Epidemiology and Infection

Review Article

Publication bias in foodborne outbreaks of infectious intestinal disease and its implications for evidence-based food policy. England and Wales 1992–2003 1

S. J. O'BRIEN a1a2c1, I. A. GILLESPIE a2, M. A. SIVANESAN a2, R. ELSON a2, C. HUGHES a2 and G. K. ADAK a2
a1 Division of Medicine and Neurosciences, University of Manchester, Manchester, UK
a2 Environmental and Enteric Diseases Department, Health Protection Agency Centre for Infections, London, UK

Article author query
o'brien sj   [PubMed][Google Scholar] 
gillespie ia   [PubMed][Google Scholar] 
sivanesan ma   [PubMed][Google Scholar] 
elson r   [PubMed][Google Scholar] 
hughes c   [PubMed][Google Scholar] 
adak gk   [PubMed][Google Scholar] 


Systematic national surveillance of outbreaks of infectious intestinal disease (IID) was introduced in England and Wales in 1992 to provide comprehensive information on causative organisms, sources or vehicles of infection and modes of transmission. We compared information from this system with that published in the peer-reviewed literature between 1 January 1992 and 31 January 2003 to assess the potential effect of publication bias on food-safety policy. During the study period 1763 foodborne outbreaks of IID were reported to national surveillance. Fifty-five were published in the peer-reviewed literature. The peer-reviewed literature overestimated the impacts of milk/milk products, miscellaneous foods (e.g. sandwiches) and desserts and underestimated those of poultry, fish and shellfish, red meat/meat products and eggs/egg products. Without systematic surveillance, knowledge of causative organisms, sources or vehicles of infection and modes of transmission, as gleaned from the peer-reviewed literature, would potentially distort food-safety policy.

(Accepted November 8 2005)
(Published Online January 18 2006)

c1 Health Sciences and Epidemiology, University of Manchester, Division of Medicine and Neuroscience, Clinical Sciences Building, Hope Hospital, Stott Lane, Salford, M6 8HD, UK. (Email: Sarah.O'Brien@manchester.ac.uk)


1 This paper was presented in part at the International Conference on Emerging Infectious Diseases, Atlanta, Georgia, USA in March 2004.