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Comparing Characteristics of Sporadic and Outbreak-Associated Foodborne Illnesses, United States, 2004-2011.

ABSTRACT: Outbreak data have been used to estimate the proportion of illnesses attributable to different foods. Applying outbreak-based attribution estimates to nonoutbreak foodborne illnesses requires an assumption of similar exposure pathways for outbreak and sporadic illnesses. This assumption cannot be tested, but other comparisons can assess its veracity. Our study compares demographic, clinical, temporal, and geographic characteristics of outbreak and sporadic illnesses from Campylobacter, Escherichia coli O157, Listeria, and Salmonella bacteria ascertained by the Foodborne Diseases Active Surveillance Network (FoodNet). Differences among FoodNet sites in outbreak and sporadic illnesses might reflect differences in surveillance practices. For Campylobacter, Listeria, and Escherichia coli O157, outbreak and sporadic illnesses are similar for severity, sex, and age. For Salmonella, outbreak and sporadic illnesses are similar for severity and sex. Nevertheless, the percentage of outbreak illnesses in the youngest age category was lower. Therefore, we do not reject the assumption that outbreak and sporadic illnesses are similar.

SUBMITTER: Ebel ED

PROVIDER: S-EPMC4918141 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Each year foodborne diseases (FBD) affect approximately 1 in 6 Americans, resulting in 128 000 hospitalizations and 3000 deaths. Decreasing resources impact the ability of public health officials to identify, respond to, and control FBD outbreaks. Geographically dispersed outbreaks necessitate multijurisdictional coordination across all levels of the public health system. Rapid response depends on rapid detection.Targeted resources were provided to state and local health departments to improve completeness and timeliness of laboratory, epidemiology, and environmental health (EH) activities for FBD surveillance and outbreak response.Foodborne Disease Centers for Outbreak Response Enhancement (FoodCORE) centers, selected through competitive award, implemented work plans designed to make outbreak response more complete and faster in their jurisdiction. Performance metrics were developed and used to evaluate the impact and effectiveness of activities.Departments of Health in Connecticut, New York City, Ohio, South Carolina, Tennessee, Utah, and Wisconsin.From the first year (Y1) of the program in October 2010 to the end of the second year (Y2) in December 2012, the centers completed molecular subtyping for a higher proportion of Salmonella, Shiga toxin-producing Escherichia coli, and Listeria (SSL) isolates (86% vs 98%) and reduced the average time to complete testing from a median of 8 to 4 days. The centers attempted epidemiologic interviews with more SSL case-patients (93% vs 99%), and the average time to attempt interviews was reduced from a median of 4 to 2 days. During Y2, nearly 200 EH assessments were conducted. FoodCORE centers began documenting model practices such as streamlining and standardizing case-patient interviewing.Centers used targeted resources and process evaluation to implement and document practices that improve the completeness and timeliness of FBD surveillance and outbreak response activities in several public health settings. FoodCORE strategies and model practices could be replicated in other jurisdictions to improve FBD response.

Dataset Information

Comparing Characteristics of Sporadic and Outbreak-Associated Foodborne Illnesses, United States, 2004-2011.

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