Age and Gender Distributions of Persons in Foodborne Disease Outbreaks and Associations with Food Commodities Open Access

Strassle, Paula Diane (2014)

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Background. Foodborne disease accounts for 9.4 million illnesses caused by known pathogens in the United States every year. Identifying outbreak sources are a critical part of containment and removal. There is the potential to use demographic information to assist in the prediction and identification of contamination sources in foodborne disease outbreaks. This analysis assesses the association of gender and age distributions of persons in foodborne disease outbreaks with specific commodity sources. Methods. Outbreak data from January 1, 1998 to December 31, 2011 from the CDC Foodborne disease outbreak Surveillance System (FDOSS). Crude and adjusted odds-ratios were calculated for the seventeen defined commodities and a classification tree based-model was constructed to assess the predictability of demographic factors. Results. Age and gender were associated with multiple commodities after adjustment; men were more likely to be involved in outbreaks caused by mollusks (aOR=2.41, 95%CI 1.92, 3.03), dairy (aOR=1.60, 95%CI 1.31, 1.95), beef (aOR=1.43, 95%CI 1.24, 1.64), game (aOR=7.66, 95%CI 3.68, 15.94), and pork (aOR=1.46, 95%CI 1.23, 1.72). Women were more likely to be involved in outbreaks caused by fruit-nuts (aOR=2.61, 95%CI 2.13, 3.20), leafy vegetables (aOR=1.85, 95%CI 1.57, 2.18), sprouts (aOR=3.35, 95%CI 1.97, 5.70), and vine-stalk vegetables (aOR=1.53, 95%CI 1.14, 2.05). Higher proportions of children (under 4 and 5-19), were involved in outbreaks caused by dairy, aOR=4.10 (95%CI 3.37, 5.00) and 3.47 (95%CI 2.85, 4.23), respectively, beef, aOR=1.50 (95%CI 1.27, 1.78) and 1.51 (95%CI 1.31, 1.73), pork, aOR=1.46 (95%CI 1.20, 1.78), and 1.45 (95%CI 1.23, 1.71) and poultry, aOR=1.30 (95%CI 1.13, 1.50) and 1.24 (95%CI 1.11, 1.40). Older adults were more commonly involved in outbreaks caused by fish (aOR=1.54, 95%CI 1.29, 1.83), mollusks (aOR=1.62, 95%CI 1.23, 2.15), fruit-nuts (aOR=2.78, 95%CI 1.24, 6.23), root vegetables (aOR=2.18, 95%CI 1.45, 3.28), and vine-stalk vegetables (aOR=1.68, 95%CI 1.20, 2.36). The tree based model had a kappa agreement of 0.17. Discussion. This analysis provides preliminary support that age and gender groups are more likely to be associated with certain foods causing outbreaks. Further analysis is needed in to better understand these relationships and the utility of demographic profiles to help in predicting food sources in outbreaks.

Table of Contents

Chapter I: Introduction/Literature Review (1-9)

Introduction (1)

Literature Review (3)

References (9)

Chapter II: Manuscript ( 11-28)

Title, Authors, Abstract (11)

Background (12)

Methods (15)

Results (16)

Discussion, Strengths and Weaknesses (19)

References (22)

Tables (24)

Figures, Figure Legends (30)

Chapter III: Summary Public Health Implications, Possible Future Directions ( 31)

Appendix ( 33)

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