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Use of gender distribution in routine surveillance data to detect potential transmission of gastrointestinal infections among men who have sex with men in England

  • P. Mook (a1) (a2), D. Gardiner (a1), S. Kanagarajah (a1), M. Kerac (a1) (a3) (a4), G. Hughes (a5), N. Field (a5) (a6), N. McCarthy (a1) (a2) (a7), C. Rawlings (a1), I. Simms (a5), C. Lane (a8) and P. D. Crook (a1)...

Abstract

Detecting gastrointestinal (GI) infection transmission among men who have sex with men (MSM) in England is complicated by a lack of routine sexual behavioural data. We investigated whether gender distributions might generate signals for increased transmission of GI pathogens among MSM. We examined the percentage male of laboratory-confirmed patient-episodes for patients with no known travel history for 10 GI infections of public health interest in England between 2003 and 2013, stratified by age and region. An adult male excess was observed for Shigella spp. (annual maximum 71% male); most pronounced for those aged 25–49 years and living in London, Brighton and Manchester. An adult male excess was observed every year for Entamoeba histolytica (range 59.8–76.1% male), Giardia (53.1–57.6%) and Campylobacter (52.1–53.5%) and for a minority of years for hepatitis A (max. 69.8%) and typhoidal salmonella (max. 65.7%). This approach generated a signal for excess male episodes for six GI pathogens, including a characterised outbreak of Shigella among MSM. Stratified analyses by geography and age group were consistent with MSM transmission for Shigella. Optimisation and routine application of this technique by public health authorities elsewhere might help identify potential GI infection outbreaks due to sexual transmission among MSM, for further investigation.

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Copyright

Corresponding author

Author for correspondence: P. D. Crook, E-mail: Paul.crook@phe.gov.uk

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These authors contributed equally to this work.

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References

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1.Morgan, O et al. (2006) Shigella sonnei outbreak among homosexual men, London. Emerging Infectious Diseases 12, 14581460.
2.Centers for Disease Control and Prevention (2005) Shigella flexneri serotype 3 infections among men who have sex with men – Chicago, Illinois, 2003–2004. MMWR morbidity and mortality weekly report. CDC Surveillance Summaries 54, 820822.
3.Gaudreau, C et al. (2013) Campylobacter coli outbreak in men who have sex with men, Quebec, Canada, 2010–2011. Emerging Infectious Diseases 19, 764767.
4.Gaudreau, C and Michaud, S (2003) Cluster of erythromycin-and ciprofloxacin-resistant Campylobacter jejuni subsp. jejuni from 1999 to 2001 in men who have sex with men, Quebec, Canada. Clinical Infectious Diseases 37, 131136.
5.Simms, I et al. (2014) Identification of verocytotoxin-producing Escherichia coli O117:H7 in men who have sex with men, England, November 2013 to August 2014. Eurosurveillance 19(43). pii: 20946.
6.Beltrami, JF, Shouse, RL and Blake, PA (2005) Trends in infectious diseases and the male to female ratio: possible clues to changes in behavior among men who have sex with men. AIDS Education and Prevention 17, 4959.
7.Di Benedetto, MA et al. (2012) Prevalence of sexually transmitted infections and enteric protozoa among homosexual men in western Sicily (south Italy). Journal of Preventive Medicine and Hygiene 53, 181185.
8.Reller, ME et al. (2003) Sexual transmission of typhoid fever: a multistate outbreak among men who have sex with men. Clinical Infectious Diseases 37, 141144.
9.Danila, RN et al. (2014) Two concurrent enteric disease outbreaks among men who have sex with men, Minneapolis-St Paul area. Clinical Infectious Diseases 59, 987989.
10.Hellard, M et al. (2003) Risk factors leading to Cryptosporidium infection in men who have sex with men. Sexually Transmitted Infections 79, 412414.
11.Bell, A et al. (2001) An outbreak of hepatitis A among young men associated with having sex in public venues. Communicable Disease and Public Health 4, 163170.
12.Bordi, L et al. (2012) Monophyletic outbreak of hepatitis A involving HIV-infected men who have sex with men, Rome, Italy 2008–2009. Journal of Clinical Virology 54, 2629.
13.Mazick, A et al. (2005) Hepatitis A outbreak among MSM linked to casual sex and gay saunas in Copenhagen, Denmark. Eurosurveillance 10, 111114.
14.European Centre for Disease Prevention and Control (ECDC). (2016) Hepatitis A Outbreaks in the EU/EEA Mostly Affecting Men Who Have Sex with Men. Stockholm: ECDC.
15.Hung, CC, Chang, SY and Ji, DD (2012) Entamoeba histolytica infection in men who have sex with men. Lancet Infectious Diseases 12, 729736.
16.Mitchell, H and Hughes, G (2018) Recent epidemiology of sexually transmissible enteric infections in men who have sex with men. Current Opinion in Infectious Diseases 31, 5056.
17.Lo, YC, Ji, DD and Hung, CC (2014) Prevalent and incident HIV diagnoses among Entamoeba histolytica-infected adult males: a changing epidemiology associated with sexual transmission – Taiwan, 2006–2013. PLoS Neglected Tropical Diseases 8, e3222.
18.Quinn, TC et al. (1986) AIDS in Africa: an epidemiologic paradigm. Science 234, 955963.
19.Borg, ML et al. (2012) Ongoing outbreak of Shigella flexneri serotype 3a in men who have sex with men in England and Wales, data from 2009–2011. Eurosurveillance 17(13). pii: 20137.
20.Gilbart, VL et al. (2015) Sex, drugs and smart phone applications: findings from semistructured interviews with men who have sex with men diagnosed with Shigella flexneri 3a in England and Wales. Sexually Transmitted Infections 91, 598602.
21.Cresswell, FV et al. (2015) Shigella flexneri: a cause of significant morbidity and associated with sexually transmitted infections in men who have sex with men. Sexually Transmitted Diseases 42, 344.
22.Childs, T et al. (2015) Rapid increase in lymphogranuloma venereum in men who have sex with men, United Kingdom, 2003 to September 2015. Eurosurveillance 20, 30076.
23.Hughes, G et al. (2013) Lymphogranuloma venereum diagnoses among men who have sex with men in the U.K.: interpreting a cross-sectional study using an epidemic phase-specific framework. Sexually Transmitted Infections 89, 542547.
24.Mohammed, H et al. (2016) Increase in sexually transmitted infections among men who have sex with men, England, 2014. Emerging Infectious Diseases 22, 8891.
25.van Kampen, S et al. (2017) Producing modelled estimates of the size of the lesbian, gay and bisexual (LGB) population of England. Public Health England. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/585349/PHE_Final_report_FINAL_DRAFT_14.12.2016NB230117v2.pdf.
26.Briscoe, ME (1987) Why do people go to the doctor? Sex differences in the correlates of GP consultation. Social Science and Medicine 25, 507513.
27.Office for National Statistics International Passenger Survey Travelpac 2013 database. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/leisureandtourism/datasets/travelpac. (Accessed 1 February 2018).
28.Tam, CC et al. (2012) Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice. Gut 61, 6977.
29.Simms, I et al. (2015) Intensified shigellosis epidemic associated with sexual transmission in men who have sex with men – Shigella flexneri and S. sonnei in England, 2004 to end of February 2015. Eurosurveillance 20(15). pii: 21097.
30.O'Sullivan, D (2004) Hepatitis A outbreak in men who have sex with men, London, August–September 2004. Eurosurveillance 8(40). pii: 2558.
31.Sundkvist, T et al. (2003) Outbreak of hepatitis A infection among intravenous drug users in Suffolk and suspected risk factors. Communicable Disease and Public Health 6, 101105.
32.Syed, NA et al. (2003) Outbreak of hepatitis A in the injecting drug user and homeless populations in Bristol: control by a targeted vaccination programme and possible parenteral transmission. European Journal of Gastroenterology and Hepatology 15, 901906.
33.Hay, G et al. (2009) Capture – recapture and anchored prevalence estimation of injecting drug users in England: national and regional estimates. Statistical Methods in Medical Research 18, 323339.
34.Edelstein, M et al. (2010) Hepatitis A outbreak in an Orthodox Jewish community in London, July 2010. Eurosurveillance 15(37). pii: 19662.
35.Gillespie, IA et al. (2008) Demographic determinants for Campylobacter infection in England and Wales: implications for future epidemiological studies. Epidemiology and Infection 136, 17171725.
36.Campylobacter sentinel surveillance scheme collaborators (2003) Ethnicity and Campylobacter infection: a population-based questionnaire survey. Journal of Infection 47, 210216.
37.Wilmer, A et al. (2015) Shigella flexneri serotype 1 infections in men who have sex with men in Vancouver, Canada. HIV Medicine 16, 168175.
38.Chiou, CS et al. (2016) The worldwide spread of ciprofloxacin-resistant Shigella sonnei among HIV-infected men who have sex with men, Taiwan. Clinical Microbiology and Infection 22, 383 e311–e316.
39.Baker, KS et al. (2015) Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study. Lancet Infectious Diseases 15, 913921.
40.Mook, P et al. (2016) ESBL-Producing and macrolide-resistant Shigella sonnei infections among men who have sex with men, England, 2015. Emerging Infectious Diseases 22, 19481952.
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