Enteric (diarrheal) disease outbreaks include foodborne, waterborne, and those spread through person-to-person or animal contact. The goal of outbreak investigations is to identify the source of illness in order to control the outbreak, limit the number of cases, and identify recommendations to prevent future outbreaks.
However, the proportion of solved enteric disease outbreaks is low. Internationally, the current benchmark for solved outbreaks is 50% (Centres for Disease Control and Prevention). Outbreak investigations are also expensive and resource intensive. Responding to false alarms and unsuccessful investigations leads to a waste of public health resources.
At the BC Centre for Disease Control, a need was recognized for a set of criteria to help teams identify which alerts or clusters are more likely to lead to solved or controlled outbreak investigations. The criteria include objective thresholds such as the number of cases, pathogen typing, time between the earliest available case and notification date, and geographical spread. To our knowledge, there are no other objective criteria used in Canada to initiate enteric outbreaks investigations.
The criteria have allowed the percentage of outbreaks solved to remain stable, while freeing time for BC Centre for Disease Control and regional health authority staff to focus on other projects geared toward improving the number of outbreaks solved. The project has resulted in improved relationships with regional health authority stakeholders, as the criteria have improved transparency of the investigation process. Most importantly, improving the ability to solve outbreaks leads to a decrease in morbidity and mortality for clients and families in BC.
Title: Physician Epidemiologist
Contact information: Eleni.Galanis@bccdc.ca