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The use of clinical profiles in the investigation of foodborne outbreaks in restaurants: United States, 1982-1997.
Epidemiol Infect. 2008 Jan; 136(1):65-72.EI

Abstract

Improving the efficiency of outbreak investigation in restaurants is critical to reducing outbreak-associated illness and improving prevention strategies. Because clinical characteristics of outbreaks are usually available before results of laboratory testing, we examined their use for determining contributing factors in outbreaks caused by restaurants. All confirmed foodborne outbreaks reported to the Centers for Disease Control and Prevention (CDC) from 1982 to 1997 were reviewed. Clinical profiles were developed based on outbreak characteristics. We compared the percentage of contributing factors by known agent and clinical profile to their occurrence in outbreaks of unclassified aetiology. In total, 2246 foodborne outbreaks were included: 697 (31%) with known aetiology and 1549 (69%) with aetiology undetermined. Salmonella accounted for 65% of outbreaks with a known aetiology. Norovirus-like clinical profiles were noted in 54% of outbreaks with undetermined aetiology. Improper holding times and temperatures were associated with outbreaks caused by Clostridium perfringens, Bacillus cereus, Staphylococcus aureus, and Salmonella, and also with outbreaks of undetermined aetiology that fitted diarrhoea-toxin and vomiting-toxin clinical profiles. Poor personal hygiene was associated with norovirus, Shigella, and Salmonella, and also with outbreaks that fitted norovirus-like and vomiting-toxin clinical profiles. Contributing factors were similar for outbreaks with known aetiology and for those where aetiology was assigned by corresponding clinical profile. Rapidly categorizing outbreaks by clinical profile, before results of laboratory testing are available, can help identification of factors which contributed to the occurrence of the outbreak and will promote timely and efficient outbreak investigations.

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Authors+Show Affiliations

Hedberg CW
Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA. hedbe005@umn.edu
Palazzi-Churas KL
No affiliation info available
Radke VJ
No affiliation info available
Selman CA
No affiliation info available
Tauxe RV
No affiliation info available

MeSH

Bacillus cereusClostridium perfringensDisease OutbreaksFood HandlingFoodborne DiseasesHumansNorovirusPopulation SurveillanceRestaurantsSalmonellaSalmonella Food PoisoningSeverity of Illness IndexStaphylococcus aureusUnited States

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

17335632

Citation

Hedberg, C W., et al. "The Use of Clinical Profiles in the Investigation of Foodborne Outbreaks in Restaurants: United States, 1982-1997." Epidemiology and Infection, vol. 136, no. 1, 2008, pp. 65-72.
Hedberg CW, Palazzi-Churas KL, Radke VJ, et al. The use of clinical profiles in the investigation of foodborne outbreaks in restaurants: United States, 1982-1997. Epidemiol Infect. 2008;136(1):65-72.
Hedberg, C. W., Palazzi-Churas, K. L., Radke, V. J., Selman, C. A., & Tauxe, R. V. (2008). The use of clinical profiles in the investigation of foodborne outbreaks in restaurants: United States, 1982-1997. Epidemiology and Infection, 136(1), 65-72.
Hedberg CW, et al. The Use of Clinical Profiles in the Investigation of Foodborne Outbreaks in Restaurants: United States, 1982-1997. Epidemiol Infect. 2008;136(1):65-72. PubMed PMID: 17335632.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of clinical profiles in the investigation of foodborne outbreaks in restaurants: United States, 1982-1997. AU - Hedberg,C W, AU - Palazzi-Churas,K L, AU - Radke,V J, AU - Selman,C A, AU - Tauxe,R V, Y1 - 2007/03/05/ PY - 2007/3/6/pubmed PY - 2008/3/1/medline PY - 2007/3/6/entrez SP - 65 EP - 72 JF - Epidemiology and infection JO - Epidemiol Infect VL - 136 IS - 1 N2 - Improving the efficiency of outbreak investigation in restaurants is critical to reducing outbreak-associated illness and improving prevention strategies. Because clinical characteristics of outbreaks are usually available before results of laboratory testing, we examined their use for determining contributing factors in outbreaks caused by restaurants. All confirmed foodborne outbreaks reported to the Centers for Disease Control and Prevention (CDC) from 1982 to 1997 were reviewed. Clinical profiles were developed based on outbreak characteristics. We compared the percentage of contributing factors by known agent and clinical profile to their occurrence in outbreaks of unclassified aetiology. In total, 2246 foodborne outbreaks were included: 697 (31%) with known aetiology and 1549 (69%) with aetiology undetermined. Salmonella accounted for 65% of outbreaks with a known aetiology. Norovirus-like clinical profiles were noted in 54% of outbreaks with undetermined aetiology. Improper holding times and temperatures were associated with outbreaks caused by Clostridium perfringens, Bacillus cereus, Staphylococcus aureus, and Salmonella, and also with outbreaks of undetermined aetiology that fitted diarrhoea-toxin and vomiting-toxin clinical profiles. Poor personal hygiene was associated with norovirus, Shigella, and Salmonella, and also with outbreaks that fitted norovirus-like and vomiting-toxin clinical profiles. Contributing factors were similar for outbreaks with known aetiology and for those where aetiology was assigned by corresponding clinical profile. Rapidly categorizing outbreaks by clinical profile, before results of laboratory testing are available, can help identification of factors which contributed to the occurrence of the outbreak and will promote timely and efficient outbreak investigations. SN - 0950-2688 UR - https://www.unboundmedicine.com/medline/citation/17335632/The_use_of_clinical_profiles_in_the_investigation_of_foodborne_outbreaks_in_restaurants:_United_States_1982_1997_ L2 - https://www.cambridge.org/core/product/identifier/S0950268807008199/type/journal_article DB - PRIME DP - Unbound Medicine ER -