Are food exposures obtained through commercial market panels representative of the general population? Implications for outbreak investigations

Inns, Thomas; Curtis, Daniele; Crook, Paul; Vivancos, Roberto; Gardiner, Daniel; McCarthy, Noel D.; Mook, Piers

doi:10.1017/s0950268819000219

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…As traditional controls are often recruited with days or weeks of delay after the outbreak occurs, they have more difficulties to remember their food exposures at a particular time point. Panelists would then be particularly useful when investigating outbreaks caused by uncommon food exposures, as they are oftentimes more forgotten than common food exposures (32). Additionally, online surveys are less likely to suffer from social desirability bias as other data collection methods, such as phone or face-to-face interviews (26).…”

Section: Suitability Of Panel Controls For Outbreak Investigationmentioning

confidence: 99%

“…The differences in the magnitude of the effect estimates (odds ratio) between historical and HuGO studies did not affect the ability of panellists to successfully identify the outbreak sources. As odds ratios measuring associations between contaminated food items and the disease are usually very high during food and waterborne outbreaks [ 32 ], we argue that they are not significantly affected by differences in exposure proportions between panellists and traditional controls.…”

Section: Reliability Of Control Panels To Identify Outbreak Sourcesmentioning

confidence: 99%

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Use of a non-probabilistic online panel as a control group for case–control studies to investigate food and waterborne outbreaks in Lower Saxony, Germany

Perriat

Mertens²,

Dreesman³

2022

Epidemiol. Infect.

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Established methods of recruiting population controls for case–control studies in infectious disease outbreak investigations are resource- and time-intensive, and are often subject to bias. The online panel have recently gained interest as an easy and timely method to select controls. We examined the feasibility, suitability and reliability of using an online panel to select controls for case–control studies as part of investigations of diffuse food and waterborne outbreaks. In January 2019, we deployed a web survey by email to the 277 members of a non-probabilistic online panel in Lower Saxony, Germany. We questioned them on basic sociodemographic characteristics and eating habits. They were frequency matched to cases on sex and age. Their food exposures were compared to those of traditionally recruited controls of four historical case–controls studies, which successfully investigated food and waterborne outbreaks. We used logistic regressions to assess the association between the food exposures and the disease (odds ratios). The use of a control panel successfully led to the identification of the food items in three of the four historical outbreak investigations, and their recruitment benefitted from increased speed and limited costs. Timely outbreak investigations would enable rapidly implementing control measures. We recommend the further evaluation of using panellists as controls in parallel case–control studies and case–panel studies.

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Section: Suitability Of Panel Controls For Outbreak Investigationmentioning

confidence: 99%

Section: Reliability Of Control Panels To Identify Outbreak Sourcesmentioning

confidence: 99%

Use of a non-probabilistic online panel as a control group for case–control studies to investigate food and waterborne outbreaks in Lower Saxony, Germany

Perriat

Mertens²,

Dreesman³

2022

Epidemiol. Infect.

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“…Over the last decade, there has been a shift to using other methods such as populationbased food consumption surveys including the use of binomial calculation and case-case analysis to generate or test a hypothesis [3][4][5][6][7]. These methods have their own challenges.…”

mentioning

confidence: 99%

Online population control surveys: A new method for investigating foodborne outbreaks

Taylor

Galanis

2020

Epidemiol. Infect.

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In foodborne outbreak investigations, case-control and cohort studies are used to test hypotheses and identify a source, but these studies are resource-intensive and may have challenges of representativeness, temporality or accessibility. We used online surveys to collect population control data for two foodborne outbreaks and compared the data collected to our cases and existing population exposure data. Online survey population controls were comparable to cases based on age and sex. Exposure data collected through online surveys were more precise than existing control data, represented the disease-specific exposure period and could be easily modified. In one outbreak the online control exposure data differed from established population data. In both outbreaks, the information from the online population control survey supported the hypothesis of the investigation. Our findings demonstrate that online surveys were a rapid and representative way to collect responses from controls during outbreak investigations.

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Enhanced molecular-based (MLST/whole genome) surveillance and source attribution of Campylobacter infections in the UK

McCarthy¹,

Taylor²,

Maiden³

et al. 2021

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This human campylobacteriosis sentinel surveillance project was based at two sites in Oxfordshire and North East England chosen (i) to be representative of the English population on the Office for National Statistics urban-rural classification and (ii) to provide continuity with genetic surveillance started in Oxfordshire in October 2003. Between October 2015 and September 2018 epidemiological questionnaires and genome sequencing of isolates from human cases was accompanied by sampling and genome sequencing of isolates from possible food animal sources. The principal aim was to estimate the contributions of the main sources of human infection and to identify any changes over time. An extension to the project focussed on antimicrobial resistance in study isolates and older archived isolates. These older isolates were from earlier years at the Oxfordshire site and the earliest available coherent set of isolates from the national archive at Public Health England (1997/8). The aim of this additional work was to analyse the emergence of the antimicrobial resistance that is now present among human isolates and to describe and compare antimicrobial resistance in recent food animal isolates. Having identified the presence of bias in population genetic attribution, and that this was not addressed in the published literature, this study developed an approach to adjust for bias in population genetic attribution, and an alternative approach to attribution using sentinel types. Using these approaches the study estimated that approximately 70% of Campylobacter jejuni and just under 50% of C. coli infection in our sample was linked to the chicken source and that this was relatively stable over time. Ruminants were identified as the second most common source for C. jejuni and the most common for C. coli where there was also some evidence for pig as a source although less common than ruminant or chicken. These genomic attributions of themselves make no inference on routes of transmission. However, those infected with isolates genetically typical of chicken origin were substantially more likely to have eaten chicken than those infected with ruminant types. Consumption of lamb’s liver was very strongly associated with infection by a strain genetically typical of a ruminant source. These findings support consumption of these foods as being important in the transmission of these infections and highlight a potentially important role for lamb’s liver consumption as a source of Campylobacter infection. Antimicrobial resistance was predicted from genomic data using a pipeline validated by Public Health England and using BIGSdb software. In C. jejuni this showed a nine-fold increase in resistance to fluoroquinolones from 1997 to 2018. Tetracycline resistance was also common, with higher initial resistance (1997) and less substantial change over time. Resistance to aminoglycosides or macrolides remained low in human cases across all time periods. Among C. jejuni food animal isolates, fluoroquinolone resistance was common among isolates from chicken and substantially less common among ruminants, ducks or pigs. Tetracycline resistance was common across chicken, duck and pig but lower among ruminant origin isolates. In C. coli resistance to all four antimicrobial classes rose from low levels in 1997. The fluoroquinolone rise appears to have levelled off earlier and among animals, levels are high in duck as well as chicken isolates, although based on small sample sizes, macrolide and aminoglycoside resistance, was substantially higher than for C. jejuni among humans and highest among pig origin isolates. Tetracycline resistance is high in isolates from pigs and the very small sample from ducks. Antibiotic use following diagnosis was relatively high (43.4%) among respondents in the human surveillance study. Moreover, it varied substantially across sites and was highest among non-elderly adults compared to older adults or children suggesting opportunities for improved antimicrobial stewardship. The study also found evidence for stable lineages over time across human and source animal species as well as some tighter genomic clusters that may represent outbreaks. The genomic dataset will allow extensive further work beyond the specific goals of the study. This has been made accessible on the web, with access supported by data visualisation tools.

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Are food exposures obtained through commercial market panels representative of the general population? Implications for outbreak investigations

Cited by 3 publications

References 27 publications

Use of a non-probabilistic online panel as a control group for case–control studies to investigate food and waterborne outbreaks in Lower Saxony, Germany

Use of a non-probabilistic online panel as a control group for case–control studies to investigate food and waterborne outbreaks in Lower Saxony, Germany

Online population control surveys: A new method for investigating foodborne outbreaks

Enhanced molecular-based (MLST/whole genome) surveillance and source attribution of Campylobacter infections in the UK

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