Volume 6, Number 2—April 2000
Dispatch
The Impact of Health Communication and Enhanced Laboratory-Based Surveillance on Detection of Cyclosporiasis Outbreaks in California
Janet C. Mohle-Boetani*
, S. Benson Werner*, Stephen H. Waterman*, and Duc J. Vugia*†
, S. Benson Werner*, Stephen H. Waterman*, and Duc J. Vugia*†Table
Event-associated outbreaks of cyclosporiasis, California, 1997
| Outbreak number, type month/day of event | Event to symptoms | Symptoms to medical care | Seeking of medical carea | Timing of stool collection | Stool testinga | Stool collection to Cyclospora verification | Method of outbreak detectionb |
|---|---|---|---|---|---|---|---|
| 1, Banquet, 4/1 | 7 days | None–patient was physician | No | 39 days after onset | No | 2 days | Report of illness cluster by patientd |
| 2, Conference, 4/17 | 7 days | None–patient was physician | No | 19 days after onset | No | 6 days | Report of illness cluster by physiciand |
| 3, Wedding, 5/3 | 7 days | 18 days | Yes (I) bride sent information | 1 day after visiting physician | Yes (I) patient requested | 1 day | Interview of index patient identified through ELBf surveillance, 4 days |
| 4, Barbecue, 5/10 | 8 days | 1 day and repeat phone calls for 2 weeks | No | 15 days after visiting physician | Yes (M) patient requested | 1 day | Interview of index patient identified through ELBf surveillance, 6 days |
| 5, Picnic, 5/11 | 7 days | 18 days | Yes (M and I) Internet searches after media reports | 1 day after visiting physician | Yes (I) patient requested | 4 days | Interview of index patient identified through ELBf surveillance, 41 days |
| 6, Card Party, 5/14 | 7 days | 14 days | No | 24 days after visiting physician | Yes (M) patient notified health dept., which recommended testing | 3 days | Report of illness cluster by patientd |
| 7, Dinner, 5/21 | 5 days | 3 days | No | 1 day after visiting physician | Yes (M) physician saw TV show on outbreaks | 3 days | Interview of index patient identified through ELBf surveillance, 3 days |
| 8, Luncheon, 5/24 | 6 days | 1 day | Yes (M, and I) Internet searches after media reports | 2 days after visiting physician | Yes (I) patient requested | 1 day | Interview of index patient identified through ELBf surveillance, 3 days |
| Median | 7 days | 8.5 days | 2 days | 2.5 days | 4 days | ||
| (range) | (5-8 days) | (1-18 days) | (1-24 days) | (1-6 days) | (3-41 days) For ELB surveillance notifications for all outbreaks |
aPrompted by Internet (I) or Media (M) information.
bBy local health department, time from laboratory verification to notification of the health department (if applicable).
cTesting was requested by the patient based on her knowledge of tropical medicine.
dThe health department was aware of pending test results and the index patient was known to the health department prior to laboratory verification.
eSpecific testing was not requested by a physician but was conducted by a laboratorian who had just read a journal article about Cyclospora.
fELB denotes enhanced laboratory-based surveillance.
