BBQ Event at Senior Community First case (HUS) reported by provider Multiple illnesses reported from...
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BBQ Event at Senior Community First case (HUS) reported by provider Multiple illnesses reported from community Online survey link distributed via email Community residents advised to destroy leftover Food and stool specimens submitted for testing Online survey closed Preliminar y data analysis completed Follow up phone survey deployed Food sample positive for C. perfringens Final data analysis completed Phone survey closed Use of an Online Survey During an Outbreak of Clostridium perfringens in a Retirement Community, Arizona 2012 Discussion We present an outbreak investigation in a retirement community of 3,000 residents with more than 66 cases of GI illness caused by beef contaminated with Clostridium perfringens Investigation conducted using an online survey; allowed rapid deployment, data analysis, implementation of public health intervention, and dissemination of information to stakeholders Investigation confirms findings from prior studies which demonstrates distinct advantages of online surveys used by local public health Decreased staff time Faster data analysis Concerns for the validity of using email in this population led to follow up survey Follow up survey demonstrates widespread internet use in this retirement community Conclusion This Clostridium perfringens outbreak in a retirement community demonstrated the utility of an online survey to rapidly collect information and respond to a foodborne outbreak among an older demographic. Introduction On March 12, 2012, an 85-year-old male with hemolytic uremic syndrome was reported to Maricopa County Department of Public Health (MCDPH). On March 7, he had consumed food at a BBQ attended by 2,300 retirement community residents. On March 10, a BBQ attendee with gastrointestinal illness was reported to MCDPH. An environmental assessment and outbreak investigation ensued to determine the cause of the outbreak and implement control and prevention activities. Seema Yasmin, MD 1 , Kristen Pogreba-Brown,PhD 2 , Jennifer Stewart, MS 3 , Rebecca Sunenshine, MD 3,4 1 CDC EIS Officer, 2 University of Arizona SAFER Coordinator, 3 Maricopa County Department of Public Health Division of Disease Control, 4 CDC, Office of Public Health Preparedness and Response Rationale for Online Survey Use Useful tool for rapid investigation of outbreaks Less time consuming versus traditional phone interviews Rapid preliminary data analysis possible Email listserv available for community Little information exists on: Utility and acceptability in older populations Amount of computer literacy available in this population Methods A retrospective cohort study was conducted utilizing an online survey distributed through the community email listserv. To assess internet access and computer- literacy amongst this population, a follow-up telephone survey targeting 552 persons was conducted Approximately 1,000 residents on listserv Results 370/2,300 (16%) retirement community residents responded to the online survey 66 (17.8%) reported gastrointestinal illness following the BBQ (median incubation period 9.5 hours) 63 cases (95%) reported diarrhea and 5 (8%) reported vomiting Leftover beef from an attendee’s refrigerator grew Clostridium perfringens Access to internet and email capabilities of respondents: 101 (89%) reported the ability to send and receive email 82 (72.5%) checked email daily 28 (24.7%) checked email on a handheld device ID # 1197 3/7/ 12 3/12/1 2 3/14/1 2 3/15/1 2 3/16/1 2 3/20/1 2 3/21/1 2 3/27/1 2 3/30/1 2 4/1/12 4/26/1 2 Limitations: Likely selection bias – original survey had an attack rate of 18%, with the follow up survey estimating an attack rate of 3% Ill individuals more likely to participate in a voluntary survey Not enough ill individuals in follow up survey to accurately characterize incubation period and attack rate Response rate for telephone survey sub-optimal Table 1. Results of Online and Telephone Survey Among Retirement Community Residents following an Outbreak of GI Illness, Maricopa County, Arizona Online Survey Telephone Survey Number of Responses 370 113 Response Rate 37% 20.5% Male 38.7% 37% Female 61.3% 63% Median Age 70 71.5 Median Incubation Period (Hours) 9.5 * Attack Rate 17.8% 3% Average Time for Survey Completion (minutes) ** 14 11 *Number ill was too small to accurately calculate incubation period ** Note that surveys were of different lengths Figure 1. Timeline of Events following BBQ at Retirement Community, Maricopa County, AZ
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Transcript of BBQ Event at Senior Community First case (HUS) reported by provider Multiple illnesses reported from...
BBQ Event at Senior
Community
First case (HUS)
reported by provider
Multiple illnesses
reported from community
Online survey link distributed via email
Community residents advised to destroy
leftover food
Food and stool
specimens submitted for
testing
Online survey closed
Preliminary data analysis
completed
Follow up phone survey
deployed
Food sample positive for C.
perfringens
Final data analysis
completed
Phone survey closed
Use of an Online Survey During an Outbreak of Clostridium perfringens in aRetirement Community, Arizona 2012
DiscussionWe present an outbreak investigation in a retirement
community of 3,000 residents with more than 66 cases of GI illness caused by beef contaminated with Clostridium perfringens
Investigation conducted using an online survey; allowed rapid deployment, data analysis, implementation of public health intervention, and dissemination of information to stakeholders
Investigation confirms findings from prior studies which demonstrates distinct advantages of online surveys used by local public healthDecreased staff timeFaster data analysis
Concerns for the validity of using email in this population led to follow up survey
Follow up survey demonstrates widespread internet use in this retirement community
ConclusionThis Clostridium perfringens outbreak in a
retirement community demonstrated the utility of an online survey to rapidly collect information and respond to a foodborne outbreak among an older demographic.
IntroductionOn March 12, 2012, an 85-year-old male with hemolytic uremic syndrome was reported to Maricopa County Department of Public Health (MCDPH). On March 7, he had consumed food at a BBQ attended by 2,300 retirement community residents. On March 10, a BBQ attendee with gastrointestinal illness was reported to MCDPH. An environmental assessment and outbreak investigation ensued to determine the cause of the outbreak and implement control and prevention activities.
Seema Yasmin, MD1, Kristen Pogreba-Brown,PhD2, Jennifer Stewart, MS3, Rebecca Sunenshine, MD3,4 1CDC EIS Officer, 2University of Arizona SAFER Coordinator, 3Maricopa County Department of Public Health Division of Disease Control, 4CDC, Office of Public Health Preparedness and Response
Rationale for Online Survey Use
Useful tool for rapid investigation of outbreaks Less time consuming versus traditional phone
interviews Rapid preliminary data analysis possible Email listserv available for community Little information exists on:
Utility and acceptability in older populations Amount of computer literacy available in this
population
Methods A retrospective cohort study was conducted utilizing an
online survey distributed through the community email listserv.
To assess internet access and computer-literacy amongst this population, a follow-up telephone survey targeting 552 persons was conducted
Approximately 1,000 residents on listserv
Results 370/2,300 (16%) retirement community residents
responded to the online survey 66 (17.8%) reported gastrointestinal illness following the
BBQ (median incubation period 9.5 hours) 63 cases (95%) reported diarrhea and 5 (8%) reported
vomiting Leftover beef from an attendee’s refrigerator grew
Clostridium perfringens Access to internet and email capabilities of respondents:
101 (89%) reported the ability to send and receive email
82 (72.5%) checked email daily 28 (24.7%) checked email on a handheld device
ID # 1197
3/7/12
3/12/12
3/14/12
3/15/12
3/16/12
3/20/12
3/21/12
3/27/12
3/30/12
4/1/12
4/26/12
Limitations:Likely selection bias – original survey
had an attack rate of 18%, with the follow up survey estimating an attack rate of 3%Ill individuals more likely to participate
in a voluntary surveyNot enough ill individuals in follow up
survey to accurately characterize incubation period and attack rate
Response rate for telephone survey sub-optimal
Table 1. Results of Online and Telephone Survey Among Retirement Community Residents following an Outbreak of GI Illness, Maricopa County, Arizona
Online Survey
Telephone Survey
Number of Responses 370 113
Response Rate 37% 20.5%
Male 38.7% 37%
Female 61.3% 63%
Median Age 70 71.5
Median Incubation Period (Hours) 9.5 *
Attack Rate 17.8% 3%
Average Time for Survey Completion (minutes) ** 14 11
*Number ill was too small to accurately calculate incubation period
** Note that surveys were of different lengths
Figure 1. Timeline of Events following BBQ at Retirement Community, Maricopa County, AZ
