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At least 19 recordsLinked to original sources
PubMed2006

Building PulseNet International: an interconnected system of laboratory networks to facilitate timely public health recognition and response to foodborne disease outbreaks and emerging foodborne diseases.

PulseNet USA, the national molecular subtyping network for foodborne disease surveillance, began functioning in the United States in 1996 and soon established itself as a critical early warning system for foodborne disease outbreaks, particularly those in which cases may be geographically dispersed. The PulseNet network is now being replicated in different ways in Canada, Europe, the Asia Pacific region, and Latin America. These independent networks work together in PulseNet International allowing public health officials and laboratorians to share molecular epidemiologic information in real-time and enabling rapid recognition and investigation of multi-national foodborne disease outbreaks. Routine communication between the various international PulseNet networks will provide early warning on foodborne disease outbreaks to participating public health institutions and countries.

Bacterial Typing Techniques↗
PubMed2004

Limitations to successful investigation and reporting of foodborne outbreaks: an analysis of foodborne disease outbreaks in FoodNet catchment areas, 1998-1999.

To better understand factors associated with confirming the etiologic organism and identifying the food vehicle responsible for foodborne-disease outbreaks, we examined data from outbreaks reported in 1998 and 1999 through active surveillance by Foodborne Disease Active Surveillance Network (FoodNet) surveillance areas in 7 states. In 71% of these outbreaks, no confirmed etiology was identified, and in 46%, no suspected food vehicle was identified. Outbreaks involving > or =10 cases were significantly more likely to have their etiology identified than were smaller outbreaks. In two-thirds of outbreaks in which an etiology was not confirmed, no stool specimens were collected for laboratory testing; in 55% of these outbreaks, neither clinical specimens nor food samples were tested. If the etiology of and factors contributing to foodborne-disease outbreaks are to be understood, adequate resources must be available to allow specimens to be collected and tested and epidemiologic investigations to be conducted appropriately.

Disease Outbreaks↗
PubMed2006

Infectious disease outbreaks in competitive sports: a review of the literature.

Recent outbreaks of infectious diseases in athletes in competitive sports have stimulated considerable interest. The environments in which these athletes compete, practice, receive therapy for injuries, and travel, both domestically and internationally, provide varied opportunities for the transmission of infectious organisms. The purpose of this medical literature review is to identify the agents most commonly reported in the medical literature as responsible for infectious disease outbreaks in specific sports and their modes of transmission and to guide targeted prevention efforts. A literature review of English-language articles in medical publications that reported outbreaks of infectious diseases in competitive athletes was conducted in PubMed MEDLINE from 1966 through May 2005. Outbreaks that were solely food borne were excluded. Fifty-nine reports of infectious disease outbreaks in competitive sports were identified in the published medical literature. Herpes simplex virus infections appear to be common among wrestlers and rugby players, with no single strain responsible for the outbreaks. Methicillin-resistant Staphylococcus aureus was responsible for several recent outbreaks of soft tissue and skin infections among collegiate and professional athletes. The most common mode of transmission in outbreaks was direct, person-to-person (primarily skin-to-skin) contact. Blood-borne exposure was implicated in 2 confirmed outbreaks of hepatitis. Airborne and vector transmissions were rarely reported. This review provides an overview of infectious disease outbreaks thought to be either serious enough or unusual enough to report. Appropriate surveillance of the frequency of infections will allow sports medicine staff to identify outbreaks quickly and take necessary measures to contain further transmission and prevent future outbreaks.

Communicable Diseases↗
PubMedDate not supplied

Ethical issues in occupational disease outbreak investigations.

Occupational disease outbreak investigations usually involve rapid, small-scale analysis of reports of diseases with a suspected occupational etiology, usually in a single workplace or among workers of a single employer. Ethical issues are similar to those encountered in epidemiologic studies in the workplace, with the added constraints of the need to respond rapidly, limited numbers of subjects, low statistical power, and the mandate to issue results even when the ability to generalize them is limited. Informed consent, voluntary participation, fairness, and confidentiality are major ethical issues in workplace outbreak investigations. The obligation to publicly report a workplace hazard when a non-disclosure statement has been signed can also present an ethical dilemma for outbreak investigators.

Communicable Diseases↗
PubMed1988

Evaluating risk factors in disease outbreaks.

The investigation of disease outbreaks in herds and flocks includes the gathering of multiple types of discrete data on the characteristics of the disease and the potential risk factors involving agent, host, and environment. Descriptive statistics such as rates, ratios, and proportions offer the investigator tools for counting the disease occurrence, for communicating the results of the investigation to others, and for further analyzing the patterns of disease in order to identify the true risk factors. Because there are several alternative methods for calculating descriptive statistics, specific definitions of each statistic should be followed so that ambiguity and misinformation are avoided. The practitioner must choose one definition and apply it consistently in disease investigations. Consistency allows for comparison of descriptive statistics from one investigation to another, or from one time to another time within the same herd. Analytic statistics allow for a critical evaluation of the data represented in rates, ratios, and proportions. Statistical tests address the all-important question, "Could these observed associations between disease and potential risk factors have occurred by chance alone?" This question must be addressed so that the wisest intervention decisions can be made. The tools described in this article are useful in routine herd health practice situations as well as the investigation of disease outbreaks and impaired productivity. Descriptive statistics provide a system for counting disease so that the practitioner can evaluate progress in the individual herd. The ability of the practitioner to quantify changes in disease occurrence in the herd provides hard evidence for the producer of the impact of herd health approaches.

Animals↗
PubMed2004

[Foodborne disease outbreaks in China from 1992 to 2001 national foodborne disease surveillance system].

OBJECTIVE: To study the foodborne disease outbreaks in the areas covered by National Foodborne Disease Surveillance System. METHODS: Total 13 provinces were included in the surveillance system, and the foodborne disease outbreaks data during 1992 to 2001 were collected. RESULTS: During 1992-2001, a total of 5770 outbreaks of foodborne disease were reported. These outbreaks caused a reported 162,995 persons to become ill. Among outbreaks for which the etiology was determined, bacterial pathogens caused the largest percentage of outbreaks (38.5%) and the largest percentage of cases (50.9%). Vibrio parahaemolyticus (31.1%) accounted for the largest number of outbreaks and cases. Chemical agents caused 37.5% of outbreaks and 28.6% of cases. CONCLUSION: More work needs to be done to improve the foodborne disease surveillance system.

China↗
PubMed2005

Social, behavioural and environmental factors and their impact on infectious disease outbreaks.

The microbes that cause infectious diseases are complex, dynamic, and constantly evolving. They reproduce rapidly, mutate frequently, breach species barriers, adapt with relative ease to new hosts and new environments, and develop resistance to the drugs used to treat them. In their article "Meeting the challenge of epidemic infectious diseases outbreaks: an agenda for research", Kai-Lit Phua and Lai Kah Lee clearly demonstrate how social, behavioural and environmental factors, linked to a host of human activities, have accelerated and amplified these natural phenomena. By reviewing published and non-published information about outbreaks of Nipah virus in Malaysia, severe acute respiratory syndrome (SARS) and avian influenza in Asia, and the HIV pandemic, they provide a series of examples that demonstrate the various social, behavioural and environmental factors of these recent infectious disease outbreaks. They then analyse some of these same determinants in important historical epidemics and pandemics such as plague in medieval Europe, and conclude that it is important to better understand the social conditions that facilitate the appearance of diseases outbreaks in order to determine why and how societies react to outbreaks and their impact on different population groups.

Communicable Disease Control↗
PubMed2005

Environmental predictors of Ross River virus disease outbreaks in Queensland, Australia.

Ross River virus (RRV) disease is the most common mosquito-borne disease in Australia, with the majority of cases reported from Queensland. In this study we investigate the relationship between local RRV disease outbreaks and standardized rainfall and temperature data in Queensland. No one set of variables could be found to accurately predict RRV disease outbreaks across all of Queensland, although good predictive models could be developed for smaller regions. The variables identified as important in predicting RRV disease outbreaks differed between regions, and also between summer and autumn. This work highlights the sensitive relationship between virus prevalence, mosquito bionomics, and climate, illustrating that critical climatic factors differ depending on underlying environmental conditions. Identification of factors leading to RRV disease outbreaks will help local authorities identify periods of high risk, optimizing the provision of additional mosquito control measures.

Arbovirus Infections↗
PubMed1988

Waterborne enteric disease outbreaks in Israel, 1976-1985.

Waterborne enteric disease remains a major public health problem in developing countries, as well as in developed countries, such that the World Health Organization declared 1981-90 the International Water Decade. Israeli experience with waterborne disease outbreaks in the decade 1976-85 is reviewed. Community water systems accounted for 52 outbreaks, with 25 occurring between 1976 and 1980 and 27 between 1981 and 1985. Total cases reported in these outbreaks were 7,681 and 10,880 respectively. In the latter period, reported cases resulting from these outbreaks constituted a very high percentage of the total reported cases of diarrheal disease in the country. The waterborne disease outbreaks were mostly due to secondary contamination of water systems due to human error and poor maintenance. In comparison with the United States, Israel experienced 18.7 times as many community waterborne disease outbreaks per capita. The need for routine preventive chlorination, and filtration on a selective basis, of community drinking water systems is strongly indicated, as recommended in current United States and World Health Organization guidelines in order to improve this grossly substandard aspect of Israeli public health.

Bacterial Infections↗
PubMed1991

Foodborne disease outbreaks in nursing homes, 1975 through 1987.

OBJECTIVE: --To describe the epidemiology of foodborne disease outbreaks in nursing homes and to identify where preventive efforts might be focused. DATA SOURCES: --Reports by state and local health departments of foodborne disease outbreaks occurring from January 1, 1975, through December 31, 1987. STUDY SELECTION: --Foodborne disease outbreaks reported to the Centers for Disease Control, Atlanta, Ga, on standard investigation forms. DATA EXTRACTION: --Each foodborne disease outbreak report was examined by an epidemiologist or statistician. Outbreaks were considered to have a known pathogen if confirmed by laboratory tests, and a known vehicle when an epidemiologic investigation implicated a specific food item. DATA SYNTHESIS: --From 1975 through 1987, 26 states reported 115 outbreaks of foodborne disease in nursing homes, causing illness in 4944 persons and death in 51. These outbreaks represented 2% of all reported foodborne disease outbreaks and 19% of outbreak-associated deaths in this period. Of 52 outbreaks with a known cause, Salmonella was the most frequently reported pathogen, accounting for 52% of outbreaks and 81% of deaths. Salmonella enteritidis outbreaks accounted for 56% of the Salmonella-associated deaths since 1981. The implicated food vehicles in S enteritidis outbreaks were made with eggs or prepared with equipment contaminated with eggs. Staphylococcal foodborne disease was the next most commonly identified cause, accounting for 23% of outbreaks. CONCLUSIONS: --Since the elderly are at high risk for serious morbidity from foodborne disease, nursing homes should practice careful food handling, preparation, and storage procedures; provide education for food handlers; and have active infection control programs to rapidly detect and control outbreaks of foodborne disease.

Aged↗
PubMed1982

Use of prediction models to forecast and analyse airborne spread during the foot-and-mouth disease outbreaks in Brittany, Jersey and the Isle of Wight in 1981.

Between March 4 and 26, 1981 the French veterinary authorities reported a series of 14 outbreaks of disease due to type O foot-and-mouth (FMD) virus, 13 in Brittany and one in Normandy. The United Kingdom reported FMD type O in Jersey on March 19 and in the Isle of Wight on March 22. The field and laboratory investigations on the farm in the Isle of Wight are outlined. The way in which short and long range numerical models were used to forecast the airborne spread of FMD from Brittany to the UK and then to assess the risk of further airborne spread within the UK is described.

Air Microbiology↗
PubMed2004

Benchmark data and power calculations for evaluating disease outbreak detection methods.

INTRODUCTION: Early detection of disease outbreaks enables public health officials to implement immediate disease control and prevention measures. Computer-based syndromic surveillance systems are being implemented to complement reporting by physicians and other health-care professionals to improve the timeliness of disease-outbreak detection. Space-time disease-surveillance methods have been proposed as a supplement to purely temporal statistical methods for outbreak detection to detect localized outbreaks before they spread to larger regions. OBJECTIVE: The aims of this study were twofold: 1) to design and make available benchmark data sets for evaluating the statistical power of space-time early detection methods and 2) to evaluate the power of the prospective purely temporal and space-time scan statistics by applying them to the benchmark data sets at different parameter settings. METHODS: Simulated data sets based on the geography and population of New York City were created, including effects of outbreaks of varying size and location. Data sets with no outbreak effects were also created. Scan statistics were then run on these data sets, and the resulting power performances were analyzed and compared. RESULTS: The prospective space-time scan statistic performs well for a spectrum of outbreak models. By comparison, the prospective purely temporal scan statistic has higher power for detecting citywide outbreaks but lower power for detecting geographically localized outbreaks. CONCLUSIONS: The benchmark data sets created for this study can be used successfully for formal statistical power evaluations and comparisons. If an anomaly caused by an outbreak is local, purely temporal surveillance methods might be unable to detect it, in which case space-time methods would be necessary for early detection.

Benchmarking↗
PubMed2004

Use of stool collection kits delivered to patients can improve confirmation of etiology in foodborne disease outbreaks.

BACKGROUND: In 68% of foodborne disease outbreaks, no etiologic pathogen is identified. In two-thirds of outbreaks with no identified etiology, no stool specimens are submitted for testing. METHODS: From April 2001 to March 2003, we pilot-tested use of prepackaged, self-contained stool specimen collection kits in 3 states, delivered to and from patients by courier or mail, to improve rates of specimen collection in the outbreak setting. Specimens were tested for bacterial and viral pathogens at health department laboratories, and results were correlated with epidemiological investigation data. RESULTS: Specimens were returned by > or =1 person in 52 (96%) of 54 outbreaks in which kits were deployed; in total, 263 (76%) of 347 persons who received kits returned specimens. Resolution of symptoms was the most commonly cited reason for nonsubmission of kits. An etiology was confirmed in 37 (71%) of 52 outbreaks with specimens returned; 28 (76%) were attributable to norovirus, and 9 (24%) were attributed to bacterial pathogens. Stool kits were well received and cost an average of approximately 43 dollars per specimen returned. CONCLUSIONS: In two-thirds of foodborne disease outbreaks in which delivered stool collection kits were successfully deployed, an etiologic organism was identified. Delivery of kits to and from patients to improve rates of stool collection in outbreaks in which specimens might otherwise not be submitted could substantially reduce the number of outbreaks with an unknown etiology.

Disease Outbreaks↗
PubMed2005

[Disease outbreak monitoring system based on ambulance transport data].

INTRODUCTION: Disease outbreak monitoring is relevant not only for naturally occurring diseases but also for detecting a biological terror event. Surveillance systems are already operational in Denmark, but none of these has the high update frequencies necessary for early warning, and the majority monitor specific infectious diseases. MATERIALS AND METHODS: An early-warning system for detection of disease outbreaks in Denmark based on ambulance transport frequency was developed and tested employing a biological outbreak scenario. RESULTS: The system, termed "Bioalarm", demonstrated an ability to adapt to minor statistical variations due to, e.g., mild influenza epidemics and at the same time to elicit an early warning in the event of a outbreak consistent with a bioterrorist attack. CONCLUSION: Bioalarm not only is relevant for early warning of a disease outbreak as a result of a biological attack but also facilitates early detection of naturally occurring outbreaks.

Ambulances↗
PubMed2006

Automated detection of infectious disease outbreaks: hierarchical time series models.

The purpose of infectious disease surveillance is to inform the public health policy makers on the incidence and trends of infectious diseases and to trigger appropriate actions to control infectious disease outbreaks. The enormous amount of data collected with automated laboratory-based surveillance systems require automated algorithms for detecting unexpected aberrations that may signal infectious disease outbreaks. In this paper, we explore the potential of hierarchical time series models to detect deviations from expected incidence. As these count data are extremely noisy it can be expected that these models are suitable to detect signal from noise and accommodate for possible autocorrelation. The proposed procedure consists of three steps; (1) the model parameters are estimated by empirical Bayes on a training period of, e.g. a year; (2) the expected values are updated for small time steps (e.g. daily) as new data arrive; (3) threshold levels are updated conditionally on the past expected values and an alarm is triggered when the threshold level is exceeded. To test the potential of the models we estimated sensitivity, specificity and timeliness on simulated time series and compared the results with an alternative approach of a linear regression model adjusted for trends and season. We also used two observed series for Rubella notifications and Salmonella infections and compared our findings with the expert opinions on these series. The hierarchical time series models approach shows high sensitivity and specificity and correctly identifies outbreaks at an early stage. This, in our opinion, makes the proposed model a reliable tool for adequate automated detection of infectious disease outbreaks.

Algorithms↗
PubMedDate not supplied

[Impact of guidelines in investigating foodborne disease outbreaks services in Lazio region, Italy].

Epidemiological investigation of foodborne disease outbreaks helps us to better define the risks, hazards and vehicles involved. In 1997 guidelines on epidemiological methods for investigating these outbreaks were implemented in the Lazio Region. Methods used in investigating the 410 foodborne disease outbreaks reported in the 1996-2000 period were analysed to evaluate the impact of the guide lines on health services. Specific food attack-rates (epidemiological methods) were calculated more frequently in outbreaks with setting of mass catering with many exposed people (46% of these outbreaks) than in outbreaks in home setting with few exposed people (13% of these cases). Inversely, in smaller outbreaks the proportion of cases with detected aetiology (microbiological method) was higher (66%) than in larger ones (43%). For foodborne disease outbreaks with at least 30 people exposed epidemiological methods of investigating showed temporal trend in the period 1996-2000: the epidemics in which attack rates were calculated increased from 50% to 83%, those in which epidemic curve was drawn increased from 17% to 79%, and those in which food specific attack rates were calculated increased from 33% to 58%. The hazard analysis of critical control points (HACCP) was performed only in 18.3% of the cases. In conclusion, the guide lines resulted in a wider application of epidemiological methods in large outbreaks with a well defined exposure resulting in an improved detection of vehicles of foodborne diseases. Epidemiological methods possibly are not adequate to investigate smaller foodborne outbreaks.

Cohort Studies↗