Utility of clinical-epidemiological profiles in outbreaks of foodborne disease, Catalonia, 2002 through 2006.
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.
Domínguez
A
A
Department of Public Health. University of Barcelona, Casanova 143, Barcelona 08036, Spain.
Broner
S
S
Torner
N
N
Martínez
A
A
Jansà
J M
JM
Alvarez
J
J
Barrabeig
I
I
Caylà
J
J
Godoy
P
P
Minguell
S
S
Camps
N
N
Sala
M R
MR
D002167:Campylobacter / Q000302:isolation & purification; D004196:Disease Outbreaks; D005506:Food Contamination / Q000032:analysis*; D005511:Food Handling / Q000379:methods*; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D006920:Hygiene; D029322:Norovirus / Q000302:isolation & purification; D016017:Odds Ratio; D011159:Population Surveillance; D012475:Salmonella / Q000302:isolation & purification; D012478:Salmonella Food Poisoning / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000473:pathology; D013030:Spain / Q000453:epidemiology