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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
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
Copyright
2001 Cambridge University Press