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Epidemiologic profiling: evaluating foodborne outbreaks for which no pathogen was isolated by routine laboratory testing: United States, 1982–9

Published online by Cambridge University Press:  05 February 2002

J. A. HALL ,
J. S. GOULDING ,
N. H. BEAN ,
R. V. TAUXE  and
C. W. HEDBERG
J. A. HALL
Affiliation:
Minnesota Department of Health, Minneapolis, MN, USA
J. S. GOULDING
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA, USA
N. H. BEAN
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA, USA
R. V. TAUXE
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA, USA
C. W. HEDBERG
Affiliation:
Minnesota Department of Health, Minneapolis, MN, USA
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Abstract

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The objective was to evaluate foodborne outbreaks of undetermined aetiology by comparing them to pathogen-specific epidemiologic profiles of laboratory-confirmed foodborne outbreaks. National foodborne outbreak data reported to CDC during 1982–9 were categorized by clinico-epidemiologic profiles based on incubation, duration, percent vomiting, fever and vomiting to fever ratio. From the pathogen-specific profiles, five syndromes were developed: a vomiting-toxin syndrome resembling Bacillus cereus and Staphylococcus aureus; a diarrhoea-toxin syndrome characteristic of Clostridium perfringens, a diarrhaeogenic Escherichia coli syndrome, a Norwalk-like virus syndrome, and a salmonella like syndrome. Of 712 outbreaks, 624 (87·6%) matched one of five syndromes; 340 (47·8%) matched the Norwalk-like syndrome and 83 (11·7%) matched the salmonella-like syndrome. After combining information on known pathogens and epidemiologic profiles, only 88 (12·4%) outbreaks remained unclassified. Norwalk-like virus outbreaks appear as common as salmonella-like outbreaks. We conclude that profiling can help classify outbreaks, guide investigations and direct laboratory testing to help detect new and emerging pathogens.

Type
Research Article
Information
Epidemiology & Infection , Volume 127 , Issue 3 , December 2001 , pp. 381 - 387
Copyright
2001 Cambridge University Press