis is much more prevalent with more than 400 cases reported in England and Wales alone in 2009.

The authors note that the "regional distribution of zoonotic infections can be very distinctive and often reflects the underlying distribution of the disease vector or reservoir species."

Toxoplasmosis cases, for instance, ranged from 0.52 per 100,000 individuals in the East Midlands to 4.55 per 100,000 in London. For Lyme borreliosis, over 65% of cases emerged from the southwest and southeast regions of England. The largest outbreak of Q fever ever recorded in the UK involved more than 140 infected slaughterhouse employees .

"Whilst the source of the infection was not conclusively identified, it is likely that Coxiella burnetii entered the site via infected sheep, became aerosolized in the lairage and disseminated into an area frequented by workers," write Halsby and colleagues.

By medwireNews Reporters

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