上海市非伤寒沙门菌感染的流行病学负担概率估计

目的概率评估上海市非伤寒沙门菌(以下简称"沙门菌")感染的流行病学负担,为上海市食源性疾病的防控提供决策依据。方法随机抽取上海市60个街道/乡镇,通过入户问卷调查获得居民急性胃肠炎的人年发病及就诊情况。随机抽取上海市23家监测医院,获得患者采样率、检测率、阳性率等数据。从国家"传染病报告信息管理系统"中获得沙门菌感染病例的报告率。根据疾病发病与报告金字塔建立模型,采用蒙特卡洛模拟,从主动监测和被动报告两种方法估计上海市沙门菌流行病学负担。结果上海市居民急性胃肠炎人群调查获得年发生率为23 261例/10万,患者就诊率为20.47%(26/127)。监测医院腹泻病例的粪便采样率为21.66%(5 974/27 587),沙门菌阳性率为3.53%(211/5 974)。沙门菌阳性的报告率为81.04%(171/211)。根据被动报告病例直接计算的年发病率仅为5例/10万。被动报告概率估计的上海市沙门菌年发病率为270例/10万[95%可信区间(95%CI):185~399],估计每年发病人数6.21万(95%CI:4.25~9.18),总低估系数为60∶1。主动监测估计沙门菌感染年发病率为686例/10万(95%CI:549~843),估计每年发病人数为15.78万(95%CI:12.64~19.42),总低估系数为154∶1。经过比较,主动监测估计结果为被动报告估计结果的2.54倍。沙门菌感染具有较明显季节性,每年5~8月是沙门菌感染的高发期。结论食源性疾病主动监测估算沙门菌感染年发病率远高于被动报告估算的年发病率,说明主动监测在掌握疾病发病、就诊和流行病学负担估计方面具有较好的优势,同时发现患者就诊率是影响沙门菌感染总病例数估计的最大因素。本研究进一步证明疾病负担金字塔模型在我国食源性疾病单病种疾病负担领域的可行性。     

黑龙江省食源性非伤寒沙门菌急性胃肠炎疾病负担估计

目的 估计黑龙江省非伤寒沙门菌导致的食源性急性胃肠炎的疾病负担,为食源性疾病的管理和监测提供依据。方法 通过黑龙江省急性胃肠炎疾病负担人群调查获得急性胃肠炎的就诊率;通过食源性疾病监测系统获得黑龙江省的监测数据,从而计算非伤寒沙门菌的采样率、检测率及报告病例数。利用上述两部分数据构建金字塔模型,并估计黑龙江省由非伤寒沙门菌导致的急性胃肠炎的病例数量及发病率。利用@Risk8.2软件对非伤寒沙门菌导致的急性胃肠炎的发病数据进行概率估计以及不确定性分析,并进一步估计由非伤寒沙门菌导致的食源性急性胃肠炎发病情况。结果 估计黑龙江省由非伤寒沙门菌导致的食源性急性胃肠炎76 224人次（95%CI:60 203～96 626）,年发病率202.0/10万（95%CI:159.6/10万～256.1/10万）。结论 非伤寒沙门菌给黑龙江省造成了较大的食源性疾病负担,老年人和婴幼儿的疾病负担尤为显著。     

2014年金华市食源性疾病监测结果分析

了解金华市食源性疾病发生的基本情况,为预防和控制食源性疾病提供更为准确、充分的科学依据。方法 对金华市食源性疾病主动监测、食源性疾病暴发报告结果进行统计分析。结果 2014年哨点医院共监测食源性疾病病例4 095例,男女比例1.33∶1,以20～59岁年龄组为主(52.60%,2 154/4 095),职业以农民为主;采集粪便标本3 927份进行特定病原体检测,共检出致病菌120株,其中副溶血性弧菌55株、沙门菌46株、志贺菌18株、致泻性大肠埃希菌1株。2014年共报告食源性疾病暴发事件14 起,发病人数125人,以致病菌导致的感染性腹泻为主,5～8月为高发期,副溶血性弧菌的检出率最高。结论 食源性疾病监测结果反映金华市食源性疾病发生处于低水平,应重点加强监测关键环节的质量控制,建议进一步扩大主动监测的覆盖范围。     

2014年温州市特定病原体的食源性疾病病例监测结果分析

目的通过对温州市2014年特定病原体的食源性疾病病例监测结果分析,了解温州市食源性疾病的流行趋势和特征,为卫生行政部门制定食源性疾病监测工作提供科学依据。方法收集温州市食源性疾病监测哨点医院以腹泻症状为主诉的门诊和住院病例,采集粪便或肛拭样本,并进行沙门菌、志贺菌、副溶血性弧菌、创伤弧菌、致泻性大肠埃希菌和诺如病毒检测,同时对患者进行相关信息采集、分析。结果 2014年温州市共监测腹泻病例4 216例,采集样本4 190份,检出阳性病原菌321株,分别为副溶血性弧菌218株、诺如病毒48株、沙门菌44株,致泻性大肠埃希菌6株,志贺菌3株,创伤弧菌2株。病例数以7~11月较为集中,占总病例的69.38%,呈现较明显的夏秋季高峰。5岁以下年龄组及16~45岁年龄组为高发病人群,可疑食品中以水产及其制品占比最大,其次为肉类、禽类及其制品。结论副溶血性弧菌是目前温州市食源性疾病致病的主要微生物,需加强卫生行政部门-疾控机构-哨点医院三者沟通协作机制,完善食源性疾病监测网络,提高监测能力,加大食源性疾病健康教育工作,积极开展有效的防控措施。     

2018~2019年云南省沙门氏菌感染引起食源性腹泻状况分析

目的 通过对2018-2019年云南省食源性腹泻病例的沙门氏菌检出情况进行分析,为采取相应防治措施提供科学依据。方法 选取2018-2019年云南省食源性疾病监测哨点医院收集到的由食品或怀疑由食品引起的且以腹泻症状为主诉的就诊病例,通过采集患者粪便或肛拭子标本进行沙门菌检验。结果 2018-2019年云南省通过食源性疾病监测报告系统共收集食源性腹泻病例8558例,沙门氏菌检出320例,检出率3.74%(320/8558)。3～6岁年龄组病例中沙门氏菌检出率(10.18%)最高,其次为≤3岁(6.50%)和6～13岁(4.63%)年龄组;托幼儿童检出率(9.40%)最高;6月份检出率(7.41%)最高;以糖果、巧克力、蜂蜜及其制品可疑食品暴露史检出率(6.67%)最高;血清型鉴定结果肠炎沙门氏菌总检出率(50.94%)最高。结论 肠炎沙门氏菌是云南省食源性腹泻病例的主要致病菌,应重点加强云南省食源性疾病致病微生物监测;3～6岁、≤3岁和6～13岁等儿童是食源性腹泻病例的高发人群,应加强重点人群特别是儿童食源性疾病知识的宣传教育,积极开展有效的防控措施。     

2008年上海市食源性疾病监测

目的 了解上海市食源性疾病发生情况.方法 采用社区居民食源性腹泻主动症状监测、医院肠道门诊腹泻病人肛拭检测、中小学生腹泻缺课调查、药店黄连素及诺氟沙星销售量调查及食物中毒暴发事件网络报告等方法综合监测.结果 上海市社区居民食源性腹泻年发生率为26.2‰,就诊率为40.2%,医院肠道门诊腹泻病人肛拭检测副溶血性弧菌阳性率2.95%、沙门菌阳性率0.53%,中学生、小学生腹泻缺课率分别为15.91‰,9.97‰,黄连素销售81 157盒/374 449.07元、诺氟沙星销售21 416盒/80 926.62元,食物中毒暴发事件16起/488人.监测结果显示5-10月是食源性腹泻高发月份,同时也为副溶血性弧菌阳性率高峰.结论 上海市食源性疾病监测基本反映出上海市食源性疾病发生处于低水平,但监测系统在监测对象定义、质量控制方面还需改进.     

2018年上海市非伤寒沙门菌感染流行病学特征分析

目的 了解上海市非伤寒沙门菌(以下简称“沙门菌”)感染的流行病学特征,为沙门菌感染的预防和控制提供科学依据。方法 应用描述流行病学的方法,对上海市26家食源性疾病监测哨点医院感染性腹泻病例的流行病学信息和沙门菌检测结果进行统计分析。结果 收集到5 580例感染性腹泻病例和其标本,沙门菌检出率为4.19%(234/5 580),其血清型以肠炎沙门菌和鼠伤寒沙门菌为主。不同性别、年龄和职业人群的沙门菌检出率差异无统计学意义(P＞0.05),春夏季节是沙门菌检出的高发季节。有发热症状或者发生水样便的病例,其沙门菌检出率高于无发热症状和无水样便的病例。餐饮服务业和单位食堂的病例中沙门菌检出率相对较高。结论 上海市沙门菌感染的血清型以肠炎沙门菌和鼠伤寒沙门菌为主,感染高峰出现在春夏季节。考虑到餐饮服务业和单位食堂的风险相对较高,食品安全监督管理部门应加强对其卫生监管。     

重庆市2019—2020年食源性疾病主动监测病原学及饮食史分析

目的 了解重庆市食源性疾病病原体感染情况,分析可疑饮食及其来源,为食源性疾病防控策略提供参考。方法 收集重庆市27家哨点医院2019—2020年就诊的食源性疾病病例信息。采集就诊病例的粪便或肛拭标本,检测其沙门菌、副溶血性弧菌、志贺菌、致泻大肠埃希氏菌及诺如病毒情况。结果 共监测4 294例腹泻病例,病原体总检出率为12.09%（519/4 294）,其中诺如病毒5.33%、沙门菌4.66%、致泻大肠埃希氏菌1.96%、志贺菌0.12%、副溶血性弧菌0.02%。二、三季度的病原体检出率较高（18.50%,13.00%）,呈现较明显的夏秋季高峰。不同年龄组病原体检出率以0~1岁组最高,为19.19%（71/370）。4 294例病例中有4 289例提供了可疑饮食信息,其中肉与肉制品占19.26%（846/4 289）、粮食类及其制品占17.65%（757/4 289）;食物加工方式中家庭自制占58.27%（2 502/4 289）,餐饮服务业占30.64%（1 314/4 289）;食物来源中家庭占55.42%（2 377/4 289）、餐饮店占12.17%（522/4 289）、零售店占10.91%（468/4 289）。结论 在监测的病原体中,诺如病毒和沙门菌是重庆市食源性疾病的主要病原体,可疑饮食以家庭自制食品占比较大。建议在食源性疾病高发的夏秋季加强食品安全监管,重点关注0~1岁婴儿期人群,开展家庭的食品卫生安全知识宣教。加强食源性疾病主动监测,为开展有效防控提供技术支持。     

2015—2018年上海市浦东新区食源性疾病主动监测病原学及流行病学特征分析

目的 了解上海市浦东新区特定病原体食源性疾病的流行趋势和特征,为制定食源性疾病防控策略提供参考。方法 采集2015—2018年于上海市浦东新区开展食源性疾病主动监测的数据,2家哨点医院采集以腹泻症状为主诉感染病例的粪便或肛拭子标本,进行副溶血性弧菌、沙门菌、志贺菌、致泻大肠埃希菌、空肠弯曲菌和诺如病毒检验,同时对患者进行相关信息采集、分析。结果 共监测和采集2 871例腹泻病例的粪便或肛拭子标本,病原体总体检出率为23.55%(676/2 871),其中,诺如病毒为20.04%(97/484)、致泻大肠埃希菌为11.84%(340/2 871)、空肠弯曲菌为7.21%(68/943)、副溶血性弧菌为4.01%(115/2 871)、沙门菌为3.27%(94/2 871)、志贺菌为0.28%(8/2 871);第三季度的病原体检出率较高,呈现较明显的夏秋季高峰;可疑食物主要是混合/多种食品(41.12%,278/676),其次为水产动物及其制品(22.19%,150/676)和肉与肉制品(10.95%,74/676)。结论 诺如病毒和致泻大肠埃希菌是上海市浦东新区腹泻病例的主要病原体,应进一步完善食源性疾病主动监测,对特定病原体阳性病例开展流行病学个案调查,为开展有效防控提供技术支持。     

2013—2015年吉林省食源性疾病流行病学特征分析

目的分析2013—2015年吉林省食源性疾病的流行病学特征和规律,为防控食源性疾病暴发事件提出有针对性的措施和建议。方法对2013—2015年"食源性疾病监测报告系统"中吉林省的病例进行描述性分析和统计学检验。结果 2013—2015年吉林省哨点医院共报告食源性疾病病例12 049例,其中11 497例患者的标本做病原学检测,807例患者检出致病微生物,总检出率为7.02%;诺如病毒、沙门菌、致泻性大肠埃希菌属、志贺菌、副溶血性弧菌检出率分别为15.63%(389/2 489)、2.54%(283/11 141)、1.32%(147/11 167)、0.08%(9/11 153)、0.06%(6/9 410),未检出小肠耶尔森菌(0/201)。诺如病毒、沙门菌和致泻性大肠埃希菌属与志贺菌、副溶血性弧菌和小肠耶尔森菌相比是吉林省主要流行的食源性致病微生物(P0.05)。诺如病毒在第一季度检出率(31.00%)高于其他三个季度;沙门菌、致泻性大肠埃希菌属在第二、三季度检出率(3.78%、3.12%;1.32%、1.69%)高于第一、四季度;志贺菌和副溶血性弧菌均在第三季度检出率最高(0.14%、0.15%)。诺如病毒在80岁以上和5岁以下年龄组检出率较高(20.00%、18.90%),沙门菌和致泻性大肠埃希菌属在5岁以下年龄组检出率最高(3.38%、1.75%)。2015年的食源性致病菌检出率高于2013年和2014年,差异有统计学意义(P0.05),第四季度的检出率低于前三季度差异有统计学意义(P0.05),不同性别的食源性致病菌检出率差异无统计学意义(P0.05),5岁以下年龄组儿童、商业服务人员、城市居民食源性致病微生物检出率最高,差异有统计学意义(P0.05)。结论 2013—2015年吉林省食源性疾病检出率逐年升高,第一、二、三季度检出率高于第四季度,诺如病毒、沙门菌和致泻性大肠埃希菌属是主要流行的病原体,5岁以下年龄组儿童和商业服务人员易受食源性致病微生物感染。     

Estimating the burden of acute gastroenteritis and foodborne illness caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus by using population-based telephone survey data, Miyagi Prefecture, Japan, 2005 to 2006

Most cases of acute gastroenteritis and foodborne disease are not ascertained by public health surveillance because the ill person does not always seek medical care and submit a stool sample for testing, and the laboratory does not always test for or identify the causative organism. We estimated the total burden of acute gastroenteritis in Miyagi Prefecture, Japan, using data from two 2-week cross-sectional, population-based telephone surveys conducted in 2006 and 2007. To estimate the number of acute gastroenteritis illnesses caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus in Miyagi Prefecture, we determined the number of cases for each pathogen from active laboratory-based surveillance during 2005 to 2006 and adjusted for seeking of medical care and submission of stool specimens by using data from the population-based telephone surveys. Monte Carlo simulation was used to incorporate uncertainty. The prevalence of acute gastroenteritis in the preceding 4 weeks was 3.3% (70 of 2,126) and 3.5% (74 of 2,121) in the winter and summer months, yielding an estimated 44,200 episodes of acute gastroenteritis each year in this region. Among people with acute gastroenteritis, the physician consultation rate was 32.0%, and 10.9% of persons who sought care submitted a stool sample. The estimated numbers of Campylobacter-, Salmonella-, and V. parahaemolyticus -associated episodes of acute gastroenteritis were 1,512, 209, and 100 per 100,000 population per year, respectively, in this region. These estimates are significantly higher than the number of reported cases in surveillance in this region. Cases ascertained from active surveillance were also underrepresented in the present passive surveillance, suggesting that complementary surveillance systems, such as laboratory-based active surveillance in sentinel sites, are needed to monitor food safety in Japan.     

吉林地区食源性沙门氏菌状况研究及快速检测

目的 分析吉林市哨点医院食源性沙门氏菌监测病例,为防控食源性疾病爆发提供参考依据;为缩短检出时间,利用上转发光免疫层析技术对食源性沙门氏菌进行检测,并对其检测性能进行评价;方法 收集吉林地区哨点医院食源性沙门氏菌病例的监测信息进行研究分析;针对哨点医院细菌分离培养检出的食源性沙门氏菌,采用上转发光免疫层析方法进行检测; 结果 吉林地区食源性沙门氏菌在幼儿人群组检出率最高,疑似暴露食物主要是水果类及其制品、肉与肉制品和混合食品等三类食品,疑似暴露食物以散装最多,疑似暴露食物购买地点主要是市场,检出的食源性沙门氏菌主要是肠炎沙门氏菌和鼠伤寒沙门氏菌;对照细菌分离培养,上转发光免疫层析检测结果与其高度一致（符合率达100%）。结论 加强吉林市食品安全卫生监督,降低食源性疾病发生;上转发光免疫层析可满足食源性沙门氏菌菌株的快速检测。     

2018—2019年嘉兴市社区人群急性胃肠炎疾病负担评估

目的 了解社区人群急性胃肠炎流行特征和经济负担,为评估人群食源性疾病的患病情况及单病种疾病负担提供更准确的基础数据。方法 采用分层多阶段随机抽样方法抽取秀洲区和桐乡市共10个街道(乡镇)的20个居委会(行政村)作为调查点,于2018年7月至2019年6月,每月入户问卷调查急性胃肠炎发病情况和经济负担等。结果 现场实际调查2 400户2 400人,发现急性胃肠炎病例62人次,月发病率2.58%(95%CI: 1.95%～3.22%),城镇和农村、不同年龄性别发病差异无统计学意义。根据人口性别、年龄构成调整后的月发病率为2.92%(95%CI: 2.25%～3.60%),推算年发病率为0.38次/人年(95%CI:0.36～0.40)。7～9月为高发季节,医院就诊率12.77%,72.34%的病例与不洁饮食相关,62.50%的29岁及以下年龄病例,83.33%的学龄前儿童,以及学生和办事员病例,均在食用外购食品后发病。病例次均经济负担399.62元,其中次均直接医疗费用294.61元,次均直接非医疗费用39.83元,次均间接费用65.18元,估算全市急性胃肠炎型总经济负担为7.19亿元,其中食源性急性胃肠炎总经济负担为5.20亿元。结论 嘉兴市急性胃肠炎疾病负担较重,建议加强重点人群健康教育,引导建立健康饮食行为,并持续开展相关监测。     

Disease burden of foodborne pathogens in the Netherlands, 2009

To inform risk management decisions on control, prevention and surveillance of foodborne disease, the disease burden of foodborne pathogens is estimated using Disability Adjusted Life Years as a summary metric of public health. Fourteen pathogens that can be transmitted by food are included in the study (four infectious bacteria, three toxin-producing bacteria, four viruses and three protozoa). Data represent the burden in the Netherlands in 2009. The incidence of community-acquired non-consulting cases, patients consulting their general practitioner, those admitted to hospital, as well as the incidence of sequelae and fatal cases is estimated using surveillance data, cohort studies and published data. Disease burden includes estimates of duration and disability weights for non-fatal cases and loss of statistical life expectancy for fatal cases. Results at pathogen level are combined with data from an expert survey to assess the fraction of cases attributable to food, and the main food groups contributing to transmission. Among 1.8 million cases of disease (approx. 10,600 per 100,000) and 233 deaths (1.4 per 100,000) by these fourteen pathogens, approximately one-third (680,000 cases; 4100 per 100,000) and 78 deaths (0.5 per 100,000) are attributable to foodborne transmission. The total burden is 13,500 DALY (82 DALY per 100,000). On a population level, Toxoplasma gondii, thermophilic Campylobacter spp., rotaviruses, noroviruses and Salmonella spp. cause the highest disease burden. The burden per case is highest for perinatal listeriosis and congenital toxoplasmosis. Approximately 45% of the total burden is attributed to food. T. gondii and Campylobacter spp. appear to be key targets for additional intervention efforts, with a focus on food and environmental pathways. The ranking of foodborne pathogens based on burden is very different compared to when only incidence is considered. The burden of acute disease is a relatively small part of the total burden. In the Netherlands, the burden of foodborne pathogens is similar to the burden of upper respiratory and urinary tract infections.     

2013—2016年青海省婴幼儿食源性腹泻流行病学特征及病原研究

目的 分析青海省婴幼儿食源性腹泻的流行病学特征,为青海省婴幼儿食源性腹泻防控提供参考依据。方法 收集2013年1月—2016年12月,在青海省13家哨点医院就诊的以腹泻为主诉的婴幼儿(<4岁)食源性腹泻病例信息,并采集粪便或肛拭子标本进行4种致病菌(沙门菌、志贺菌、副溶血性弧菌、致泻大肠埃希菌)及诺如病毒的常见病原体的检测。结果 共监测3 068例婴幼儿食源性腹泻病例,腹泻性状以水样便为主,54.66%(1 677/3 068)的病例伴有发热;共检出病原体150例,检出率为4.89%(150/3 068),其中以志贺菌检出率最高(2.36%,72/3 049),其次是沙门菌(2.11%,64/3 035)和诺如病毒(1.02%,10/983);婴幼儿食源性腹泻的发生呈较明显的夏秋季高峰;婴儿组病原体的检出率高于幼儿组;乳类食品为首位原因食品。结论 青海省婴幼儿食源性腹泻的主要优势致病菌为志贺菌和沙门菌,并有诺如病毒检出,应加强对目标病原的持续监测,开展婴幼儿食源性腹泻知识宣传教育并有效防控。     

黑龙江省急性胃肠炎疾病负担流行病学调查

目的了解黑龙江省急性胃肠炎流行病学负担及影响因素。方法采用多阶段分层随机抽样方法抽取调查对象,每月入户调查其过去4周内急性胃肠炎发病情况。结果共调查19 171人,人群急性胃肠炎月患病率为3.51%[95%置信区间(95%CI):3.25%～3.77%],年发病比例为37.24%,年发病率为0.466次/人,加权月患病率为3.61%,加权年发病比例为38.07%,加权年发病率为0.479次/人。估计全省急性胃肠炎平均每年1 442.3万人发病,共发病1 814.7万人次。多因素Logistic回归分析结果显示,居住地性质、季节、年龄、过去2周是否因出差旅游离开居住地、家庭年人均收入为居民急性胃肠炎患病的影响因素。58.66%的急性胃肠炎病例认为是受污染的食物导致。结论黑龙江省急性胃肠炎流行病学负担较重,食源性比例较高,应予以足够的关注和重视。     

北京市食源性非伤寒沙门菌的分子分型和耐药性研究

目的了解北京市食源性非伤寒沙门菌的分子特征及耐药情况。方法对2004—2010年北京市食源性致病菌监测网收集的100株沙门菌进行脉冲场凝胶电泳(PFGE)分型和抗生素敏感性检测。结果 100株非伤寒沙门菌通过PFGE分型分为62个不同的带型,每个带型包含1~11株菌。抗生素敏感性结果显示,100株菌中有55株菌表现为对至少1种抗生素耐药,其中多重耐药菌株15株。菌株对各抗生素的耐药率为萘啶酸40%、四环素30%、氯霉素15%、庆大霉素10%、甲氧苄啶/磺胺甲恶唑10%、环丙沙星9%、头孢西丁1%、头孢噻肟0%。结论沙门菌PFGE带型和耐药谱均与血清型存在很高的一致性。提示北京市食源性非伤寒沙门菌的耐药情况比较严重,开展对该菌分子分型与耐药特征分析的联合监测意义重大。     

Development of a Salmonella screening tool for consumer complaint-based foodborne illness surveillance systems

Foodborne illness surveillance based on consumer complaints detects outbreaks by finding common exposures among callers, but this process is often difficult. Laboratory testing of ill callers could also help identify potential outbreaks. However, collection of stool samples from all callers is not feasible. Methods to help screen calls for etiology are needed to increase the efficiency of complaint surveillance systems and increase the likelihood of detecting foodborne outbreaks caused by Salmonella. Data from the Minnesota Department of Health foodborne illness surveillance database (2000 to 2008) were analyzed. Complaints with identified etiologies were examined to create a predictive model for Salmonella. Bootstrap methods were used to internally validate the model. Seventy-one percent of complaints in the foodborne illness database with known etiologies were due to norovirus. The predictive model had a good discriminatory ability to identify Salmonella calls. Three cutoffs for the predictive model were tested: one that maximized sensitivity, one that maximized specificity, and one that maximized predictive ability, providing sensitivities and specificities of 32 and 96%, 100 and 54%, and 89 and 72%, respectively. Development of a predictive model for Salmonella could help screen calls for etiology. The cutoff that provided the best predictive ability for Salmonella corresponded to a caller reporting diarrhea and fever with no vomiting, and five or fewer people ill. Screening calls for etiology would help identify complaints for further follow-up and result in identifying Salmonella cases that would otherwise go unconfirmed; in turn, this could lead to the identification of more outbreaks.     

Incidence of foodborne illnesses reported by the foodborne diseases active surveillance network (FoodNet)-1997. FoodNet Working Group

In 1997, the Foodborne Diseases Active Surveillance Program (FoodNet) conducted active surveillance for culture-confirmed cases of Campylobacter, Escherichia coli O157, Listeria, Salmonella, Shigella, Vibrio, Yersinia, Cyclospora, and Cryptosporidium in five Emerging Infections Program sites. FoodNet is a collaborative effort of the Centers for Disease Control and Prevention's National Center for Infectious Diseases, the United States Department of Agriculture's Food Safety and Inspection Service, the Food and Drug Administration's Center for Food Safety and Applied Nutrition, and state health departments in California, Connecticut, Georgia, Minnesota, and Oregon. The population under active surveillance for foodborne infections was approximately 16.1 million persons or roughly 6% of the United States Population. Through weekly or monthly contact with all clinical laboratories in these sites, 8,576 total isolations were recorded: 2,205 cases of salmonellosis, 1,273 cases of shigellosis, 468 cases of cryptosporidiosis, 340 of E. coli O157:H7 infections, 139 of yersiniosis, 77 of listeriosis, 51 of Vibrio infections, and 49 of cyclosporiasis. Results from 1997 demonstrate that while there are regional and seasonal differences in reported incidence rates of certain bacterial and parasitic diseases, and that some pathogens showed a change in incidence from 1996, the overall incidence of illness caused by pathogens under surveillance was stable. More data over more years are needed to assess if observed variations in incidence reflect yearly fluctuations or true changes in the burden of foodborne illness.