We reviewed timeline information for a sample of Salmonella spp., Shigella spp., Campylobacter spp., and Escherichia coli O157:H7 cases and all confi rmed foodborne outbreaks reported in 6 states during 2002. Increasing the timeliness of case follow-up, molecular subtyping, and linkage of results are critical to reducing delays in the investigation of foodborne outbreaks.T imely reporting of foodborne diseases is necessary to identify persons at risk for exposure and to prevent additional cases in outbreak settings (1). The present study assesses time intervals for surveillance of foodborne diseases and investigation of outbreaks. Results establish baseline measures to evaluate foodborne disease surveillance systems and identify strategies for improvement (2-4). The StudyData on case investigation timelines in 2002 were collected from records at state and local health departments and public health laboratories in each of 6 states for <100 Salmonella spp. isolates, <50 Shigella spp., Escherichia coli O157:H7, and Campylobacter spp. isolates, and for all foodborne outbreaks. Participating states included 1 with a large population (>6 million), 3 with a medium-sized population, and 2 with a small (<2 million) population from 5 different geographic regions. Two states received supplemental funding through FoodNet. Rules mandated reporting of diagnosed cases from physicians or clinical laboratories to local health departments (2 states), to the state health department (2 states), or to both (2 states). Cases were selected by systematically choosing every nth record on the basis of the number of cases reported and the number sampled. The median intervals from onset of symptoms to surveillance milestone events for individual cases were as follows (Table 1): collection of stool samples, 2-4 days; initial stool culture results, 5-8 days; case report to health department, 7-9 days; isolate submission to public health laboratory, 8-10 days. For case-patients who were interviewed, the median interval from onset of symptoms to interview was 12 days for E. coli O157:H7 cases, 14 days for Salmonella spp. and Shigella spp. cases, and 18 days for Campylobacter spp. cases. For isolates that were subtyped by PFGE, the median intervals from onset of symptoms to subtyping were 15 days for E. coli O157:H7, 18 days for Salmonella spp., and 21 days for Shigella spp.A higher percentage of isolates were submitted to the public health laboratory in states where submission was required (98% for Salmonella spp. isolates, 100% for E. coli O157:H7) compared to states where submission was not required (75% for Salmonella spp. isolates, 80%Emerging Infectious Diseases • www
Foodborne disease reporting can increase through infrastructure improvements.
ABSTRACT.Objective. To evaluate current performance on recommended perinatal hepatitis B and rubella prevention practices in New Hampshire.Methods. Data were extracted from 2021 paired mother-infant records for the year 2000 birth cohort in New Hampshire's 25 delivery hospitals. Assessment was done on the following: prenatal screening for hepatitis B and rubella, administration of the hepatitis B vaccine birth dose to all infants, administration of hepatitis B immune globulin to infants who were born to hepatitis B surface antigen-positive mothers, rubella immunity, and administration of in-hospital postpartum rubella vaccine to rubella nonimmune women.Results. Prenatal screening rates for hepatitis B (98.8%) and rubella (99.4%) were high. Hepatitis B vaccine birth dose was administered to 76.2% of all infants. All infants who were born to hepatitis B surface antigenpositive mothers also received hepatitis B immune globulin. Multivariate logistic regression showed that the month of delivery and infant birth weight were independent predictors of hepatitis B vaccination. The proportion of infants who were vaccinated in January and February 2000 (48.5% and 67.5%, respectively) was less than any other months, whereas the proportion who were vaccinated in December 2000 (88.2%) was the highest. Women who were born between 1971 and 1975 had the highest rate of rubella nonimmunity (9.5%). In-hospital postpartum rubella vaccine administration was documented for 75.6% of nonimmune women.Conclusion. This study documents good compliance in New Hampshire's birthing hospitals with national guidelines for perinatal hepatitis B and rubella prevention and highlights potential areas for improvement. Pediatrics 2005;115:e594-e599. URL: www.pediatrics.org/ cgi
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