scholarly journals Contributing Factors in Restaurant-Associated Foodborne Disease Outbreaks, FoodNet Sites, 2006 and 2007†

2013 ◽  
Vol 76 (11) ◽  
pp. 1824-1828 ◽  
Author(s):  
L. HANNAH GOULD ◽  
IDA ROSENBLUM ◽  
DAVID NICHOLAS ◽  
QUYEN PHAN ◽  
TIMOTHY F. JONES
Keyword(s):  
Local Level ◽  
Disease Outbreaks ◽  
The United States ◽  
Foodborne Disease ◽  
Contributing Factors ◽  
Surveillance Network ◽  
Factors Associated ◽  
Control And Prevention ◽  
Food Workers

An estimated 48 million cases of foodborne illness occur each year in the United States, resulting in approximately 128,000 hospitalizations and 3,000 deaths. Over half of all foodborne disease outbreaks reported to the Centers for Disease Control and Prevention are associated with eating in restaurants or delicatessens. We reviewed data from restaurant-associated foodborne disease outbreaks to better understand the factors that contribute to these outbreaks. Data on restaurant-associated foodborne disease outbreaks reported by sites participating in the Foodborne Diseases Active Surveillance Network (FoodNet) were analyzed to characterize contributing factors reported in foodborne disease outbreaks and the levels of evidence used to identify these factors. Of 457 foodborne disease outbreaks reported in 2006 and 2007 by FoodNet sites, 300 (66%) were restaurant associated, and of these 295 (98%) had at least one reported contributing factor. One to nine (with a median of two) contributing factors were reported per outbreak. Of the 257 outbreaks with a single etiology reported, contributing factors associated with food worker health and hygiene were reported for 165 outbreaks (64%), factors associated with food preparation practices within the establishment were reported for 88 outbreaks (34%), and factors associated with contamination introduced before reaching the restaurant were reported for 56 outbreaks (22%). The pronounced role of food workers in propagating outbreaks makes it clear that more work is needed to address prevention at the local level. Food workers should be instructed not to prepare food while ill to prevent the risk of transmitting pathogens.

scholarly journals Epidemiology of restaurant-associated foodborne disease outbreaks, United States, 1998–2013

2016 ◽  
Vol 145 (3) ◽  
pp. 523-534 ◽  
Author(s):  
K. M. ANGELO ◽  
A. L. NISLER ◽  
A. J. HALL ◽  
L. G. BROWN ◽  
L. H. GOULD
Keyword(s):  
Surveillance System ◽  
Disease Outbreaks ◽  
Disease Outbreak ◽  
Foodborne Illness ◽  
Annual Number ◽  
Common Source ◽  
Foodborne Disease ◽  
Contributing Factors ◽  
Food Workers

SUMMARYAlthough contamination of food can occur at any point from farm to table, restaurant food workers are a common source of foodborne illness. We describe the characteristics of restaurant-associated foodborne disease outbreaks and explore the role of food workers by analysing outbreaks associated with restaurants from 1998 to 2013 reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. We identified 9788 restaurant-associated outbreaks. The median annual number of outbreaks was 620 (interquartile range 618–629). In 3072 outbreaks with a single confirmed aetiology reported, norovirus caused the largest number of outbreaks (1425, 46%). Of outbreaks with a single food reported and a confirmed aetiology, fish (254 outbreaks, 34%) was most commonly implicated, and these outbreaks were commonly caused by scombroid toxin (219 outbreaks, 86% of fish outbreaks). Most outbreaks (79%) occurred at sit-down establishments. The most commonly reported contributing factors were those related to food handling and preparation practices in the restaurant (2955 outbreaks, 61%). Food workers contributed to 2415 (25%) outbreaks. Knowledge of the foods, aetiologies, and contributing factors that result in foodborne disease restaurant outbreaks can help guide efforts to prevent foodborne illness.

Outbreaks Where Food Workers Have Been Implicated in the Spread of Foodborne Disease. Part 1. Description of the Problem, Methods, and Agents Involved

2007 ◽  
Vol 70 (7) ◽  
pp. 1752-1761 ◽  
Author(s):  
JUDY D. GREIG ◽  
EWEN C. D. TODD ◽  
CHARLES A. BARTLESON ◽  
BARRY S. MICHAELS
Keyword(s):  
Hepatitis A ◽  
Hepatitis A Virus ◽  
International Association ◽  
Disease Outbreaks ◽  
The United States ◽  
Personal Contact ◽  
Foodborne Disease ◽  
Food Protection ◽  
Shigella Spp ◽  
Food Workers

Food workers in many settings have been responsible for foodborne disease outbreaks for decades, and there is no indication that this is diminishing. The Committee on Control of Foodborne Illnesses of the International Association for Food Protection was tasked with collecting and evaluating any data on worker-associated outbreaks. A total of 816 reports with 80,682 cases were collected from events that occurred from 1927 until the first quarter of 2006. Most of the outbreaks reviewed were from the United States, Canada, Europe, and Australia, with relatively few from other parts of the world, indicating the skewed set of data because of availability in the literature or personal contact. Outbreaks were caused by 14 agents: norovirus or probable norovirus (338), Salmonella enterica (151), hepatitis A virus (84), Staphylococcus aureus (53), Shigella spp. (33), Streptococcus Lancefield groups A and G (17), and parasites Cyclospora, Giardia, and Cryptosporidium (23). Streptococcal, staphylococcal, and typhoid outbreaks seem to be diminishing over time; hepatitis A virus remains static, whereas norovirus and maybe nontyphoidal Salmonella are increasing. Multiple foods and multi-ingredient foods were identified most frequently with outbreaks, perhaps because of more frequent hand contact during preparation and serving.

Mass School Shootings in the United States: A Novel Root Cause Analysis Using Lay Press Reports

2019 ◽  
Vol 58 (13) ◽  
pp. 1423-1428 ◽  
Author(s):  
Chris A. Rees ◽  
Lois K. Lee ◽  
Eric W. Fleegler ◽  
Rebekah Mannix
Keyword(s):  
United States ◽  
Environmental Factors ◽  
Root Cause Analysis ◽  
The United States ◽  
School Shootings ◽  
Contributing Factors ◽  
Mass Shootings ◽  
Cause Analysis ◽  
Factors Associated ◽  
Root Cause

School shootings comprise a small proportion of childhood deaths from firearms; however, these shootings receive a disproportionately large share of media attention. We conducted a root cause analysis of 2 recent school shootings in the United States using lay press reports. We reviewed 1760 and analyzed 282 articles from the 10 most trusted news sources. We identified 356 factors associated with the school shootings. Policy-level factors, including a paucity of adequate legislation controlling firearm purchase and ownership, were the most common contributing factors to school shootings. Mental illness was a commonly cited person-level factor, and access to firearms in the home and availability of large-capacity firearms were commonly cited environmental factors. Novel approaches, including root cause analyses using lay media, can identify factors contributing to mass shootings. The policy, person, and environmental factors associated with these school shootings should be addressed as part of a multipronged effort to prevent future mass shootings.

Cheese-Associated Outbreaks of Human Illness in the United States, 1973 to 1992: Sanitary Manufacturing Practices Protect Consumers

1998 ◽  
Vol 61 (10) ◽  
pp. 1405-1407 ◽  
Author(s):  
SEAN F. ALTEKRUSE ◽  
BABAGALEH B. TIMBO ◽  
JOHN C. MOWBRAY ◽  
NANCY H. BEAN ◽  
MORRIS E. POTTER
Keyword(s):  
Public Health Problem ◽  
The United States ◽  
Contributing Factors ◽  
E Coli ◽  
Salmonella Infections ◽  
Consumer Safety ◽  
Control And Prevention ◽  
Control Step ◽  
Pathogen Control ◽  
Human Illness

To identify contributing factors for cheese-associated outbreaks, we reviewed all cheese-associated outbreaks of human illness reported to the Centers for Disease Control and Prevention (CDC) with onsets during 1973 to 1992. The infrequency of large, cheese-associated outbreaks was notable because such outbreaks had been a frequent public health problem before the mid-20th century. Of 32 reported cheese-associated outbreaks, 11 attributed to manufacturing errors caused most of the illnesses and hospitalizations and all 58 deaths. Important factors in these 11 outbreaks were manufacturing cheese with raw or improperly pasteurized milk and postpasteurization contamination. If current Food and Drug Administration sanitary requirements for cheesemaking had been met, these outbreaks would have been preventable. In two outbreaks of Salmonella infections, fewer than 10 Salmonella per 100 g of cheese were detected. In two outbreaks of Brucella infections, efforts to recover the pathogen from the implicated cheese were unsuccessful, emphasizing the inadequacy of end product testing for assuring consumer safety. Curing cheeses kills most bacteria present in cheeses; however, evidence from sources other than the CDC Foodborne Disease Outbreak Surveillance System suggests that curing alone may not be a sufficient pathogen control step to eliminate Salmonella, Listeria, and E. coli O157:H7 from cheese.

Factors Associated With Designation of a Substitute Decision-Maker in Older Asian Americans: The Role of Cultural Factors

2019 ◽  
Vol 91 (1) ◽  
pp. 21-36 ◽  
Author(s):  
Min-Kyoung Rhee ◽  
Yuri Jang
Keyword(s):  
United States ◽  
End Of Life ◽  
Decision Maker ◽  
Asian Americans ◽  
English Proficiency ◽  
The United States ◽  
Cultural Factors ◽  
Factors Associated ◽  
Substitute Decision Maker

The present study examined the prevalence of and factors associated with the designation of a substitute decision-maker (SDM) in a sample of older Asian Americans. Particular emphasis was placed on cultural factors (ethnicity, time in the United States, English proficiency, acculturation, and cultural belief) that might influence on one’s attitudes toward death and dying or end-of-life decision-making. Data were drawn from the 499 participants aged 60 years and older using the 2015 Asian American Quality of Life survey. Twenty-two percent of the sample had completed a legal document identifying a SDM. Results of a hierarchical logistic regression indicated that ethnicity, time in the United States, English proficiency, and acculturation were significant predictors. By examining the role of cultural factors in predicting SDM designation, the present study provided implications for culturally tailored strategies to help older Asian Americans plan their end-of-life care.

OCCURRENCE OF BACILLUS CEREUS IN SELECTED DRY FOOD PRODUCTS1,2

1971 ◽  
Vol 34 (1) ◽  
pp. 12-15 ◽  
Author(s):  
H. U. Kim ◽  
J. M. Goepfert
Keyword(s):  
Bacillus Cereus ◽  
Egg Yolk ◽  
The United States ◽  
Food Samples ◽  
Confirmatory Test ◽  
Foodborne Disease ◽  
Biochemical Tests ◽  
Precipitin Test ◽  
Dry Food

One hundred seventy samples of dried food products in national distribution were examined for the incidence and level of contamination by Bacillus cereus. Twenty-five per cent of the samples yielded B. cereus at a level not exceeding 4000 per gram. Mannitol-egg yolk-polymyxin (MYP) agar was used as a presumptive test for the presence of B. cereus in the food samples. Various biochemical tests for the confirmation of suspicious colonies appearing on MYP agar were evaluated. A precipitin test employing spore precipitinogens was investigated as a confirmatory test for B. cereus. The possible role of B. cereus in outbreaks of foodborne disease in the United States is discussed.

Should Tamiflu™ be stockpiled locally?

2006 ◽  
Vol 4 (3) ◽  
pp. 21
Author(s):  
Sandro Cinti, MD ◽  
Gerald Blackburn, DO
Keyword(s):  
United States ◽  
Avian Influenza ◽  
Hurricane Katrina ◽  
Local Governments ◽  
Influenza Pandemic ◽  
The United States ◽  
H5n1 Avian Influenza ◽  
Control And Prevention ◽  
Federal Response

The outbreak of H5N1 avian influenza in Asia raises serious concerns about an influenza pandemic of the kind seen in 1918. In addition, the recent federal response to Hurricane Katrina highlights the need for advanced local preparation for biological disasters. It is clear that there will not be enough vaccine early in an influenza pandemic. Without vaccine, the role of antivirals, especially oseltamivir (Tamiflu™), in treatment and prophylaxis becomes of paramount importance. It is unlikely that the Centers for Disease Control and Prevention (CDC) will be able to stockpile enough oseltamivir to protect every first responder in the United States. Thus, it is important that local governments and hospitals consider stockpiling oseltamivir for the treatment and/or prophylaxis of local first responders.

scholarly journals Interim Analysis of Risk Factors for Severe Outcomes among a Cohort of Hospitalized Adults Identified through the U.S. Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET)

2020 ◽  
Author(s):  
Lindsay Kim ◽  
Shikha Garg ◽  
Alissa O'Halloran ◽  
Michael Whitaker ◽  
Huong Pham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Invasive Mechanical Ventilation ◽  
The United States ◽  
Surveillance Network ◽  
Adjusted Risk ◽  
Factors Associated ◽  
Icu Admission ◽  
Male Sex ◽  
Race Ethnicity

Background: As of May 15, 2020, the United States has reported the greatest number of coronavirus disease 2019 (COVID-19) cases and deaths globally. Objective: To describe risk factors for severe outcomes among adults hospitalized with COVID-19. Design: Cohort study of patients identified through the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network. Setting: 154 acute care hospitals in 74 counties in 13 states. Patients: 2491 patients hospitalized with laboratory-confirmed COVID-19 during March 1-May 2, 2020. Measurements: Age, sex, race/ethnicity, and underlying medical conditions. Results: Ninety-two percent of patients had at least 1 underlying condition; 32% required intensive care unit (ICU) admission; 19% invasive mechanical ventilation; 15% vasopressors; and 17% died during hospitalization. Independent factors associated with ICU admission included ages 50-64, 65-74, 75-84 and 85+ years versus 18-39 years (adjusted risk ratio (aRR) 1.53, 1.65, 1.84 and 1.43, respectively); male sex (aRR 1.34); obesity (aRR 1.31); immunosuppression (aRR 1.29); and diabetes (aRR 1.13). Independent factors associated with in-hospital mortality included ages 50-64, 65-74, 75-84 and 85+ years versus 18-39 years (aRR 3.11, 5.77, 7.67 and 10.98, respectively); male sex (aRR 1.30); immunosuppression (aRR 1.39); renal disease (aRR 1.33); chronic lung disease (aRR 1.31); cardiovascular disease (aRR 1.28); neurologic disorders (aRR 1.25); and diabetes (aRR 1.19). Race/ethnicity was not associated with either ICU admission or death. Limitation: Data were limited to patients who were discharged or died in-hospital and had complete chart abstractions; patients who were still hospitalized or did not have accessible medical records were excluded. Conclusion: In-hospital mortality for COVID-19 increased markedly with increasing age. These data help to characterize persons at highest risk for severe COVID-19-associated outcomes and define target groups for prevention and treatment strategies.

Altered Folate Metabolism Maybeo the Develop Linked tment of Acute Lymphoblastic Leukemia in African American Children.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4118-4118
Author(s):  
Qing Chen ◽  
Nancy Fassinger ◽  
Ronald Thomas ◽  
Ana C. Xavier ◽  
Yubin Ge ◽  
...  
Keyword(s):  
Enzyme Activity ◽  
African American ◽  
The United States ◽  
Folate Metabolism ◽  
High Birth Weight ◽  
Healthy Controls ◽  
Childhood All ◽  
Factors Associated ◽  
Significant Difference

Abstract Abstract 4118 Background Acute lymphoblastic leukaemia (ALL) is the most common form of childhood cancer in the United States. The incidence of ALL is approximately 2-3-fold higher in Caucasian compared to African American (AA) children, suggesting potential differences in genetic susceptibility and/or exogenous exposures. Multiple epidemiologic studies have examined both genetic and environmental factors linked to the development of childhood ALL, primarily in Caucasian populations. Hence, identifying factors associated with racial differences in incidence of leukemia may provide new insights into the role of endogenous versus exogenous factors in the development of leukemia. A number of studies have reported relationships between folate metabolism and the risk of developing ALL including: i)maternal folate supplementation during pregnancy (reduced risk of ALL in offspring); and ii)polymorphisms of genes encoding enzymes involved in folate metabolism, including 5,10-methylenetetrahydrofolate reductase (MTHFR) (increased and decreased risks). To date, no studies have been performed specifically examining the role of folate metabolism in AA children. The objective of this study was to identify factors associated with folate metabolism which may be linked to the development of ALL in AA children compared to healthy controls. Patients and Methods AA children with B-precursor (BP) ALL were enrolled from the Hematology/Oncology Division of Children's Hospital of Michigan, while healthy AA children were enrolled as controls. Patients' racial backgrounds were based on parental reporting. The frequencies of polymorphisms in the MTHFR [677C>T, 1298A>C], thymidylate synthase [TS 2R3R], cystathionine-β-synthase [CBS 844ins(68)], and reduced folate carrier [RFC 80G>A] genes were determined by genotyping between AA childhood BP-ALL [n=26; 14 males] and healthy AA children [n=87; 47 males]. The distributions of genotypes between cases and controls were compared using Fisher's exact test. Results The genotype distributions of the polymorphisms of the folate pathway genes are summarized in Table 1. The frequencies of the MTHFR gene variants 677 CT/TT were 2-fold higher in the ALL cohort than that in the healthy control cohort. MTHFR 677 CT/TT was significantly associated with a risk of developing ALL in the AA patients. There were no significant differences in the distributions of the TS, CBS, or RFC polymorphisms between the groups. High birth weight has been associated with an increased risk of developing ALL, though we found no significant difference in birth weights between ALL and control groups. Conclusion Our study is the first to demonstrate that there is a higher frequency of the variant MTHFR C677T polymorphism (associated with reduced enzyme activity and altered distribution of folate forms) in AA children with ALL compared to healthy controls. Low MTHFR enzyme activity leads to imbalances in the thymidylate and de novo purine biosynthetic pathways, ultimately affecting DNA synthesis and repair and likely increasing the risk of leukemia. Thus, the role of altered folate metabolism may contribute to the development of ALL in AA children similar to Caucasian children, although additional studies are still required to identify factors linked to the higher incidence of ALL in Caucasian children and/or low incidence in AA children. Disclosures: No relevant conflicts of interest to declare.

scholarly journals COVID-19 Crisis in Africa: Revisiting the Contributing Factors

2021 ◽  
Vol 1 (1) ◽  
pp. 64-67
Author(s):  
Ugochukwu A Eze ◽  
Kingsley I Ndoh ◽  
Kehinde K Kanmodi
Keyword(s):  
Disease Surveillance ◽  
Democratic Republic Of Congo ◽  
The United States ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Contributing Factors ◽  
African Countries ◽  
The World ◽  
Control And Prevention ◽  
Sub Saharan

Abstract The COVID-19 pandemic has been a major threat to people and healthcare systems around the world. Each region of the world has had unique factors such as culture, demographics, socioeconomic and the political landscape that has either fueled or mitigated the severity of the pandemic. For example, the 2021 Indian Kumbh Mela festival fueled a devastating wave of the pandemic in India. Similarly, the pandemic in the United States has in part been fueled an epidemic of disinformation that led to a growing number of anti-vaxxers, and those who are opposed to COVID-19 prevention guidelines set by agencies like the Centers for Disease Control and Prevention. In Africa, burial practices in Liberia and the Democratic Republic of Congo once fueled the Ebola epidemic. Likewise, in the context of COVID-19, there are factors that are unique to Africa that may have either fueled or mitigated the severity of the pandemic. The anti-COVID-19 measures in many African countries significantly affected household income without commensurate deployment of palliative measures to cushion the effect. Fortunately, the pandemic has run a relatively milder course in sub-Saharan Africa—defying earlier devastating projections. Therefore, to be prepared for the next pandemic, African governments must involve critical stakeholders such as religious and traditional leaders, strengthen current disease surveillance systems and invest in systems that encourage private investments in local vaccine manufacturing.

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