Does Outbreak Size Matter? An Analysis Comparing the Epidemiologic Characteristics of Small and Large Foodborne Disease Outbreaks. Open Access
Harrison, Cassandra (2011)
Published
Abstract
Abstract
Does Outbreak Size Matter?
An Analysis Comparing the Epidemiologic Characteristics of Small
and Large
Foodborne Disease Outbreaks.
By Cassandra Harrison
Background
Foodborne diseases are a substantial contributor to illness,
hospitalizations, and
deaths each year in the United States. Data provided from outbreak
investigations can
lead to a better understanding of the epidemiologic features of
foodborne illnesses. The
objectives of this study were to describe the epidemiologic factors
associated with small
and large foodborne disease outbreaks in the United States and to
also determine
differences between small and large outbreaks that might inform
food safety policy.
Methods
Descriptive, bivariate, and logistic regression analyses were
performed on
foodborne disease outbreaks occurring between 1999-2008 that were
voluntarily reported
to the Centers for Disease Control and Prevention (CDC) Foodborne
Disease Outbreak
Surveillance System by September 1, 2010. Analyses focused on the
demographic
features, etiologic agents, settings, and commodities associated
with small outbreaks (less
than 10 illnesses) and large outbreaks (10 or more illnesses).
Results
During the ten-year period between 1999 and 2008, a total of 12,068
foodborne
disease outbreaks were reported to the CDC. There were 6,704 small
outbreaks (median
outbreak size 4 illnesses) and 5,364 large outbreaks (median
outbreak size 22 illnesses),
comprising 56% and 44% of the dataset, respectively. Small
outbreaks were less likely to
be laboratory-confirmed or be caused by norovirus, but were more
likely to be due to
Ciguatoxin and Scombroid toxin from finfish. Results from the
multivariable logistic
model revealed that small outbreaks were most often associated with
retail preparation
settings, chemical toxin etiologies, and missing etiology data. On
the other hand, large
outbreaks were associated with institution and other settings, and
viral etiologic agents.
Conclusions
Although small outbreaks do not often receive the same level of
attention as large
outbreaks in the mainstream media or scientific literature, small
outbreaks are more
common than large outbreaks and are commonly associated with retail
preparation
settings. Consequently, it is important to continue investigating
and reporting these in
order to understand the factors contributing to these outbreaks and
prevent future
illnesses.
Table of Contents
Table of Contents
BACKGROUND.........1
METHODS...............3
RESULTS.................7
TABLES...................15
FIGURES.................17
REFERENCES...........19
APPENDIX...............21
About this Master's Thesis
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