Skip to main content
    • Aa
    • Aa

Acute gastrointestinal illness in two Inuit communities: burden of illness in Rigolet and Iqaluit, Canada

  • S. L. HARPER (a1), V. L. EDGE (a1) (a2), J. FORD (a3), M. K. THOMAS (a1) (a4), D. L. PEARL (a1), J. SHIRLEY (a5) and S. A. McEWEN (a1)...

Food- and waterborne disease is thought to be high in some Canadian Indigenous communities; however, the burden of acute gastrointestinal illness (AGI) is not well understood due to limited availability and quality of surveillance data. This study estimated the burden of community-level self-reported AGI in the Inuit communities of Rigolet, Nunatsiavut, and Iqaluit, Nunavut, Canada. Cross-sectional retrospective surveys captured information on AGI and potential environmental risk factors. Multivariable logistic regression models identified potential AGI risk factors. The annual incidence of AGI ranged from 2·9–3·9 cases/person per year in Rigolet and Iqaluit. In Rigolet, increased spending on obtaining country foods, a homeless person in the house, not visiting a cabin recently, exposure to puppies, and alternative sources of drinking water were associated with increased odds of AGI. In Iqaluit, eating country fish often, exposure to cats, employment status of the person responsible for food preparation, not washing the countertop with soap after preparing meat, a homeless person in the house, and overcrowding were associated with increased odds of AGI. The results highlight the need for systematic data collection to better understand and support previously anecdotal indications of high AGI incidence, as well as insights into unique AGI environmental risk factors in Indigenous populations.

Corresponding author
*Author for correspondence: S. L. Harper, Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada, N1G 2W1. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2. A Costello , Managing the health effects of climate change. Lancet 2009; 373: 16931733.

5. MK Thomas , Population distribution and burden of acute gastrointestinal illness in British Columbia, Canada. BMC Public Health 2006; 6: 307.

6. E Scallan , Prevalence of diarrhoea in the community in Australia, Canada, Ireland, and the United States. International Journal of Epidemiology 2005; 34: 454460.

8. L MacDougall , Under-reporting of infectious gastrointestinal illness in British Columbia, Canada: who is counted in provincial communicable disease statistics? Epidemiology and Infection 2008; 136: 248256.

13. AAC Cheng , JR McDonald , NM Thielman . Infectious diarrhea in developed and developing countries. Journal of Clinical Gastroenterology 2005; 39: 757–73.

16. A Pardhan-Ali , A descriptive analysis of notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991–2008. BMJ Open 2012; 2(4).

17. SE Hrudey , Safe water? Depends on where you live! Canadian Medical Association Journal 2008; 178: 975.

18. SE Hrudey , EJ Hrudey . Published case studies of waterborne disease outbreaks – evidence of a recurrent threat. Water Environment Research 2007; 79: 233–45.

20. SL Harper , Weather, water quality and infectious gastrointestinal illness in two Inuit communities in Nunatsiavut, Canada: potential implications for climate change. EcoHealth 2011; 8: 93108.

21. M King , A Smith , M Gracey . Indigenous health, Part 2: the underlying causes of the health gap. Lancet 2009; 374: 7685.

22. J Smylie , M Anderson . Understanding the health of Indigenous peoples in Canada: key methodological and conceptual challenges. Canadian Medical Association Journal 2006; 175: 602605.

25. Willox A Cunsolo , Climate change and mental health: an exploratory case study from Rigolet, Nunatsiavut, Canada. Climatic Change 2013; 121: 255270.

26. Willox A Cunsolo , ‘From this place and of this place’: climate change, sense of place, and health in Nunatsiavut, Canada. Social Science & Medicine 2012; 75: 538547.

27. Willox A Cunsolo , The land enriches the soul: on climatic and environmental change, affect, and emotional health and well-being in Rigolet, Nunatsiavut, Canada. Emotion, Space and Society 2013; 6: 1424.

30. SE Majowicz , J Horrocks , K Bocking . Demographic determinants of acute gastrointestinal illness in Canada: a population study. BMC Public Health 2007; 7: 162.

33. TD Pearce , Community Collaboration and climate change research in the Canadian Arctic. Polar Research 2009; 28: 1027.

37. G Hall , Frequency of infectious gastrointestinal illness in Australia, 2002: regional, seasonal and demographic variation. Epidemiology and Infection 2006; 134: 111118.

42. AJ Parkinson , JC Butler . Potential Impacts of climate change on infectious diseases in the Arctic. International Journal of Circumpolar Health 2005; 64: 478486.

43. EL Pufall , Perception of the importance of traditional country foods to the physical, mental, and spiritual health of Labrador Inuit. Arctic 2011; 64: 242250.

44. DR Boulware . Influence of hygiene on gastrointestinal illness among wilderness backpackers. Journal of Travel Medicine 2004; 11: 2733.

47. TD Procter , A cross-sectional study examining Campylobacter and other zoonotic enteric pathogens in dogs that frequent dog parks in three cities in south-western Ontario and risk factors for shedding of Campylobacter spp. Zoonoses and Public Health 2014; 61: 208218.

48. EK Leonard , Comparison of antimicrobial resistance patterns of Salmonella spp. and Escherichia coli recovered from pet dogs from volunteer households in Ontario (2005–06). Journal of Antimicrobial Chemotherapy 2012; 67: 174181.

49. SL Lefebvre , Incidence of acquisition of methicillin-resistant Staphylococcus aureus, Clostridium difficile, and Other health-care-associated pathogens by dogs that participate in animal-assisted interventions. Journal of the American Veterinary Medical Association 2009; 234: 14041417.

50. Y Febriani , The association between farming activities, precipitation, and the risk of acute gastrointestinal illness in rural municipalities of Quebec, Canada: A Cross-Sectional Study. BMC Public Health 2010; 10: 48.

51. R Gorman , S Bloomfield , CC Adley . A study of cross-contamination of food-borne pathogens in the domestic kitchen in the Republic of Ireland. International Journal of Food Microbiology 2002; 76: 143150.

61. SE Majowicz , A common, symptom-based case definition for gastroenteritis. Epidemiology and Infection 2008; 136: 886894.

62. JD Ford . Indigenous Health and Climate Change. American Journal of Public Health 2012; 102: 12601266.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 5
Total number of PDF views: 38 *
Loading metrics...

Abstract views

Total abstract views: 221 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 28th June 2017. This data will be updated every 24 hours.