Scotland -Gastrointestinal & Zoonoses Biennial Report 2020/2021


This report presents provisional information on laboratory reports of gastrointestinal and zoonotic pathogens in Scotland up to the end of 2021. In previous years, PHS produced separate annual reports for each organism.
This year, we have integrated these separate reports into a single document. Routine reporting was suspended during the pandemic due to significant service disruption, as almost all resources were redirected to the response. This report represents the return of annual Gastrointestinal and Zoonotic (GIZ) reporting and includes the first presentation of data from the period of suspended reporting. This report is also the first annual GIZ report published by Public Health Scotland (PHS) since it was established in April 2020 during the COVID-19 pandemic.
This report provides an overview of data trends and presents data observed during the height of the COVID-19 pandemic when strict non-pharmaceutical interventions were in place. Such interventions affected not only the epidemiology of COVID-19, but also that of other pathogens, including GIZ. Data presented in this report are based on laboratory confirmed reports from clinical diagnosticand reference laboratories in Scotland which are provided to PHS via Electronic Communication of Surveillance in Scotland (ECOSS). ECOSS is a national tool for monitoring organisms, infections and microbial intoxications that are of clinical or public health importance.
Most samples are taken for clinical reasons and are not designed to inform surveillance. Data arising from these results represents therefore only a proportion of the true underlying infection burden and may be biased towards certain groups who are more likely to be tested such as the very young and the old, or those who have travelled. Different pathogens may be subject to different biases. Because of these inevitable limitations, interpretation of surveillance data can be difficult.The laboratory reports arise from samples from both community and healthcare settings.
Laboratory reports represent a small proportion of the true incidence in the population. The second study of infectious intestinal disease in the community (IID 2 study) estimated the overall rate of IID in the UK in 2009 to determine the extent of under-reporting.

The extent of underreporting may have been exacerbated during 2020 and 2021 due to restrictions in place, and changes in healthcare seeking behaviours. This underrepresentation is also recognised to apply to many other pathogens, including non-foodborne zoonoses.In summary, unprecedented behavioural changes during the pandemic such as travel, diet and time spent outside will have impacted on the epidemiology of many GIZ pathogens. In addition, changes in healthcare seeking behaviour during the same time frame will have affected diagnosis of disease arising from these pathogens. Therefore, interpretation of the data must be heavily caveated with the uncertainty that arises from these factors.Any changes in data previously published are a result of PHS data validation.

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