Outbreak response

CDC (2005) US Foodborne Disease Outbreaks, Team Outbreak Response and Surveillance http //www.cdc.gov/foodborneoutbreaks/US outb.htm. 

CDC (2000) Report. Food borne outbreak response and surveillance unit, http //www.cdc.gov/foodborneout-breaks/us outb/fbo2000/bacterial00.htm). In Cook, K.A. et at. (1998) Outbreak of Salmonella serotype Hartford infections associated with unpasteurized orange juice. Journal of the American Medical Association 280, 1 504-1 509. 

Influenza. The ACIP recommends annual influenza vaccination for all persons who are at risk from infections of the lower respiratory tract and for all older persons. Influen2a vimses types A and B are responsible for periodic outbreaks of febrile respiratory disease. 

Composition and Methods of Manufacture. Two types of influen2a vimses, A and B, are responsible for causing periodic outbreaks of febrile respiratory disease. The manufacture of an effective vaccine is compHcated by antigenic variation or drift, which can occur from year to year within the two vims types, making the previous year s vaccine less effective. Each year, antigenic characteri2ation is important for selecting the vims strains to be included in the vaccine. 

Flammable liquids are widely used in many types of factories, and their misuse is responsible for many outbreaks of fire. The fire risks from the flammable liquids in common use such as petrol, paraffin, white spirit, cellulose solutions and thinners are well known, but these are only a few of the liquids which present hazards in industry. The variety of flammable liquids used in processes as solvents or carriers and for other purposes is constantly extending. 

Oevere toxicological responses have been associated with certain chloro- dibenzodioxins. One of these responses is chloracne, a folliculosis first associated with skin contamination by chlorohydrocarbons in 1899 (3). Serious outbreaks of chloracne-like lesions associated with runaway reactions in the production of 2,4,5-trichlorophenol occurred in Germany in the early 1950 s (5). 2,4,5-Trichlorophenol itself does not cause acne (S), but the contaminants which may be formed in the uncontrolled production of 2,4,5-trichlorophenol are extremely potent acnegens (5). 2,3,7,8-Tetrachlorodibenzo-p-dioxin and tri- and tetra-... 

Second, there has been another severe outbreak of paralytic shellfish poisoning along the Pacific coast of Central America, with veiy high levels of shellHsh toxicity detected in Guatemala. There have, however, been no deaths and very few illnesses reported there, due to a timely response based on information gained from detailed investigations of the first outbreak. This time they were ready. 

Different strains of a number of bacterial species can be distinguished by their sensitivity to a collection of phages. Bacteria which can be typed in this way include Stop/ , aureus and Salmonella typhi. The particular strain ol say, Staph, aureus responsible for an outbreak of infection is characterized by the pattern of its sensitivity to a standard set of phages and then possible sources of infection are examined for the presence of that same phage type of Staph, aureus. 

NoV are readily transferred from hands to fomites and vice versa (Bidawid et al., 2004 D Souza et al., 2006). The pronoimced environmental stability of NoV particles also contributes to the spread of outbreaks from point sources of surface contamination. All stability studies have made use of surrogate organisms to model NoV response to conditions, since the human virus is not easily grown in cell culture (Duizer et al., 2004b Straub et al., 2007). The murine norovirus (MNV) and the feline calicivirus (FCV) have both been used, with the mouse virus providing more... 

EHEC are the pathogenic subgroup of Stx-producing E. coli (STEC). Acute hemorrhagic colitis has been associated mainly with the 0157 H7 serotype. This serotype has been responsible for larger outbreaks of infection, has higher rates of complications, and appears to be more pathogenic than non-EHEC STEC strains. The spectrum of disease associated with E. coli 0157 H7 includes bloody diarrhea, which is seen in as many as 95% of patients, nonbloody diarrhea, hemolytic-uremic syndrome (HUS), and thrombotic thrombocytopenic purpura. 

The Centers for Disease Control (CDC) in the USA has estimated that Campylobacter and Salmonella are the top two bacterial foodbome pathogens as they are responsible for a total of 2 and 1.3 million foodbome infections every year (Mead et al., 1999). Most of the cases of infection with Campylobacter and Salmonella appear to be due to eggs and poultry, but a significant number of cases are related to beef products (CDC, 2005 Jay, 2000). EHEC does not cause as many infections as the top two pathogens (approximately 100,000 in the USA), but EHEC is frequently linked to outbreaks of diarrhea caused by the consumption of contaminated ground beef (Mead et al., 1999, Rangel et al., 2005). Infections caused by EHEC are the major microbial public health concern related to ruminant food products. 

In the last 20 years, an increased number of enterohemorrhagic diarrhea outbreaks have been caused by highly virulent E. coli strains. EHEC are capable of causing serious complications such as hemolytic uremic syndrome in children and vascular disease in elderly people. E. coli serotype 0157 H7 has been the primary cause of outbreaks of EHEC, but other serotypes such as 026 and Olll are also a major public health concern. The Center for Disease Control has calculated that E. coli 0157 H7 is responsible for more than 70,000 infections and 60 deaths, and other EHEC strains cause approximately 36,000 illnesses and 30 deaths every year in the USA (Mead et al., 1999). In 1994 E. coli 0157 H7 was legally declared an adulterant in ground beef in the USA (USDA/FSIS Directive 10,010.1, 2004). Since then... 

Clostridium difficile responsible for a nosocomial outbreak of Clostridium difficile-associated diarrhea. J Clin Microbiol 2000,38 2706-2714. 

Knox, D.P., H.W. Reid, and J.G. Peters. 1987. An outbreak of selenium responsive unthriftiness in farmed red deer (Cervus elephus). Veterin. Rec. 120(4) 91-92. 

The neurotoxicity of -hexane was first observed in the shoe industries of Japan and Italy in the 1960s and early 1970s. A number of epidemiological studies were initiated in response to outbreaks of apparent peripheral neuropathy in shoe workers. While the clinical course of the disease was well described, elucidation of a dose-duration response relationship has been difficult. In most cases, concentrations of -hexane in the workplace air were not measured until after disease developed. Also, in almost all cases, workers were concurrently exposed to other chemicals which may have affected their response to -hexane. 

Persons with a history of convulsive disorders would be expected to be at increased risk from exposure to endrin. Children may be more sensitive than adults to the acute toxic effects of endrin. In an endrin poisoning episode in Pakistan, children 1-9 years old represented about 70% of the cases of convulsions (Rowley et al. 1987). The causative factor responsible for the outbreak was not identified, however, and the age distribution of cases could be explained by age-specific exposure situations. In general, following oral administration, female animals appear to be more susceptible to endrin toxicity than males (Gaines 1960 Treon et al. 1955). The difference may be due to the more rapid excretion of endrin by male versus female rats (Hutson et al. 1975 Klevay 1971 Korte et al. 1970). A sex-related difference in toxicity was not apparent following dermal exposure (Gaines 1960, 1969). No sex-based differences in endrin-related... 

Global cooperation in surveillance and outbreak alert and response... 

Poisonings associated with eating seafood significantly impact public health worldwide. For example during 1971 to 1990, seafood was the most important vehicle in food poisoning outbreaks in Korea (32%) and Japan (22%) and was responsible for 43% and 62%, respectively, of outbreak-related fatalities (Chan, 1995 Lee, 1996). 

Fish and seafood are generally responsible for infections caused by C. botulinum type E (Centers for Disease Control and Prevention, 1998). Many verified cases of botulism type E have been reported in Japan (166 cases and 58 deaths between 1951 and 1960). In 2003, C. botulinum type E was involved in the outbreak in western Alaska linked to consumption of a beached whale (Anonymous, 2003). Many outbreaks were also associated with a Japanese izuschi dish containing fermented raw fish, vegetables, and cooked and malted rice (okji). In Canada, Alaska, or Scandinavia, botulism is caused by consumption of fish and fermented meat dishes, very often prepared as traditional native dishes (Kotev et ah, 1987 Knubley et ah, 1995). 

Biotoxins, mainly of the spirolide family, have been principally monitored in shellfish samples. Reported toxin levels vary from 2-585 ng/g [206] to 11-7,950 ng/g [205] in shellfish from France and Italy, respectively, whereas reported values for Spanish mussels were in the range of 13-20 ng/g [82]. This study employed the use of different MS modes of operation, enhanced MS (EMS) and MS3 experiments in order to confirm the first occurrence of spirolides in Spanish shellfish. Okadaic acids were the principal toxin contaminants found in shellfish samples from Galicia, Spain, with levels reaching 2,012 ng/g [204]. Putative palytoxin was for the first time detected in Italian waters at levels of 1,350 ng for plankton pellet) and 1,950 ng for butanol extract thus, it was suggested to be the causative agent responsible for the Genoa 2005 outbreak showing respiratory Ulness in people exposed to marine aerosols [31]. 

---