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Utility of Clinical-Epidemiological Profiles in Outbreaks of Foodborne Disease, Catalonia, 2002 through 2006

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Abstract:

The objective of this study was to evaluate the use of clinical-epidemiological profiles for classifying non–laboratory-confirmed outbreaks of foodborne disease (FBD) in Catalonia between 2002 and 2006 and for elucidating associations among factors contributing to these outbreaks. A total of 275 nonfamily outbreaks were studied, of which 190 (69.1%) were laboratory confirmed and 85 (30.9%) were not. In 176 (92.6%) of laboratory-confirmed outbreaks and 69 (81.2%) of non–laboratory-confirmed outbreaks, information was obtained on contributing factors (P = 0.009). In 72% of non–laboratory-confirmed outbreaks, the etiology was assigned by using clinical-epidemiological profiles; thus, 93% of outbreaks eventually were associated with an etiology. In laboratory-confirmed outbreaks, poor personal hygiene was positively associated with norovirus (odds ratio [OR], 2.69; 95% confidence interval [CI], 1.47 to 4.89; P = 0.0007) and negatively associated with Salmonella and Campylobacter (OR, 0.54; 95% CI, 0.33 to 0.89; P = 0.01), and an unsafe source was positively associated with Salmonella and Campylobacter (OR, 4.07; 95% CI, 1.72 to 10.09; P = 0.001) and negatively associated with norovirus (OR, 0.14; 95% CI, 0.04 to 0.58; P = 0.001). No differences were found among contributing factors associated with outbreaks with a laboratory-confirmed etiology and those associated with outbreaks with an etiology assigned according to the clinical-epidemiological profiles. Clinical-epidemiological profiles are useful for determining what prevention and control strategies are appropriate to the agents involved in each community and for designing outbreak investigations.

Document Type: Research Article

Affiliations: 1: Department of Public Health. University of Barcelona, Casanova 143, Barcelona 08036, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Aiguader 88, Barcelona 08003, Spain 2: Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Aiguader 88, Barcelona 08003, Spain 3: Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Aiguader 88, Barcelona 08003, Spain; Department of Health, Generalitat of Catalonia, Roc Boronat 81-95, Barcelona 08005, Spain 4: Department of Health, Generalitat of Catalonia, Roc Boronat 81-95, Barcelona 08005, Spain 5: Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Aiguader 88, Barcelona 08003, Spain; Public Health Agency of Barcelona, Pl Lesseps 1, Barcelona 08024, Spain

Publication date: January 1, 2010

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