2014.ISDS.Abstracts.Final.pdf


ISDS Annual Conference Proceedings 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
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ISDS 2014 Conference Abstracts

An Integrated System for Enteric Disease Surveillance 
and Outbreak Detection

Kristen Soto*1, Quyen Phan1, Meghan Maloney1, Jessica Brockmeyer1, Paula Clogher2 and 
Therese Rabatsky-Ehr1

1Epidemiology, Connecticut Department of Public Health, Hartford, CT, USA; 2Yale Emerging Infections Program, New Haven, CT, 
USA

Objective
To develop an integrated system for routine enteric disease 

surveillance, cluster detection and monitioring, information sharing 
among key stakeholders, and documentation.

Introduction
The Connecticut Department of Public Health (DPH), in 

collaboration with Yale Emerging Infections Program (EIP), 
receives funding to particpate in the Foodborne Diseases Active 
Surveillance Network (FoodNet) and Foodborne Disease Centers 
for Outbreak Response Enhancement (FoodCORE). FoodNet is an 
active population-based surveillance network that monitors trends for 
ten enteric diseases and conducts special studies to better understand 
the causes of foodborne illness.1 FoodCORE develops best practices 
related to the detection, investigation, and control or disease outbreaks, 
particularly those due to to Salmonella, Shiga toxin-producing E. coli, 
and Listeria (SSL).2 Foodborne disease surveillance and response is 
a collaborative effort requiring real-time data sharing between key 
stakeholders including: DPH Epidemiology, DPH Laboratory, DPH 
Food Protection Program, Yale EIP, and local health department 
(LHD) staff.

Methods
Prior to 2011, DPH and Yale EIP maintained several separate 

Access and Epi-Info databases to manage foodborne surveillance, 
disease follow-up, and outbreak management activities. Surveillance 
and laboaratory data were routinely reviewed to identify clusters 
based on demographic information or spatial/temporal clusttering. 
During 2011, foodborne disease surveillance and follow-up 
activities were migrated to Maven, Connecticut’s Electronic Disease 
Surveillance System (CEDSS)3. All cases of physician or laboratory 
reportable foodborne illness are initiated as events in Maven. Each 
event contains demographic, laboratory, and follow-up information 
for the case. Foodborne clusters and outbreaks are also initiated 
as unique events in Maven; each outbreak events contains basic 
summary information, a repository of relevant documentation, and 
outcome measures data. Outbreak events are linked with associated 
case events. Workflows and reports have been developed to facilitate 
data management and analysis, and to generate automated alerts. DPH 
Epidemiology, DPH Laboratory, DPH Food Protection Program, Yale 
EIP, and LHD staff can access records in Maven to update data and to 
facilitate information sharing.

Results
During January 2012-June 2014 3238 enteric disease cases and 152 

SSL clusters, including 16 identified outbreak events, were initiated 
and managed in CEDSS. During 2012 a FoodCORE student interview 
team was formed resulting in increased completeness of Salmonella 
follow-up from 51% (2009-2011) to 82% (2012); data management 
and information sharing were facilitated through CEDSS.

Conclusions
The use of a centralized electronic disease surveillance system has 

improved foodborne disease surveillance and outbreak detection by 
streamlining data management needs and improving communication 
and data sharing among key stakeholders. Future areas of development 
involve implementing electronic laboratory reporting and integrating 
information from the DPH Food Protection Program’s foodborne 
complaint and restaurant inspection systems. Ongoing system 
evaluation is needed to continue to identify areas for increased 
streamlining and data sharing of foodborne disease information.

Keywords
foodborne diseases; Foodborne outbreaks; Surveillance system; 
Information sharing; Integrated disease surveillance

References

1. Foodborne Disease Active Surveillance Network (FoodNet) [Internet]. 
Atlanta: Centers for Disease Control and Prevention.; Updated 2014 
Jul 18; cited 2014 Sep 8]. Available from: http://www.cdc.gov/
foodnet.

2. Foodborne Diseases Centers for Outbreak Response Enhancement
(FoodCORE) [Internet]. Atlanta: Centers for Disease Control and 
Prevention.; Updated 2014 Aug 14; cited 2014 Sep 8]. Available from: 
http://www.cdc.gov/foodcore.

3. Consilience Software. Maven Electronic Disease Surveillance System, 
Version 4.0. Austin, TX.

*Kristen Soto

E-mail: kristen.soto@ct.gov    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 7(1):e160, 2015