December 14th, 2011 by RyanDuBosar in Research
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The investigation of a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7 (STEC) that sickened 77 people and hospitalized 35 was traced back to ready-to-bake cookie dough, prompting infectious disease specialists to ask for stronger pasteurization and more consumer warnings.
A report in Clinical Infectious Diseases outlined the outbreak and the work done by national and local health officials to track down the source.
No single source could be identified for certain for the outbreak. But one brand of dough was present in 94% of cases, and three nonoutbreak STEC strains were isolated from it, leading to a recall of 3.6 million packages of the cookie dough.
The detective work began with May 19, 2009, through PulseNet, the network of public health and food regulatory agency laboratories coordinated by the CDC. It identified Read more »
*This blog post was originally published at ACP Internist*
September 17th, 2011 by admin in Health Tips
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With the release of the movie Contagion, I thought it would be appropriate to post my cheat sheet on how to investigate a disease outbreak. Aspiring disease detectives take notes!
What do you think of when you hear the word “outbreak”? Maybe you envision a population decimated by a terrible, novel, and incurable disease like in the aformentioned movie Contagion or you think of Dustin Hoffman roaming around California in a blue biocontainment suit with Rene Russo trying to protect folks from a tiny monkey and narrowly preventing an airstrike by the US military?
Hollywood has done their best to capture what an outbreak is…but here are the facts. An outbreak, or epidemic, occurs when there are more cases of disease than would normally be expected in a specific time and place. The disease may be something doctors have already seen before just in a new form or abnormally high numbers, such as foodborne or healthcare-associated infections, or it may be an emerging disease that we don’t know much about like SARS. Either way, we need to investigate to determine why it is happening and how to prevent other people from getting sick or dying. 
Outbreaks are usually noticed by an astute clinician, such as those who first noticed AIDS in New York City and San Francisco, but there are also many high tech disease detection systems available to help us spot any increase in illness. PulseNet is a laboratory network that uses PFGE (pulsed-field gel electrophoresis) to help identify foodborne outbreaks by monitoring the genetic make-up of the bacteria causing what may otherwise look like unrelated illnesses. In the recent events of the Salmonella outbreak in ground turkey, PulseNet and the National Antimicrobial Resistance Monitoring System helped identify the cause of the outbreak as well as determine how widely it had spread. Programs such as Biosense and First Watch monitor the chief complaint or reason that someone called 9-1-1 or went to the hospital (aka syndromic surveillance). We also monitor news media for reports of outbreaks and websites such as Google Flu trends, which tracks circulating viruses and illnesses. With new technology ordinary citizens can also increasingly report outbreaks in their communities too.
The Magic Formula
So how do you figure out the who, what, when, and where of a disease outbreak? Read more »
*This blog post was originally published at Public Health Matters Blog*
A report in Clinical Infectious Diseases outlined the outbreak and the work done by national and local health officials to track down the source.
