Epidemiology of respiratory tract infections in Dutch general practice: a historical analysis.

Aims: To describe time trends in the incidence of respiratory tract infections in general practice in the Netherlands and its relation to sex and age. Design and Methods: Data will be presented from several morbidity surveys conducted in general practices in the Netherlands: the Intermittent Morbidity Study (1966), the Continuous Morbidity Registration Nijmegen (1967-2001), two Dutch National Surveys of General Practice (1987 and 2001); and from a general practice based case-control study on pathogens causing acute respiratory tract infections (2001-2003). Results: Acute upper respiratory tract infection (URTI) was the most frequently recorded diagnosis in all surveys with an incidence rate ranging from 69 to 133 per 1000 over the years. The incidence rate was consistently highest in young children, varying from 237 to 550 per 1000 over the years. Women presented URTI slightly more frequently than men consistently over time. Time trends show a decline of URTI incidence rates in general practice. The case-control study revealed that in 53% of URTI cases a virus could be isolated and in 18% a pathogenic bacteria. Viral and bacterial pathogens were also found in controls (29% and 8% respectively). Conclusions: URTI is the most frequent disease presented in general practice and is mainly caused by viruses. In The Netherlands URTI incidence rates are declining