Food companies, step it up: US multistate foodborne outbreaks, 2010-2014

Posted on November 4, 2015 by Douglas Powell

Multistate outbreaks cause more than half of all deaths in foodborne disease outbreaks despite accounting for only a tiny fraction (3 percent) of reported outbreaks in the United States, according to a new U.S Centers for Disease Control report.

Recent outbreaks of foodborne illness linked to tainted cucumbers, ice cream and soft cheeses show the devastating consequences when food is contaminated with dangerous germs before it reaches a restaurant or home kitchen.

Highlights from the report on multistate foodborne outbreaks during 2010-2014 include:

• An average of 24 multistate outbreaks occurred each year, involving two to 37 states.

Salmonella accounted for the most illnesses and hospitalizations and was the cause of the three largest outbreaks, which were traced to eggs, chicken and raw ground tuna.
Listeria caused the most deaths, largely due to an outbreak caused by contaminated cantaloupe in 2011 that killed 33 people.
Imported foods accounted for 18 of the 120 reported outbreaks. Food imported from Mexico was the leading source in these outbreaks, followed by food imported from Turkey.

The report recommends that local, state, and national health agencies work closely with food industries to understand how their foods are produced and distributed to speed multistate outbreak investigations. These investigations can reveal fixable problems that resulted in food becoming contaminated and lessons learned that can help strengthen food safety.

The report highlights the need for food industries to play a larger role in improving food safety by following best practices for growing, processing, and shipping foods. In addition, food industries can help stop outbreaks and lessen their impact by keeping detailed records to allow faster tracing of foods from source to destination, by using store loyalty cards to help identify what foods made people sick, and by notifying customers of food recalls.

“Reacting to problems isn’t sufficient in today’s food system, nor is it the best way to practice public health,” Dr. Kathleen Gensheimer, director of FDA’s Coordinated Outbreak Response & Evaluation Network, said in a teleconference.

Gensheimer stressed that in the past, food safety has been focused on reacting to outbreaks, but new regulations set to take effect in 2016 will require companies to take a science-based approach to building safety controls into food production.

“Industry is a very critical partner,” she said.

For example, although it is still not clear what caused the E. coli outbreak at Chipotle, Gensheimer said on the call that the company has shared “all of their records and is working with us in any way possible to give us information about their suppliers.”

Gensheimer also said after the current investigation ends, the company expressed interest in meeting with FDA and the CDC to work out ways to prevent future outbreaks.

CDC Director Dr. Tom Frieden said state-of-the-art disease tracking tools, and the introduction of gene tools, are helping to quickly track down the source of food-borne outbreaks in collaboration with state and national partners.

Frieden said disease detectives are “cracking the cases much more frequently than in past years because we have this new DNA fingerprinting tool being used increasingly,” but many cases still go unsolved.

He said companies are also stepping up to help, noting new requirements at Wal-Mart Stores Inc for food suppliers that set new control for suppliers to reduce contamination and the wholesaler’s Costco’s use of membership card lists to notify customers about recalled foods.

The leading causes of multistate outbreaks – Salmonella, E. coli, and Listeria – are more dangerous than the leading causes of single-state outbreaks. These three germs, which cause 91 percent of multistate outbreaks, can contaminate widely distributed foods, such as vegetables, beef, chicken and fresh fruits, and end up sickening people in many states.

“Americans should not have to worry about getting sick from the food they eat,” said CDC Director Tom Frieden, M.D., M.P.H. “Top-notch epidemiology and new gene sequencing tools are helping us quickly track down the source of foodborne outbreaks – and together with our national partners we are working with the food industry to prevent them from happening in the first place.”

Introduction: Millions of U.S. residents become ill from foodborne pathogens each year. Most foodborne outbreaks occur among small groups of persons in a localized area. However, because many foods are distributed widely and rapidly, and because detection methods have improved, outbreaks that occur in multiple states and that even span the entire country are being recognized with increasing frequency.

Methods: This report analyzes data from CDC’s Foodborne Disease Outbreak Surveillance System to describe multistate foodborne outbreaks that occurred in the United States during 2010–2014.

Results: During this 5-year period, 120 multistate foodborne disease outbreaks (with identified pathogen and food or common setting) were reported to CDC. These multistate outbreaks accounted for 3% (120 of 4,163) of all reported foodborne outbreaks, but were responsible for 11% (7,929 of 71,747) of illnesses, 34% (1,460 of 4,247) of hospitalizations, and 56% (66 of 118) of deaths associated with foodborne outbreaks. Salmonella (63 outbreaks), Shiga toxin-producing E. coli (34), and Listeria monocytogenes (12) were the leading pathogens. Fruits (17), vegetable row crops (15), beef (13), sprouts (10), and seeded vegetables (nine) were the most commonly implicated foods. Traceback investigations to identify the food origin were conducted for 87 outbreaks, of which 55 led to a product recall. Imported foods were linked to 18 multistate outbreaks.

Conclusions: Multistate foodborne disease outbreaks account for a disproportionate number of outbreak-associated illnesses, hospitalizations, and deaths relative to their occurrence. Working together, food industries and public health departments and agencies can develop and implement more effective ways to identify and to trace contaminated foods linked to multistate outbreaks. Lessons learned during outbreak investigations can help improve food safety practices and regulations, and might prevent future outbreaks.

MMWR November 3, 2015 / 64(Early Release);1-5

Samuel J. Crowe, PhD1,2; Barbara E. Mahon, MD2; Antonio R. Vieira, PhD2; L. Hannah Gould, PhD

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm64e1103a1.htm?s_cid=mm64e1103a1_w

The kids are not alright: STEC in England

Posted on October 26, 2015 by Douglas Powell

Between 1 January 2009 and 31 December 2012 in England, a total of 3717 cases were reported with evidence of Shiga toxin-producing E. coli (STEC) infection, and the crude incidence of STEC infection was 1·80/100 000 person-years.

Incidence was highest in children aged 1–4 years (7·63/100 000 person-years). Females had a higher incidence of STEC than males [rate ratio (RR) 1·24, P < 0·001], and white ethnic groups had a higher incidence than non-white ethnic groups (RR 1·43, P < 0·001). Progression to haemolytic uraemic syndrome (HUS) was more frequent in females and children. Non-O157 STEC strains were associated with higher hospitalization and HUS rates than O157 STEC strains.

In STEC O157 cases, phage type (PT) 21/28, predominantly indigenously acquired, was also associated with more severe disease than other PTs, as were strains encoding stx2 genes.

Incidence of STEC was over four times higher in people residing in rural areas than urban areas (RR 4·39, P < 0·001). Exposure to livestock and/or their faeces was reported twice as often in cases living in rural areas than urban areas (P < 0·001). Environmental/animal contact remains an important risk factor for STEC transmission and is a significant driver in the burden of sporadic STEC infection.

The most commonly detected STEC serogroup in England was O157. However, a bias in testing methods results in an unquantifiable under-ascertainment of non-O157 STEC infections. Implementation of PCR-based diagnostic methods designed to detect all STEC, to address this diagnostic deficit, is therefore important.

The epidemiology, microbiology and clinical impact of Shiga toxin-producing Escherichia coli in England, 2009–2012

Epidemiology and Infection / Volume 143 / Issue 16 / December 2015, pp 3475-3487

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10012382&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG

Foodborne and waterborne disease outbreaks — United States, 1971–2012

Posted on October 23, 2015 by Douglas Powell

The U.S. Centers for Disease Control and Prevention collects data on foodborne and waterborne disease outbreaks reported by all U.S. states and territories through the Foodborne Disease Outbreak Surveillance System (FDOSS) and the Waterborne Disease and Outbreak Surveillance System (WBDOSS), respectively. These two systems are the primary source of national data describing the number of illnesses, hospitalizations, and deaths; etiologic agents; water source or implicated foods; settings of exposure; and other factors associated with recognized foodborne and waterborne disease outbreaks in the United States.

This report summarizes data on foodborne disease outbreaks reported during 1973–2012 and waterborne disease outbreaks reported during 1971–2012. This report is a part of the first-ever Summary of Notifiable Noninfectious Conditions and Disease Outbreaks, which encompasses various surveillance years but is being published in 2015 (1). The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases (2).

Background

Foodborne Disease Outbreak Surveillance

Foodborne diseases cause an estimated 48 million illnesses each year in the United States, including 9.4 million caused by known pathogens (3,4). Only a minority of foodborne illnesses, hospitalizations, and deaths occur as part of recognized outbreaks (5). However, information gathered from foodborne disease outbreak surveillance provides valuable insights into the agents that cause foodborne illness, types of implicated foods and ingredients, and settings in which transmission occurs.

Foodborne disease outbreaks have been nationally notifiable since 2010; however, reports of foodborne disease outbreaks have been collected by CDC through FDOSS since 1973. Initially a paper-based system, FDOSS became web-based in 1998. In 2009, the system was transitioned to an enhanced reporting platform, the National Outbreak Reporting System (NORS), which also collects information on waterborne disease outbreaks and enteric disease outbreaks with modes of transmission other than food, including person-to-person contact, animal contact, and environmental contamination. Information about NORS is available at http://www.cdc.gov/nors.

Foodborne disease outbreak surveillance data highlight the etiologic agents, foods, and settings involved most often in outbreaks and can help to identify food commodities and preparation settings in which interventions might be most effective. Surveillance for foodborne disease outbreaks provides insight into the effectiveness of regulations and control measures, helps identify new and emerging pathogens, provides information regarding the food preparation and consumption settings where outbreaks occur, informs prevention and control measures in the food industry by identifying points of contamination, and can be used to describe trends in foodborne disease outbreaks over time.

Waterborne Disease Outbreak Surveillance

Despite advances in water management and sanitation, waterborne disease and outbreaks continue to occur in the United States. CDC collects data on waterborne disease outbreaks associated with drinking water, recreational water, and other water exposures through WBDOSS. Waterborne disease outbreaks have been nationally notifiable since 2010; however, reports of waterborne disease outbreaks have been collected by CDC since 1971. Initially utilizing a paper-based reporting process, the system transitioned to web-based reporting with the launch of NORS in 2009.

CDC uses waterborne disease outbreak surveillance data to identify the types of etiologic agents, settings, recreational water venues, and drinking water systems associated with waterborne disease outbreaks; inform regulations and public awareness activities to promote healthy swimming and safe drinking water; and establish public health priorities to improve prevention efforts, guidelines, and regulations at the local, state, and federal levels.

Data Sources

Foodborne Disease Outbreak Surveillance

State, local, and territorial health departments use a standard form (CDC form 52.13, available at http://www.cdc.gov/nors/pdf/NORS_CDC_5213.pdf ) to report foodborne disease outbreaks to CDC. Data requested for each outbreak include reporting state; date of first illness onset; the number of illnesses, hospitalizations, and deaths; the etiology; the implicated food vehicle; the setting of food preparation and consumption; and contributing factors. Multistate outbreaks (i.e., those in which exposure to the implicated food occurred in more than one state) typically are reported to the system by CDC.

Only reports meeting the definition of a foodborne disease outbreak (i.e., the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food) are included in this summary. Outbreaks that occurred on cruise ships and those involving food eaten outside the United States, even if the illness occurred in the United States, are not included in FDOSS.

Laboratory and clinical guidelines for confirming an etiology are specific to each bacterial, chemical/toxin, parasitic, and viral agent (http://www.cdc.gov/foodsafety/outbreaks/investigating-outbreaks/confirming_diagnosis.html). Suspected etiologies are those that do not meet the confirmation guidelines. The cause of an outbreak is categorized as “multiple etiologies” if more than one etiologic agent is reported.

Waterborne Disease Outbreak Surveillance

State, local, and territorial health departments use a standard form (CDC form 52.12, available at http://www.cdc.gov/nors/forms.html#waterborne) to report waterborne disease outbreaks to CDC. Data requested for each outbreak include reporting state; date of first illness onset; the number of illnesses, hospitalizations, and deaths; the etiology; the type of water exposure (e.g., recreational); the implicated venue or system, the setting of exposure; water quality indicators; and contributing factors.

Only reports meeting the definition of a waterborne disease outbreak (i.e., the occurrence of two or more cases of a similar illness resulting from exposure to a common water source) are included in this summary. WBDOSS includes reports of both gastrointestinal illness outbreaks and other illness outbreaks (e.g., legionellosis). Outbreaks that occurred on cruise ships and those in which the water exposure occurred outside the United States, even if the illness occurred in the United States, are not included in WBDOSS.

Interpreting Data

Outbreaks represent only a small fraction of the number of foodborne and waterborne illnesses reported each year. Outbreaks caused by certain pathogens or vehicles might be more likely to be recognized or investigated. However, some illnesses reported as sporadic likely are not recognized as being part of a reported outbreak or are part of undetected outbreaks. In addition, all outbreak-related illnesses might not be identified during an investigation, smaller outbreaks might not come to the attention of public health authorities, and some outbreaks might not be investigated or reported to CDC. Reporting practices for foodborne and waterborne disease outbreaks also vary among states, which might have differing definitions of which events are reportable and unique laws related to disease outbreak reporting. For these reasons, variations in reporting rates by state might reflect variations in levels of effort and funding for foodborne and waterborne disease outbreak investigation rather than actual differences in reporting rates by state. Finally, NORS maintains a dynamic database; this analysis included data on March 27, 2015 for foodborne disease outbreaks and April 27, 2015 for waterborne disease outbreaks. Results might differ from those published earlier or later.

Methods for Identifying Foodborne and Waterborne Disease Outbreaks

Guidance for states and jurisdictions for reporting foodborne and waterborne disease outbreaks is provided by CDC (http://www.cdc.gov/nors/forms.html). As for all notifiable conditions, reporting to CDC is voluntary, and state and local laws, regulations, and practices vary. For example, CDC advises states to report outbreaks with cases in the same household; however, state or local jurisdictions might determine that these outbreaks do not require investigation or might deem them nonreportable at the state level.

Publication Criteria

Foodborne disease outbreaks are defined as two or more cases of a similar illness resulting from ingestion of a common food. Waterborne disease outbreaks are defined as two or more cases of a similar illness linked epidemiologically by time and location to exposure to water or water-associated chemicals volatized into the air.

Highlights

Foodborne Disease Outbreaks

During 1973–2012, CDC received reports of 29,429 foodborne disease outbreaks with 729,020 outbreak-associated illnesses from 50 states, Puerto Rico, the District of Columbia, and freely associated states/territories. An average of 736 (range: 298–1404) outbreaks were reported each year (Figure 1). The average annual number of foodborne disease outbreaks reported to CDC during 1998–2012 was more than double the average annual number reported during 1973–1997, coinciding with the transition to an electronic reporting system.

In 2012, a total of 804 single-state exposure outbreaks were reported with 13,320 illnesses by 49 states and Puerto Rico (Table, Figure 2). An additional 25 multistate outbreaks (i.e., outbreaks in which exposure to the implicated food occurred in more than one state) with 1,496 associated illnesses were also reported.

More detailed annual summaries describing the implicated foods, etiologic agents, settings, and points of contamination associated with foodborne disease outbreaks are published periodically by CDC. A summary of foodborne disease outbreaks in 2013, the most recent year for which data are available, is available at http://www.cdc.gov/foodsafety/fdoss/data/annual-summaries/index.html.

Waterborne Disease Outbreaks

During 1971–2012, CDC received reports of 1,901 waterborne disease outbreaks with 639,949 outbreak-associated illnesses from 50 states and six freely associated states/territories. An average of 45 waterborne outbreaks were reported each year (Figure 1).

In 2012, a total of 73 outbreaks causing at least 1,261 illnesses occurred in 27 states and one territory. No multistate outbreaks were reported (Table,Figure 3).

CDC publishes separate and more detailed summaries of waterborne disease outbreaks associated with recreational water and waterborne disease outbreaks associated with drinking water. These summaries are available at http://www.cdc.gov/healthywater/surveillance/surveillance-reports.html.

References

Summary of notifiable noninfectious conditions and disease outbreaks—United States. MMWR Morb Mortal Wkly Rep 2013;62(54).
Summary of notifiable infectious diseases—United States. MMWR Morb Mortal Wkly Rep 2013;62(53).
Scallan E, Hoekstra RM, Angulo FJ, et al. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis 2011;17:7–15.
Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM. Foodborne illness acquired in the United States—unspecified agents. Emerg Infect Dis 2011;17:16–22.
Preliminary FoodNet data on the incidence of infection with pathogens transmitted commonly through food—10 states, 2009. MMWR Morb Mortal Wkly Rep 2010;59:418–22.

It can happen: Surveillance artefacts

Posted on October 17, 2015 by Douglas Powell

In 1991, 1999 and 2006, randomly selected individuals from the Danish Central Personal Register provided a serum sample. From individuals aged 30 years and above, 500 samples from each year were analysed for Campylobacter IgG, IgA and IgM antibodies using a direct ELISA method.

We applied a seroincidence calculator available from the European Centre for Disease Prevention and Control to perform a mathematical back-calculation to estimate the annual Campylobacter seroincidence in the Danish population. The estimated Campylobacter seroincidence did not differ significantly between the 1991, 1999 and 2006 studies although the reported number of culture-confirmed cases of Campylobacter infection increased 2.5 fold from 1993 to 1999 among individuals aged 30 years and above.

This suggests that Campylobacter was widely present in the Danish population before the increase in poultry-associated clinical Campylobacter infections observed from 1993 to 2001 among individuals of this age groups.

Was the increase in culture-confirmed Campylobacter infections in Denmark during the 1990s a surveillance artefact?

Euro Surveill. 2015;20(41):pii=30041

Emborg H-D, Teunis P, Simonsen J, Krogfelt KA, Jørgensen CS, Takkinen J, Mølbak Kåre

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21277

Multi-source surveillance works; ciguatera fish poisoning outbreak identified using linked databases

Posted on October 15, 2015 by Ben Chapman

Ciguatera fish poisoning sounds awful. Symptoms include paradoxical temperature perception, paresthesias, extremity numbness, a metallic taste, nausea, vomiting, abdominal pain, diarrhea, arthralgia, and myalgia. And a female fish lover in Florida experienced all of these things, according to CDC’s MMWR, after eating black grouper in October 2014.

Following her illness she notified Florida’s Department of Health through an online reportable illness complaint system.

Keen epi folks took this single case as a signal, went into the Inter and Intra-nets of the public health and identified five additional cases. After reviewing food histories (and black grouper consumption) they were able to trace the fish to a common supplier and solved the mystery.

What looked like two separate events turned out to be a bigger deal. Yay for databases.

On November 3, 2014, the Florida Department of Health in Orange County (DOH-Orange) received a report through the DOH online foodborne illness complaint system from a person (patient A) describing paresthesias and numbness that suggested CFP, which had occurred on October 31, the day after eating two fish meals. The day the report was received, DOH-Orange interviewed patient A and determined that her illness met the CFP case definition. In Florida, a single case of CFP is considered an outbreak. Multiple data sources were used to identify five additional CFP cases. DOH-Orange, the DOH Bureau of Epidemiology, the Florida Department of Business and Professional Regulation (DBPR), the Florida Department of Agriculture and Consumer Services (DACS), and the U.S. Food and Drug Administration (FDA) collaborated to conduct investigations at two restaurants, one grocery store, two fish distributors, and one fish supplier to identify the outbreak food source. The six persons with CFP had eaten black grouper either at a local restaurant or purchased from a grocery store; the fish was traced back to a common international distributor. Rapid identification and reporting of CFP cases to public health officials is imperative to facilitate supportive medical care and source-food traceback efforts.

The toxin associated with ciguatera fish poisoning is produced by a dinoflagellates (usually Gambierdiscus toxicus which lives on algae or dead coral) and is eaten up by sporting fish like barracuda, amber jack, snapper and black grouper

The fish eat the small organisms and overtime bioaccumulate the toxin in their tissue.

Then folks who like fish, eat it and get sick. Even if it’s cooked.

The toxin is pretty heat stable (FAO says that even 20 min of cooking at 158°F/70°C for 20 min was insufficient to fully denature the toxin protein).

Campy up, E. coli O157 down: Foodborne diseases active surveillance network (FoodNet)

Posted on October 13, 2015 by Douglas Powell

The U.S. Centers for Disease Control and Prevention Foodborne Diseases Active Surveillance Network, or FoodNet, has been tracking trends for infections transmitted commonly through food since 1996.

FoodNet provides a foundation for food safety policy and prevention efforts. It estimates the number of foodborne illnesses, monitors trends in incidence of specific foodborne illnesses over time, attributes illnesses to specific foods and settings, and disseminates this information.

“FoodNet has matured and transformed over 20 years, and continues to evolve as technologies change,” says Dr. Olga Henao, FoodNet Team Lead.

The Foodborne Diseases Active Surveillance Network, or FoodNet, has been tracking trends in foodborne infections since 1996.

FoodNet provides a foundation for food safety policy and prevention efforts by estimating the number of foodborne illnesses, monitoring trends of specific foodborne illnesses, conducting studies to understand the causes of these illnesses, and informing the public about its findings.

FoodNet began to collect information on two pathogen cases identified by CIDT in 2009 and expanded the collection to other pathogens in 2011.

FoodNet has conducted surveillance for laboratory-confirmed cases of infection in humans caused by Campylobacter, Listeria, Salmonella, Shiga toxin-producing E. coli (STEC) O157, Shigella, Vibrio, and Yersinia since 1996, Cryptosporidium and Cyclospora since 1997, and STEC non-O157 since 2000. FoodNet staff in state health departments contact clinical laboratories in the surveillance area to get reports of infections diagnosed in residents.

Special Studies

Although foodborne outbreaks are common, most foodborne infections are sporadic, meaning they are not related to an outbreak. We can only rarely determine how one person got an infection but, by studying a large number of people with the same type of infection, we can often determine risk factors for getting ill.

Major Contributions

FoodNet is the only U.S. system focused on obtaining comprehensive information about sporadic infections caused by pathogens transmitted commonly through food. The network’s contributions to food safety policy and illness prevention include:

Establishing reliable, active population-based surveillance to understand who gets sick and why;

Developing and implementing studies that determine risk and protective factors for foodborne infections;

Conducting population surveys and laboratory surveys that describe the features of gastrointestinal illnesses, medical care-seeking behavior, foods eaten, and laboratory practices; and

Improving our ability at the federal and state level to track and study foodborne illnesses and respond to new issues as they arise.

About FoodNet

Surveillance in an area that includes 15% of the U.S. population (approximately 48 million people)

Collaboration among CDC, 10 state health departments, the U.S. Department of Agriculture’s Food Safety and Inspection Service, and the Food and Drug Administration. (Image: U.S. map showing FoodNet sites.)

Principal foodborne disease component of CDC’s Emerging Infections Program

Provides the data necessary for measuring the progress in foodborne disease prevention.

Predicting food fraud, EU style

Posted on October 9, 2015 by Douglas Powell

Because food fraud can harm human health and erode consumer trust, it is imperative that it is detected at an early stage. Therefore the aim of this study was to predict the expected food fraud type for imported products for which the product category and country of origin are known in order to target enforcement activities.

For this purpose we used a Bayesian Network (BN) model that was developed based on adulteration/fraud notifications as reported in the Rapid Alert System for Food and Feed (RASFF) in the period 2000–2013. In this period 749 food fraud notifications were reported and were categorised in 6 different fraud types (i) improper, fraudulent, missing or absent health certificates, (ii) illegal importation, (iii) tampering, (iv) improper, expired, fraudulent or missing common entry documents or import declarations, (v) expiration date, (vi) mislabelling. The data were then used to develop a BN model. The constructed BN model was validated using 88 food fraud notifications reported in RASFF in 2014. The proposed model predicted 80% of food fraud types correctly when food fraud type, country and food category had been reported previously in RASFF. The model predicted 52% of all 88 food fraud types correctly when the country of origin or the product-country combination had not been recorded before in the RASFF database.

The presented model can aid the risk manager/controller in border inspection posts in deciding which fraud type to check when importing products.

Prediction of food fraud type using data from Rapid Alert System for Food and Feed (RASFF) and Bayesian network modelling

Food Control, Volume 61, March 2016, Pages 180–187

Yamine Bouzembrak, Hans J.P. Marvin

http://www.sciencedirect.com/science/article/pii/S095671351530205X

Document what works: Social media in surveillance

Posted on October 6, 2015 by Douglas Powell

Research studies show that social media may be valuable tools in the disease surveillance toolkit used for improving public health professionals’ ability to detect disease outbreaks faster than traditional methods and to enhance outbreak response.

A social media work group, consisting of surveillance practitioners, academic researchers, and other subject matter experts convened by the International Society for Disease Surveillance, conducted a systematic primary literature review using the PRISMA framework to identify research, published through February 2013, answering either of the following questions:

Can social media be integrated into disease surveillance practice and outbreak management to support and improve public health?

Can social media be used to effectively target populations, specifically vulnerable populations, to test an intervention and interact with a community to improve health outcomes?

Examples of social media included are Facebook, MySpace, microblogs (e.g., Twitter), blogs, and discussion forums. For Question 1, 33 manuscripts were identified, starting in 2009 with topics on Influenza-like Illnesses (n = 15), Infectious Diseases (n = 6), Non-infectious Diseases (n = 4), Medication and Vaccines (n = 3), and Other (n = 5). For Question 2, 32 manuscripts were identified, the first in 2000 with topics on Health Risk Behaviors (n = 10), Infectious Diseases (n = 3), Non-infectious Diseases (n = 9), and Other (n = 10).

Conclusions

The literature on the use of social media to support public health practice has identified many gaps and biases in current knowledge. Despite the potential for success identified in exploratory studies, there are limited studies on interventions and little use of social media in practice. However, information gleaned from the articles demonstrates the effectiveness of social media in supporting and improving public health and in identifying target populations for intervention. A primary recommendation resulting from the review is to identify opportunities that enable public health professionals to integrate social media analytics into disease surveillance and outbreak management practice.

Using social media for actionable disease surveillance and outbreak management: a systematic literature review

PLoS ONE 10(10): e0139701

Lauren E. Charles-Smith, Tera L. Reynolds, Mark A. Cameron, Mike Conway, Eric H. Y. Lau, Jennifer M. Olsen, Julie A. Pavlin, Mika Shigematsu, Laura C. Streichert, Katie J. Suda, Courtney D. Corley

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0139701

Raw pork liver a risk factor for hepatitis E in France

Posted on October 3, 2015 by Douglas Powell

In France, the number of confirmed autochthonous hepatitis E (HE) cases has shown a substantial increase since 2006. In 2010, a descriptive study of acute autochthonous laboratory-confirmed HE cases was implemented in order to generate hypotheses about transmission modes and contamination sources.

Acute autochthonous HE cases confirmed by the National Reference Centre (CNR) were interviewed on exposures in the 2 to 10 weeks before illness onset. Clinical, biological and epidemiological characteristics were documented for 139 autochthonous cases.

Sixty-five per cent of them resided in southern France, 59% reported underlying conditions and 74% were infected by HEV subtype 3f. Consumption of raw pig-liver products during the incubation period was more frequent among cases in southern (47%) than in northern (25%) France. HE is a frequent infection, more prevalent in Southern France, where cases frequently report the consumption of raw pork-liver products. A case control study will determine the fraction of HE cases attributable to the consumption of such products and other risk factors.

Descriptive study of autochthonous cases of hepatitis E cases, France, 2010

Couturier E, De Valk H, Letort MJ, Vaillant V, Nicand E, Tessé S, Roque-Afonso AM

Saint-Maurice : Institut de veille sanitaire

http://www.invs.sante.fr/Publications-et-outils/Rapports-et-syntheses/Maladies-infectieuses/2015/Etude-descriptive-des-cas-autochtones-d-hepatite-E-France-2010#panel2

E. coli in Qatar

Posted on October 3, 2015 by Douglas Powell

Escherichia coli O157:H7, non-O157 E. coli, and Campylobacter spp. are among the top-ranked pathogens that threaten the safety of food supply systems around the world.

The associated risks and predisposing factors were investigated in a dynamic animal population using a repeat-cross-sectional study design.

Animal and environmental samples were collected from dairy and camel farms, chicken processing plants, and abattoirs and analyzed for the presence of these pathogens using a combination of bacterial enrichment and real-time PCR tests without culture confirmation. Data on putative risk factors were also collected and analyzed.

E. coli O157:H7 was detected by PCR at higher levels in sheep and camel feces than in cattle feces (odds ratios [OR], 6.8 and 21.1, respectively). Although the genes indicating E. coli O157:H7 were detected at a relatively higher rate (4.3%) in fecal samples from dairy cattle, they were less common in milk and udder swabs from the same animals (1 and 2%, respectively).

Among the food adulterants, E. coli O103 was more common in cattle fecal samples, whereas O26 was more common in sheep feces and O45 in camel feces compared with cattle (OR, 2.6 and 3.1, respectively). The occurrence of E. coli in the targeted populations differed by the type of sample and season of the year.

Campylobacter jejuni and Campylobacter coli were more common in sheep and camel feces than in cattle feces. Most of the survey and surveillance of E. coli focused on serogroup O157 as a potential foodborne hazard; however, based on the PCR results, non-O157 Shiga toxin–producing E. coli serotypes appeared to be more common, and efforts should be made to include them in food safety programs.

Risk of Escherichia coli O157:H7, non-O157 shiga toxin–producing Escherichia coli, and Campylobacter spp. in food animals and their products in Qatar

Journal of Food Protection®, Number 10, October 2015, pp. 1776-1924, pp. 1812-1818(7)

Mohammed, Hussni O.; Stipetic, Korana; Salem, Ahmed; McDonough, Patrick; Chang, Yung Fu; Sultan, Ali

http://www.ingentaconnect.com/content/iafp/jfp/2015/00000078/00000010/art00005

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Tag Archives: Surveillance