Estimated Burden of Human Salmonella, Shigella, and Brucella Infections in Jordan, 2003-2004

Background: There is limited information on the disease burden due to foodborne pathogens in the eastern Mediterranean region. This study estimates the burden of disease in Jordan for Salmonella, Shigella, and Brucella during 1 year. Methods: Nationwide population and laboratory surveys were conducted during September 2003 and May 2004, and burden of disease estimates were calculated. A validation study was conducted prospectively from August to September 2003 to provide an estimate of the internal validity of burden estimates. Results: Each year in Jordan there are about 4.4 million episodes of diarrhea among persons >1 year of age and about 1.3 million persons seek medical care for diarrhea. For each person with laboratory-confirmed Shigella or Salmonella infection there are about 273 infected persons in the community. There are approximately 1.1 million episodes of fever and 0.7 million persons >1 year of age seeking medical care for fever each year. For each person with serological confirmed Brucella infection there are about 31 infected persons in the community. There are at least 16,260 Shigella, 6612 Salmonella, and 6912 Brucella cases yearly. Conclusion: This study provides baseline information of the burden of selected foodborne pathogens for 1 year in Jordan and indicates significant underreporting and under-diagnosis of Shigella and Salmonella infections.