Internet- versus Telephone-based Local Outbreak Investigations

Abstract

We compared 5 locally conducted, Internet-based outbreak investigations with 5 telephone-based investigations. Internet-based surveys required less completion time, and response rates were similar for both investigation methods. Participant satisfaction with Internet-based surveys was high.A lthough the Internet has been increasingly used in epidemiologic research, its use for investigation of infectious disease outbreaks has been less frequently described. Most reports of Internet-based outbreak investigations have described large, single outbreaks conducted by national or state public health agencies. Examples of reported Internet-based outbreak investigations include a communitywide norovirus outbreak in Finland, a communitywide Cryptosporidium outbreak in Kansas, a multistate Salmonella outbreak, and a conjunctivitis outbreak at a university (1-4). These reports noted several advantages of Internet use, including reductions in resource use, workload, and time required for survey completion and data entry (1-4). However, these advantages are not generally quantifi ed in outbreak reports. Moreover, Internetbased outbreak investigations are seldom reported from the local health department level, where resources are often constrained compared with those of state and national agencies. We offer an analysis of several small Internetbased outbreak investigations conducted at the local level. We describe response rates to Internet-based surveys with and without telephone follow-up, the time needed to complete Internet-based outbreak surveys in comparison with traditional telephone surveys, participant satisfaction with Internet-based surveys, and differences in Internet-based outbreak investigations based on the respondents' setting: professional versus household. The StudyFrom April through September of 2006, the Tri-County Health Department (TCHD), a local health department in metropolitan Denver, Colorado, used Internet-based surveys to investigate 5 outbreaks. Three outbreaks involved respondents in professional settings: a norovirus outbreak at a teacher appreciation luncheon, a norovirus outbreak at a catered professional meeting, and a norovirus outbreak at an offi ce staff luncheon. The other 2 outbreaks involved respondents in household settings: a norovirus outbreak at a Father's Day barbecue and a Cryptosporidium outbreak at a birthday pool party.For all 5 outbreaks, a cohort study was conducted to ascertain illness and exposure information. Internet access among cohort members was assessed before Internet-based questionnaires were used. For 2 of the professional-setting outbreaks, all cohort members were sent by email a link to an Internet-based survey with directions on how to complete it and were asked to complete it by a certain deadline. In the third professional-setting outbreak, the offi ce staff luncheon, the offi ce requested that a link be sent to 1 offi ce computer. Employees were individually given private access to that computer. In the 2 household-setting outbreaks, an email with a link to t...

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