title: [Impact of guidelines in investigating foodborne disease outbreaks services in Lazio region, Italy].
abstract: 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.
authors.affiliation: Dipartimento di epidemiologia, ASL RME, Roma. faustini@asplazio.it
authors.forename: Annunziata
authors.initials: A
authors.lastname: Faustini
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Perucci
mesh_terms: D015331:Cohort Studies; D004196:Disease Outbreaks; D004812:Epidemiologic Methods; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D012307:Risk Factors