An analysis has revealed that self-reported illness appears to have increased when restrictions related to the Coronavirus pandemic were lifted.

The findings come from two reports published by the Food Standards Agency (FSA), which examined how COVID-19 prevention measures and associated changes in behavior impacted infectious intestinal disease (IID).

IID, also called gastroenteritis, can be caused by different pathogens, including Campylobacter, Salmonella, Listeria monocytogenes, Shiga toxin-producing E. coli (STEC), and norovirus. It can be acquired through various sources, such as food, person-to-person contact, and water.

Previous research found that confirmed cases of IID-related illness declined during the pandemic. However, this could not determine how much of the reductions were real and how much fewer people were either seeking or able to access medical care.

Takeaway illness association

Six surveys were carried out between August 2020 and March 2022 to gather information about IID among the general population. Separate polls were run for adults and children, with parents responding on behalf of children.

They asked questions about whether the respondent had symptoms such as vomiting or diarrhea associated with IID during the previous 28 days. Another set of questions on behaviors covered leaving the house, going to work or school, using public transport, eating food from different food business types, and the frequency of handwashing.

The surveys found that eating food from takeaways or street food vendors in the previous four weeks was consistently associated with an increased risk of Infectious Intestinal Disease.

In the later surveys, buying ready-to-eat food outside work or school and eating food from a work or school canteen in the past month were positively associated with IID.

Analysis of the adults’ datasets found that removing food from takeaways or street vendors indicates an expected reduction in IID cases by 9 to 24 percent. Removing buying RTE food outside the workplace, school, or university resulted in a 7 to 14 percent reduction in IID, and eating food from work, school, or university canteens resulted in a 6 to 8 percent reduction.

Adults who ate from organized meal delivery services at least weekly often exhibited the strongest association with IID.

Medical angle

Estimated IID rates increased as COVID-19 restrictions eased. The first survey for adults ran in August and September 2020 and had a rate of 5.6 percent compared to 7.8 percent in the same period the following year.

The proportion of adults with domestic IID seeking medical help for their illness increased significantly between the first and last survey when most restrictions had eased.

For adults with IID, men had greater odds of seeking healthcare than women. In the early surveys, other ethnicities had more than doubled odds of seeking care compared to white ethnicity.

There was inconsistency between handwashing behaviors being associated with an increase or a decrease in IID.

Researchers said the associations do not necessarily infer causation and may indicate other causes, such as the likelihood and intensity of mixing with people outside the household.

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