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Volume 19, Number 8—August 2013

Dispatch

Acute Gastroenteritis Surveillance through the National Outbreak Reporting System, United States

Aron J. HallComments to Author , Mary E. Wikswo, Karunya Manikonda, Virginia A. Roberts, Jonathan S. Yoder, and L. Hannah Gould
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Table 1

Numbers of acute gastroenteritis outbreaks and outbreak-associated outcomes caused by various etiologic agents reported in the National Outbreak Reporting System, United States, 2009–2010*

Outbreak etiology No. (%) outbreaks
No. (%) outbreak-associated outcomes
Confirmed Suspected Total Illnesses Hospitalizations Deaths
Single agent†
Norovirus‡ 1,355 (64.2) 553 (78.1) 1,908 (67.7) 69,145 (77.7) 1,093 (45.9) 125 (85.6)
Salmonella spp. 344 (16.3) 11 (1.6) 355 (12.6) 8,590 (9.7) 773 (32.5) 6 (4.1)
Shigella spp.§ 99 (4.7) 10 (1.4) 109 (3.9) 2,135 (2.4) 115 (4.8) 1 (0.7)
STEC 88 (4.2) 13 (1.8) 101 (3.6) 1,091 (1.2) 250 (10.5) 9 (6.2)
Campylobacter spp.¶ 56 (2.7) 13 (1.8) 69 (2.4) 1,550 (1.7) 52 (2.2) 0
Clostridium spp.# 41 (1.9) 21 (3.0) 62 (2.2) 3,242 (3.6) 16 (0.7) 3 (2.1)
Cryptosporidium spp.** 17 (0.8) 30 (4.2) 47 (1.7) 598 (0.7) 21 (0.9) 1 (0.7)
Bacillus spp.†† 13 (0.6) 12 (1.7) 25 (0.9) 522 (0.6) 3 (0.1) 0
Staphylococcus aureus 11 (0.5) 11 (1.6) 22 (0.8) 263 (0.3) 0 0
Giardia intestinalis 13 (0.6) 6 (0.8) 19 (0.7) 121 (0.1) 5 (0.2) 0
Sc ombroid toxin/histamine 18 (0.9) 0 18 (0.6) 76 (0.1) 0 0
Ciguatoxin 14 (0.7) 0 14 (0.5) 59 (0.1) 6 (0.3) 0
Rotavirus 9 (0.4) 5 (0.7) 14 (0.5) 372 (0.4) 9 (0.4) 0
Other‡‡
33 (1.6)
23 (3.2)
56 (2.0)

1,194 (1.3)
38 (1.6)
1 (0.7)
All single-agent etiologies 2,111 (98.9) 708 (31.6) 2,819 (64.4) 88,958 (72.6) 2,381 (80.7) 146 (86.9)
Multiple agents 24 (1.1) 9 (0.4) 33 (0.8) 1,236 (1.0) 61 (2.1) 2 (1.2)
Unknown agent 0 1,524 (68.0) 1,524 (34.8) 32,294 (26.4) 510 (17.3) 20 (11.9)
All outbreaks 2,135 (100.0) 2,241 (100.0) 4,376 (100.0) 122,488 (100.0) 2,952 (100.0) 168 (100.0)

*STEC, Shiga toxin–producing Escherichia coli.
†Percentages for specific single agents are those among all single-agent etiology outbreaks (N = 2,819).
‡A norovirus genogroup was provided for 1,160 outbreaks: 150 GI, 1,003 GII, and 7 GI/GII.
§S. sonnei (95 confirmed and 8 suspected outbreaks), S. flexneri (5 confirmed outbreaks), Shigella sp. not known (1 confirmed outbreak).
C. jejuni (55 confirmed and 4 suspected outbreaks), Campylobacter sp. not known (8 confirmed and 2 suspected outbreaks).
#C. perfringens (37 confirmed and 20 suspected outbreaks), Clostridium sp. not known (4 confirmed and 1 suspected outbreak).
**C. parvum (10 confirmed and 1 suspected outbreak), C. hominis (6 confirmed outbreaks), Cryptosporidium sp. not known (30 confirmed outbreaks).
††B. cereus (13 confirmed and 11 suspected outbreaks), Bacilllus sp. not known (1 suspected outbreak).
‡‡Includes Vibrio sp. (8 outbreaks), cyanobacterial toxins (6 outbreaks), enterotoxigenic and enteropathogenic E. coli (4 outbreaks), Enterococcus spp. (3 outbreaks), mycotoxins (3 outbreaks), Cyclospora spp. (2 outbreaks), pesticides (2 outbreaks), sapovirus (2 outbreaks), paralytic shellfish poison (1 outbreak), Pseudomonas sp. (1 outbreak), sodium hydroxide (1 outbreak), Yersinia sp. (1 outbreak), and other unspecified etiologies (22 outbreaks).

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