Foodborne disease outbreaks, 5-year summary, 1983-1987

This report summarizes data from foodborne disease outbreaks reported to CDC from 1983 through 1987. With a few exceptions, an outbreak is defined as an incident in which two or more persons experience a similar illness and food is implicated. During this period, 2,397 outbreaks of foodborne disease were reported, representing 91,678 cases. Among outbreaks in which the etiology was determined, bacterial pathogens caused the largest number of outbreaks (66%) and cases (92%). Chemical agents caused 26% of outbreaks and 2% of cases. Parasites caused 4% of outbreaks and less than 1% of cases, and viruses caused 5% of outbreaks and 5% of cases. The discrepancies between the number of outbreaks and the number of cases attributed to each etiologic agent emphasizes the importance of evaluating both numbers before drawing conclusions. The etiologic agent was not determined in 62% of outbreaks, reflecting the need for improved investigative skills. The number of outbreaks reported by this surveillance system is only a small fraction of the true number that occur. The likelihood of an outbreak's being reported depends on many factors, such as ease of recognition and ease of laboratory confirmation. Sporadic foodborne illness is far more common and is not included in this report.     

2006年中国食源性疾病暴发的监测资料分析

目的分析2006年中国食源性疾病暴发事件的流行病学特征。方法对全国食源性疾病监测网收集的2006年食源性疾病资料进行统计分析。结果2006年,18个监测地区共上报594起食源性疾病暴发事件,累计发病13849人,死亡67人。在病因清楚的事件中,微生物引起的食源性疾病暴发事件数和患者数最多,分别占48.3%和63.3%;化学物引起的暴发事件数和患者数分别占24.8%和15.5%;动植物引起的暴发事件数和患者数分别占23.5%和17.7%。结论全国食源性疾病监测网发现,微生物性食源性疾病是中国重要的公共卫生问题,今后仍然需要强化食源性疾病的报告意识。     

Monitoring the incidence and causes of diseases potentially transmitted by food in Australia: annual report of the Ozfoodnet Network, 2006

In 2006, OzFoodNet sites reported 24,598 notifications of seven diseases or conditions that are commonly transmitted by food, representing an increase of 2.5% over the mean of the previous 5 years. The most frequently notified aetiological agents were Campylobacter (15,492 notifications) and Salmonella (8,331 notifications). Salmonella notifications increased in 2006 by 5.2% when compared to historical reports. The most common Salmonella serotype notified in Australia during 2006 was Salmonella Typhimurium, as in previous years. S. Saintpaul was the second most common serotype notified during 2006 as a result of a large multistate outbreak associated with rockmelons. During 2006, OzFoodNet sites reported 1,544 outbreaks of gastrointestinal illness including those transmitted by contaminated food. In total, these outbreaks affected 34,916 people and resulted in 769 people being admitted to hospital and 27 deaths. Food was suspected or confirmed as the primary cause for 115 of these outbreaks and affected 1,522 persons, hospitalised 146 persons but did not result in any deaths. S. Typhimurium was the most common aetiological agent in foodborne outbreaks and restaurants were the most common setting for foods implicated in foodborne outbreaks. Sixteen outbreaks were related to eggs during 2006 compared to five outbreaks in 2005. Eighty-one per cent (13/16) of these egg-associated outbreaks were due to various phage types of S. Typhimurium. Fresh fruits and vegetables, categorised as fresh produce were responsible for four outbreaks, all due to salmonellosis. Public health laboratories provided complete serotype and phage type information on more than 97% of all Salmonella notifications during 2006. Completeness of reporting for Salmonella was equivalent to 2005 and was essential to identifying and investigating outbreaks. This report demonstrates OzFoodNet's ability to detect and investigate the burden and causes of foodborne disease in Australia. OzFoodNet efforts assist agencies to develop food safety policy and prevent foodborne illness.     

Effects and Clinical Significance of GII.4 Sydney Norovirus,United States, 2012–2013

During 2012, global detection of a new norovirus (NoV) strain, GII.4 Sydney, raised concerns about its potential effect in the United States. We analyzed data from NoV outbreaks in 5 states and emergency department visits for gastrointestinal illness in 1 state during the 2012–13 season and compared the data with those of previous seasons. During August 2012–April 2013, a total of 637 NoV outbreaks were reported compared with 536 and 432 in 2011–2012 and 2010–2011 during the same period. The proportion of outbreaks attributed to GII.4 Sydney increased from 8% in September 2012 to 82% in March 2013. The increase in emergency department visits for gastrointestinal illness during the 2012–13 season was similar to that of previous seasons. GII.4 Sydney has become the predominant US NoV outbreak strain during the 2012–13 season, but its emergence did not cause outbreak activity to substantially increase from that of previous seasons.     

Foodborne disease outbreaks in Australia, 1995 to 2000.

Health agencies are increasingly conducting systematic reviews of foodborne disease outbreak investigations to develop strategies to prevent future outbreaks. We surveyed state and territory health departments to summarise the epidemiology of foodborne disease outbreaks in Australia from 1995 to 2000. From 1995 through 2000, 293 outbreaks were identified, with 214 being of foodborne origin. One hundred and seventy-four (81%) had a known aetiology, and accounted for 80 per cent (6,472/8,124) of illnesses. There were 20 deaths attributed to foodborne illness. Of the 214 outbreaks, bacterial disease was responsible for 61 per cent of outbreaks, 64 per cent of cases and 95 per cent of deaths. The most frequent aetiology of outbreaks was Salmonella in 75 (35%) outbreaks, Clostridium perfringens in 30 (14%), ciguatera toxin in 23 (11%), scombrotoxin in 7 (3%) and norovirus in 6 (3%). Salmonellosis was responsible for eight of the 20 (40%) deaths, as was Listeria monocytogenes. Restaurants and commercial caterers were associated with the highest number of outbreak reports and cases. Outbreaks in hospitals and aged care facilities were responsible for 35 per cent of deaths. The most frequently implicated vehicles in the 173 outbreaks with known vehicles were meats 64 (30%), fish 34 (16%), seafood 13 (6%), salad 12 (6%), sandwiches 11 (5%) and eggs 9 (4%). Chicken, the most frequently implicated meat, was associated with 27 (13%) outbreaks. This summary demonstrates the serious nature of foodborne disease and supports the move to risk-based food safety interventions focusing on mass catering and hospital and aged care facilities.     

2003年中国食源性疾病暴发的监测资料分析

目的持续监测国家食源性疾病监测网覆盖地区人群食源性疾病发生状况。方法对2003年监测地区13个省上报食源性疾病资料进行回顾性分析。结果2003年共上报802起食源性疾病事件,涉及患者人数达17462人。微生物引起的食源性疾病事件和涉及人数最多,分别占总体的46·4%和60·4%,其中副溶血性弧菌(40·1%)是主要致病菌。化学物引起的食源性疾病事件和涉及人数分别占总体的24·1%和13·9%。结论应不断完善中国食源性疾病监测网络建设,作为监测食源性疾病的重要平台。     

Monitoring the incidence and causes of diseases potentially transmitted by food in Australia: annual report of the OzFoodNet Network, 2009

In 2009, OzFoodNet sites reported 27,037 notifications of 9 diseases or conditions that are commonly transmitted by food. The most frequently notified infections were Campylobacter (15,973 notifications) and Salmonella (9,533 notifications). Public health authorities provided complete serotype and phage type information on 92% of all Salmonella infections in 2009. The most common Salmonella serotype notified in Australia during 2009 was Salmonella Typhimurium, and the most common phage type was S. Typhimurium 170/108. During 2009, OzFoodNet sites reported 1,820 outbreaks of gastrointestinal illness, which affected 36,426 people and resulted in 1240 people being hospitalised. There were 118 deaths during these outbreaks. The majority (82%, 1496/1820) of outbreaks were due to person-to-person spread, 9% (163/1820) were suspected or confirmed to have been transmitted by contaminated food and 9% (161/1820) were due to either waterborne transmission or outbreaks with an unknown mode of transmission. Foodborne outbreaks affected 2679 persons including 342 hospitalisations. Eight deaths were reported during these foodborne outbreaks. Salmonella was the most common aetiological agent in foodborne outbreaks and restaurants were the most common setting where foods were prepared. Eighteen outbreaks were related to dishes containing raw or undercooked eggs; the majority (n=14) due to various phage types of S. Typhimurium. This report summarises the incidence of disease potentially transmitted by food in Australia and details outbreaks associated with various food vehicles in 2009. These data assist agencies to identify emerging sources of disease, develop food safety policies, and prevent foodborne illness.     

Enteric disease outbreak reporting, New South Wales, Australia, 2000 to 2005

OBJECTIVE: To review enteric disease outbreaks reported to the NSW Department of Health. METHODS: Data from existing electronic enteric disease outbreak summary databases were used to describe the number and type of outbreaks reported, burden of illness and cause of the outbreaks. RESULTS: Between 2000 and 2005, 998 enteric disease outbreaks were reported (148 foodborne and 850 non-foodborne), affecting 24 260 people and associated with 771 hospitalisations and 21 deaths. Salmonella was confirmed in 28 per cent of foodborne outbreaks, and norovirus in 18 per cent of non-foodborne outbreaks. CONCLUSIONS: Enteric disease outbreaks cause a substantial burden of disease in NSW.     

Surveillance for foodborne disease outbreaks--United States, 2008

Foodborne agents cause an estimated 48 million illnesses annually in the United States, including 9.4 million illnesses from known pathogens. CDC collects data on foodborne disease outbreaks submitted from all states and territories through the Foodborne Disease Outbreak Surveillance System. During 2008, the most recent year for which data are finalized, 1,034 foodborne disease outbreaks were reported, which resulted in 23,152 cases of illness, 1,276 hospitalizations, and 22 deaths. Among the 479 outbreaks with a laboratory-confirmed single etiologic agent reported, norovirus was the most common, accounting for 49% of outbreaks and 46% of illnesses. Salmonella was the second most common, accounting for 23% of outbreaks and 31% of illnesses. Among the 218 outbreaks attributed to a food vehicle with ingredients from only one of 17 defined food commodities, the top commodities to which outbreaks were attributed were poultry (15%), beef (14%), and finfish (14%), whereas the top commodities to which outbreak-related illnesses were attributed were fruits and nuts (24%), vine-stalk vegetables (23%), and beef (13%). Outbreak surveillance provides insights into the agents that cause foodborne illness, types of implicated foods, and settings where transmission occurs. Public health, regulatory, and food industry professionals can use this information to target prevention efforts against pathogens and foods that cause the most foodborne disease outbreaks.     

1992～2001年食源性疾病暴发资料分析——国家食源性疾病监测网

目的　了解国家食源性疾病监测网覆盖地区人群食源性疾病爆发的发生状况。方法　对 13个监测地区 1992～ 2 0 0 1年食源性疾病爆发上报资料进行回顾性分析。结果　十年间共上报 5 770件食源性疾病暴发事件 ,涉及的患者人数达 16 2 995人。微生物引起的食源性疾病事件和涉及人数最多 ,分别占总体的38 5 %和 5 0 9%。副溶血性弧菌 (31 1% )是主要的病因物质。化学物引起的食源性疾病事件和涉及人数分别占总体的 37 5 %和 2 8 6 %。结论　应不断加强完善我国食源性疾病监测网络的建设。     

Waterborne disease outbreaks, 1986-1988

From 1986 to 1988, 24 states and Puerto Rico reported 50 outbreaks of illness due to water that people intended to drink, affecting 25,846 persons. The protozoal parasite Giardia lamblia was the agent most commonly implicated in outbreaks, as it has been for the last 10 years; many of these outbreaks were associated with ingestion of chlorinated but unfiltered surface water. Shigella sonnei was the most commonly implicated bacterial pathogen; in outbreaks caused by this pathogen, water supplies were found to be contaminated with human waste. Cryptosporidium contamination of a chlorinated, filtered public water supply caused the largest outbreak during this period, affecting an estimated 13,000 persons. A large multistate outbreak caused by commercially produced ice made from contaminated well water caused illness with Norwalk-like virus among an estimated 5,000 persons. The first reported outbreak of chronic diarrhea of unknown cause associated with drinking untreated well water occurred in 1987. Twenty-six outbreaks due to recreational water use were also reported, including outbreaks of Pseudomonas dermatitis associated with the use of hot tubs or whirlpools, and swimming-associated shigellosis, giardiasis, and viral illness. Although the total number of reported water-related outbreaks has been declining in recent years, the few large outbreaks due to Cryptosporidium, Norwalk-like agent, Shigella sonnei, and Giardia lamblia caused more cases of illness in 1987 than have been reported to the Water-Related Disease Outbreak Surveillance System for any other year since CDC and the Environmental Protection Agency began tabulating these data in 1971.     

Waterborne-disease outbreaks, 1989-1990.

For the 2-year period 1989-1990, 16 states reported 26 outbreaks due to water intended for drinking; an estimated total of 4,288 persons became ill in these outbreaks. Giardia lamblia was implicated as the etiologic agent for seven of the 12 outbreaks in which an agent was identified. The outbreaks of giardiasis were all associated with ingestion of unfiltered surface water or surface-influenced groundwater. An outbreak with four deaths was attributed to Escherichia coli O157:H7, the only bacterial pathogen implicated in any of the outbreak investigations. An outbreak of remitting, relapsing diarrhea was associated with cyanobacteria (blue-green algae)-like bodies, whose role in causing diarrheal illness is being studied. Two outbreaks due to hepatitis A and one due to a Norwalk-like agent were associated with use of well water. Eighteen states reported a total of 30 outbreaks due to the use of recreational water, which resulted in illness for an estimated total of 1,062 persons. These 30 reports comprised 13 outbreaks of whirlpool- or hot tub-associated Pseudomonas folliculitis; 13 outbreaks of swimming-associated gastroenteritis, including five outbreaks of shigellosis; one outbreak of hepatitis A associated with a swimming pool; and three cases of primary amebic meningoencephalitis caused by Naegleria. The national surveillance of outbreaks of waterborne diseases, which has proceeded for 2 decades, continues to be a useful means for characterizing the epidemiology of waterborne diseases.     

广西自治区2006—2007年诺如病毒腹泻暴发疫情特征分析

目的分析广西诺如病毒腹泻疫情的流行特征及流行因素，为预防控制提供依据。方法采用现场流行病学调查方法及描述性分析方法，对2006年1月至2007年12月广西诺如病毒腹泻疫情报告及个案资料进行调查分析。结果2006年1月至2007年12月，广西共报告9起（城市1起，农村地区8起）诺如病毒腹泻疫情，累计病例1174例，其中实验室诊断病例75例（6．39％），临床诊断病例1099例（93．61％），无死亡病例。疫情暴发地点主要为农村地区的学校、监狱、自然村屯，农村病例数构成（86．20％）高于城市（13．80％）（P〈0．01）；病例时间分布有明显季节性，2006年病例时间分布与2007年分布不一致，2006年病例全部集中在9、10和12月，2007年病例主要集中在4—6月，占总病例数的78．75％（452／574）；病例年龄主要为10～19岁（39．52％）和20-29岁（28．88％），年龄构成差异有统计学意义（P〈0．01），男女性别比为2．19：1，职业分布主要为在校学生和服刑人员。病例症状较轻，病程一般为2—3d，具有自限性。可能的传播途径包括经水和食物、人传人接触传播等多途径传播。共采集81份病例和10份密切接触者急性期粪便标本，检出诺如病毒RNA阳性72份和5份，检出率分别为88．89％和50．00％。结论广西诺如病毒腹泻暴发疫情多在农村地区的中小学校发生，具有明显季节性，主要集中在秋季和初夏季节。应加强疫情监测，提高实验室检测能力，重点针对疫情好发地区，采取健康教育、加强饮用水卫生和饮食卫生等综合措施，减少诺如病毒腹泻暴发疫情的发生。     

Norovirus Epidemiology in Community and Health Care Settings and Association with Patient Age,Denmark

Norovirus (NoV) is a major cause of gastroenteritis. NoV genotype II.4 (GII.4) is the predominant genotype in health care settings but the reason for this finding is unknown. Stool samples containing isolates with a known NoV genotype from 2,109 patients in Denmark (patients consulting a general practitioner or outpatient clinic, inpatients, and patients from foodborne outbreaks) were used to determine genotype distribution in relation to age and setting. NoV GII.4 was more prevalent among inpatients than among patients in community settings or those who became infected during foodborne outbreaks. In community and health care settings, we found an association between infection with GII.4 and increasing age. Norovirus GII.4 predominated in patients ≥60 years of age and in health care settings. A larger proportion of children than adults were infected with NoV GII.3 or GII.P21. Susceptibility to NoV infection might depend on patient age and infecting NoV genotype. Cohort studies are warranted to test this hypothesis.     

Impact of guidelines in investigating foodborne disease outbreaks services in Lazio region, Italy

Epidemiological investigation of foodborne disease outbreaks helps us to better define the risks, hazards and vehicles involved. In 1997 guidelines on epidemiological methods for investigating these outbreaks were implemented in the Lazio Region. Methods used in investigating the 410 foodborne disease outbreaks reported in the 1996-2000 period were analysed to evaluate the impact of the guide lines on health services. Specific food attack-rates (epidemiological methods) were calculated more frequently in outbreaks with setting of mass catering with many exposed people (46% of these outbreaks) than in outbreaks in home setting with few exposed people (13% of these cases). Inversely, in smaller outbreaks the proportion of cases with detected aetiology (microbiological method) was higher (66%) than in larger ones (43%). For foodborne disease outbreaks with at least 30 people exposed epidemiological methods of investigating showed temporal trend in the period 1996-2000: the epidemics in which attack rates were calculated increased from 50% to 83%, those in which epidemic curve was drawn increased from 17% to 79%, and those in which food specific attack rates were calculated increased from 33% to 58%. The hazard analysis of critical control points (HACCP) was performed only in 18.3% of the cases. In conclusion, the guide lines resulted in a wider application of epidemiological methods in large outbreaks with a well defined exposure resulting in an improved detection of vehicles of foodborne diseases. Epidemiological methods possibly are not adequate to investigate smaller foodborne outbreaks.     

Outbreaks of Norwalk-like viral gastroenteritis--Alaska and Wisconsin, 1999

Norwalk-like viruses (NLVs) are the most common cause of epidemic gastroenteritis in the United States, resulting in illness in approximately 23 million persons each year . Persons of all ages are affected because previous infection confers only short-term immunity. Most NLV gastroenteritis outbreaks involve foodborne or person-to-person transmission. This report presents investigations of a foodborne NLV outbreak in Alaska and person-to-person transmission in Wisconsin.     

2016—2020年滨州市食源性疾病暴发事件监测分析

目的 分析滨州市2016—2020年食源性疾病暴发事件发生的流行病学特征,为发现食源性疾病的预警和防控提供理论依据。方法 收集食源性疾病暴发监测系统中2016—2020年滨州市食源性疾病暴发事件数据,并对监测到的事件进行描述性流行病学特征分析。结果 2016—2020年滨州市共发生食源性疾病暴发事件234起,共暴露11 299人,发病1 276人,无死亡病例。食源性疾病暴发事件每年的发生高峰期均为第三季度,占总起数的55.13% (129/234);家庭是食源性疾病暴发的主要发生场所,占总起数的50.43% (118/234)。报告明确或可疑致病因素的55起事件中由有毒动植物及其毒素类引起的占43.64%(24/55);在查明原因食品的221起事件中,可以明确的暴露食品主要归为动物类食品87起(39.37%)。导致暴发的污染环节多是由两种或三种以上因素混合引起的,单纯引发因素以加工不当为主。结论 滨州市食源性疾病暴发事件集中在夏秋季节,高发场所为家庭,重点防控因素为有毒动植物及其毒素类。针对本市食源性疾病暴发流行病学特征,针对性地开展食品安全知识宣教工作,提高监测预警能力,降低食源性疾病事件的发生。     

Foodborne infections and intoxications in Poland in 2003

A total of 20 221 bacterial foodborne infections and intoxications were registered in 2003 (incidence 52.9/100 000 population). These illnesses were less incident in 2003, compared both to 2002 figure (26 734 cases; incidence 69.9) and the median 1998-2001 (26 902 cases; incidence 69.6). Unlike bacterial infections, the incidence of viral foodborne infections increased in the recent years (2003--21.10 vs. 2002--17.30 and median 1998-2001 6.85). The parasitic foodborne infections did not change much during the recent years. A total of 78 cases of mushroom poisonings were reported (incidence 0.2) in 2003, compared to 66 cases in 2002 (incidence 0.17) and a median of 223 cases in 1998-2001 (incidence 0.6). The incidence of foodborne infections and intoxications was higher in the age group 0-4 years, compared to other age groups and in urban areas, compared to rural areas. A total of 230 foodborne and waterborne outbreaks involving 3816 cases were reported in 2003 (in Poland only outbreaks involving 4 persons or more were reported). The most prevalent etiological factors in outbreaks were Salmonella strains (63.6% of cases),Staphylococcus aureus (10.0% of cases) and Klebsiella strains (1.4% of cases). The most prevalent Salmonella strain were S. Enteritidis (89.3%) and S. Hadar (5.0%). The main vehicle of foodborne and waterborne outbreaks were meals prepared from various (> 2) raw materials of animal sources (29.2% of cases), egg meals (27.6%) and meats (7.2%). Of the places of food contamination, the most prevalent were own apartments (26.1% of outbreaks), food producing farms (10.6%), and restaurants (4.9%). One death was attributed to an outbreak of unknown etiology.     

Enteric outbreaks in long-term care facilities and recommendations for prevention: a review

Outbreaks of enteric illness in long-term care facilities (LTCFs) were reviewed to identify preventative recommendations. Systematic review methodology identified outbreak reports of gastrointestinal illness in LTCFs either published or that occurred from January 1997 to June 2007. The inclusion criteria captured 75 outbreaks; 23 (31%) associated with bacterial agents and 52 (69%) with viral agents. Transmission was mainly foodborne (52%) for those of bacterial origin and person-to-person (71%) for viral outbreaks. Norovirus infection was associated with 58% of hospitalizations. Sixty deaths were reported, about half from Salmonella infections. Recommendations for foodborne outbreaks emphasized appropriate sourcing and preparation of eggs, staff training, and temperature control during food preparation. Recommendations from outbreaks transmitted person-to-person centred on controlling residents' movements, effective environmental cleaning and disinfection, cancelling social events and restricting visitors, excluding ill staff, encouraging effective hand hygiene, and preventing cross-contamination through gloving and gowning. In none of the 75 published outbreak reports were the suggested recommendations evaluated for effectiveness in controlling the outbreak. Applied research of this type could greatly help in the acceptance of prevention and control strategies.     

河南省2011—2020年学校食源性疾病暴发事件分析

  目的  分析河南省2011—2020年学校食源性疾病暴发事件的流行病学规律及特点,为有效防控学校食源性疾病暴发事件提供依据。  方法  对国家食品安全风险评估中心的食源性疾病暴发监测系统报告的2011—2020年河南省学校食源性疾病暴发事件进行流行病学统计分析。  结果  河南省10年间共报告学校食源性疾病暴发事件47起,累计发病人数1 258人,住院人数701人,死亡1人。河南省学校食源性疾病暴发事件报告起数前4位的城市为郑州市、驻马店市、信阳市,新乡市。学校食源性疾病事件高峰期是6和9月。中学食堂和小学食堂导致的事件数最多(均为12起)。粮食制品引起的学校食源性疾病上报事件数和发病人数最多(14起,371人)。致病菌及其毒素是引起学校食源性疾病暴发事件的主要病原因子,占查明原因事件数的78.26%。引起学校食源性疾病暴发事件最多的致病菌是蜡样芽孢杆菌,引起发病人数最多的致病因素是致泻大肠埃希菌,引发死亡病例的致病因素是毒蘑菇。除原因不明的事件外,加工不当是导致学校食源性疾病暴发事件的主要环节。  结论  中小学生是学校食源性疾病高发群体,应加强夏秋季学校食堂的监督和管理,预防粮食类食品加工储存不当导致的细菌性食源性疾病暴发事件。