OutbreakNet Enhanced Sites
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There are eighteen sites participating in OutbreakNet Enhanced, including sixteen states and two large cities.
Site Profiles
Descriptions of the work each OutbreakNet Enhanced site has completed using funds provided by the program.
Alabama
At A Glance
- Population1: 4,858,979
- Year Joined OutbreakNet Enhanced: 2016
- Structure: Largely centralized
- Initial Case Interviewing Responsibility: Area investigator (state staff)
- Whole Genome Sequencing Certified2: In progress
Program Highlight
Alabama is a new OutbreakNet Enhanced site. Highlights on its work under the program will be forthcoming.
Complementary Programs
- Alabama also participates in the following food safety programs:
Alabama Department of Public Health – Food, Milk, and Lodging
Alaska
At A Glance
- Population1: 738,432
- Year Joined OutbreakNet Enhanced: 2016
- Structure: Centralized
- Initial Case Interviewing Responsibility: Public health nurses
- Whole Genome Sequencing Certified2: Yes
Program Highlight
Alaska is a new OutbreakNet Enhanced site. Highlights on its work under the program will be forthcoming.
Complementary Programs
- Alaska also participates in the following food safety programs:
Alaska Department of Health and Social Services – Foodborne & Waterborne Disease Information
Arizona
At A Glance
- Population1: 6,828,065
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Decentralized
- Initial Case Interviewing Responsibility: Local health departments, with the option to delegate to state health department
- Whole Genome Sequencing Certified2: In progress
Program Highlight
During the 2015-2016 program year, Arizona gathered more than 1,000 responses to a pilot of an Arizona Food, Animal, and Water Exposure Survey (AZ FAWES), with questions patterned after the FoodNet Population Survey and tailored to include risk factors specific to Arizona. Participants completed the survey online, answering questions about exposures in the past seven days.
Arizona’s population includes 22 sovereign Native American communities and a large number of seasonal residents and immigrants. Thus, risk factors for the general population of Arizona may differ from those reported for populations in the existing FoodNet population survey. The results of AZ FAWES will provide baseline exposure data specific to Arizona for use during outbreak investigations.
Complementary Programs
- Arizona also participates in the following food safety programs:
Chicago
At A Glance
- Population1: 2,720,546
- Year Joined OutbreakNet Enhanced: 2016
- Structure: Decentralized
- Initial Case Interviewing Responsibility: City health department
- Whole Genome Sequencing Certified2: In progress
Program Highlight
Chicago is a new OutbreakNet Enhanced site. Highlights on its work under the program will be forthcoming.
Complementary Programs
- Chicago also participates in the following food safety programs:
Florida
At A Glance
- Population1: 20,271,272
- Year Joined OutbreakNet Enhanced: 2016
- Structure: Shared
- Initial Case Interviewing Responsibility: Local health departments
- Whole Genome Sequencing Certified2: In progress
Program Highlight
Florida is a new OutbreakNet Enhanced site. Highlights on its work under the program will be forthcoming.
Complementary Programs
- Florida also participates in the following food safety programs:
Georgia
At A Glance
- Population1: 10,214,860
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Shared
- Initial Case Interviewing Responsibility: Shared between local and state epidemiologists
- Whole Genome Sequencing Certified2: Yes
Program Highlight
During the 2015-2016 program year, Georgia created a student interview team comprised of three part-time student interns. The student team conducts enteric disease interviews and performs data entry and data cleaning. All students have been trained to use the National Hypothesis Generating Questionnaire, multiple pathogen-specific questionnaires, and outbreak-specific questionnaires.
These students have been invaluable since their start in January 2016. The student team has increased Georgia’s epidemiologic capacity to interview enteric disease cases. This increased capacity will help Georgia get more complete and timely epidemiologic information.
Complementary Programs
- Georgia also participates in the following food safety programs:
Georgia Department of Public Health – Acute Disease Epidemiology
Indiana
At A Glance
- Population1: 6,619,680
- Year Joined OutbreakNet Enhanced: 2016
- Structure: Decentralized
- Initial Case Interviewing Responsibility: Shared between local health departments and central investigation team
- Whole Genome Sequencing Certified2: In progress
Program Highlight
Indiana is a new OutbreakNet Enhanced site. Highlights on its work under the program will be forthcoming.
Complementary Programs
- Indiana also participates in the following food safety programs:
Kansas
At A Glance
- Population1: 2,911,641
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Decentralized
- Initial Case Interviewing Responsibility: Local health departments
- Whole Genome Sequencing Certified2: In progress
Program Highlight
Kansas began conducting centralized salmonellosis, listeriosis, and STEC interviews during the 2015-2016 program year. Local health departments (LHDs) were given the choice of either joining a state-centralized interview system or continuing to conduct interviews independently. Of 105 local health departments, 101 have chosen centralized interviews.
The Kansas State Health Department conducts centralized enteric interviews for all LHDs that chose this new system. LHDs can view interview information for each case, and get regular updates on centralized interviewing performance measures. This centralized interviewing system allows Kansas to conduct more efficient and complete case investigations, which will help detect enteric disease outbreaks faster.
Complementary Programs
- Kansas also participates in the following food safety programs:
Kansas Department of Health and Environment – Foodborne Disease
Massachusetts
At A Glance
- Population1: 6,794,422
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Decentralized
- Initial Case Interviewing Responsibility: Local health departments
- Whole Genome Sequencing Certified2: Yes
Program Highlight
During the summer of 2016, the Massachusetts Department of Public Health hosted two graduate student interns who worked with the foodborne team on enteric disease projects. Hosting these interns increased the capacity of the foodborne team and provided the students with a great hands-on learning opportunity.
The interns were primarily responsible for interviewing patients associated with clusters of salmonellosis, STEC, and listeriosis, and also interviewed patients with other time-sensitive illnesses including Vibrio parahaemolyticus and cyclosporiasis. The interns also compiled data from paper National Hypothesis Generating Questionnaires for cluster-associated cases of salmonellosis into an electronic database for analysis.
Complementary Programs
- Massachusetts also participates in the following food safety programs:
Massachusetts Department of Public Health – Foodborne Illness
Michigan
At A Glance
- Population1: 9,922,576
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Decentralized
- Initial Case Interviewing Responsibility: Local health departments
- Whole Genome Sequencing Certified2: Yes
Program Highlight
Every year, a number of salmonellosis patients in Michigan report exposure to live poultry. In the spring of 2016, a team of foodborne and zoonotic epidemiologists met to develop a Salmonella and Poultry Surveillance Plan of activities. This plan included coordinating environmental sampling at five local sites and was a great collaboration of epidemiologists, laboratorians, local health departments, CDC, and other state health departments.
The addition of the OutbreakNet Enhanced Epidemiology Coordinator made much of this complex surveillance process possible, and helped Michigan to achieve a more thorough and consistent investigation of Salmonella related to live poultry exposure cases than in the past.
Complementary Programs
- Michigan also participates in the following food safety programs:
Michigan Department of Health & Human services – Foodborne Illness Testing
New Hampshire
At A Glance
- Population1: 1,330,608
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Largely centralized
- Initial Case Interviewing Responsibility: Centralized for all but 2 cities
- Whole Genome Sequencing Certified2: Yes
Program Highlight
New Hampshire’s foodborne disease epidemiologist has been working to update the state’s foodborne disease data systems. These updates will make tracking enteric disease cases and gathering OutbreakNet Enhanced metric data simpler and easier. Improved tracking of enteric disease cases will enable New Hampshire to be more efficient in detecting outbreaks. The improved metric gathering capacity will make it easier for New Hampshire to detect gaps in and target improvements to their outbreak detection and response systems.
Complementary Programs
- New Hampshire also participates in the following food safety programs:
New Hampshire Department of Health and Human Services – Food Protection
New Mexico
At A Glance
- Population1: 2,085,109
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Centralized
- Initial Case Interviewing Responsibility: State health department
- Whole Genome Sequencing Certified2: In progress
Program Highlight
During the 2015-2016 program year, New Mexico hired a new epidemiologist to help with OutbreakNet Enhanced activities. New Mexico also became a volunteer FDA Food Protection Rapid Response Team (RRT). Participating in this program will help New Mexico become more prepared for foodborne disease outbreaks and develop processes to respond more effectively to food and feed outbreaks.
Complementary Programs
- New Mexico also participates in the following food safety programs:
New York State
At A Glance
- Population1: 11,245,386 (excludes New York City)
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Decentralized
- Initial Case Interviewing Responsibility: Local health departments and centralized at state
- Whole Genome Sequencing Certified2: Yes
Program Highlight
During the 2015-2016 program year, the New York State Department of Health (NYSDOH) adopted an expanded hypothesis-generating questionnaire for use on all Salmonella cases. The questionnaire is located on a secure electronic platform where local health departments (LHDs) and the state share information. LHDs were trained on the new hypothesis-generating questionnaire’s use and a team of student interviewers assisted LHDs in conducting interviews upon request and after business hours. NYSDOH staff and the student interview team were available to assist LHDs needing additional support in their initial interviews of Salmonella, Shiga toxin-producing E. coli (STEC), Listeria and any cases requiring outbreak-specific questionnaires.
The expanded hypothesis-generating questionnaire and increased interviewing capacity helped NYSDOH collect more timely and relevant epidemiologic information from patients with enteric disease, which is important in responding efficiently to enteric disease outbreaks.
Complementary Programs
- New York also participates in the following food safety programs:
New York State Department of Health – Communicable Disease Control
Philadelphia
At A Glance
- Population1: 1,567,442
- Year Joined OutbreakNet Enhanced: 2016
- Structure: Mixed
- Initial Case Interviewing Responsibility: City health department
- Whole Genome Sequencing Certified2: In progress
Program Highlight
Philadelphia is a new OutbreakNet Enhanced site. Highlights on its work under the program will be forthcoming.
Complementary Programs
- Philadelphia also participates in the following food safety programs:
Rhode Island
At A Glance
- Population1: 1,056,298
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Centralized
- Initial Case Interviewing Responsibility: State health department
- Whole Genome Sequencing Certified2: In progress
Program Highlight
In January 2016, Rhode Island hosted the Minnesota CoE for a site evaluation. The evaluation included discussions on how whole genome sequencing, culture-independent diagnostic tests, SEDRIC, and the PulseNet Webportal could be incorporated into foodborne disease investigations. The visit also provided the opportunity for staff from multiple departments to attend trainings on interviewing and analytic techniques. This experience helped Rhode Island identify several areas for improvement in its foodborne disease program.
Following this site evaluation, specific improvements were made to strengthen Rhode Island’s Salmonella and Campylobacter surveillance. Beginning in February 2016, Salmonella interviews have been conducted using a revised case report form, and beginning in July 2016, Campylobacter interviews have been attempted on all reported cases using a newly developed protocol. The Rhode Island State Health Laboratory also became certified to perform Campylobacter pulsed-field gel electrophoresis (PFGE) testing.
Complementary Programs
- Rhode Island also participates in the following food safety programs:
Texas
At A Glance
- Population1: 27,469,114
- Year Joined OutbreakNet Enhanced: 2016
- Structure: Largely decentralized
- Initial Case Interviewing Responsibility: Local health departments
- Whole Genome Sequencing Certified2: Yes
Program Highlight
Texas is a new OutbreakNet Enhanced site. Highlights on its work under the program will be forthcoming.
Complementary Programs
- Texas also participates in the following food safety programs:
Texas Department of State Health Services – Foods Program Home
Texas Department of State Health Services – Infectious Disease Control: Foodborne Illness
Virginia
At A Glance
- Population1: 8,382,993
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Largely centralized
- Initial Case Interviewing Responsibility: Local health departments
- Whole Genome Sequencing Certified2: Yes
Program Highlight
During the 2015-2016 program year, Virginia created a multidisciplinary culture-independent diagnostic test (CIDT) working group. This group is developing best practice and FAQ documents about CIDTs and creating a survey for labs throughout the state about CIDT usage, based on information provided by the Tennessee Integrated Food Safety Center of Excellence.
Best practices regarding the use and results of CIDTs are continuing to evolve. The CIDT working group in Virginia will likely prove a valuable resource to their foodborne disease team in determining how to proceed with enteric disease investigations.
Complementary Programs
- Virginia also participates in the following food safety programs:
Washington
At A Glance
- Population1: 7,170,351
- Year Joined OutbreakNet Enhanced: 2015
- Structure: Decentralized
- Initial Case Interviewing Responsibility: Local health departments
- Whole Genome Sequencing Certified2: Yes
Program Highlight
The Washington State Department of Health’s Office of Communicable Disease Epidemiology (WA DOH) has created a student team to assist with enteric disease response. The Outbreak Response and Collaborative Action (ORCA) team consists of Master’s level public health students from the University of Washington who are employed part-time by WA DOH. ORCA students primarily perform interviews at the WA DOH, and also have worked on a norovirus tool kit, built Washington’s Epi-Info data entry system, assisted in data entry, assisted in foodborne outbreak response efforts, and translated interview documents into Spanish.
WA DOH also is collaborating with a new student team at the University of Washington, the Student Epidemic Action Leaders (SEALs). The ORCAs and the SEALs were developed at the same time, but the SEAL team is not employed by WA DOH. Instead, SEALs receive academic credit through the University of Washington for assisting WA DOH and local health jurisdictions with outbreak response activities. Involving these students increases the capacity of enteric disease response efforts throughout the state and also provided the students with a great hands-on learning opportunity.
Complementary Programs
- Washington also participates in the following food safety programs:
12015 Population Estimates https://www.census.gov/quickfacts/
2PulseNet whole genome sequencing (WGS) certification is required for all laboratorians generating WGS data. The certification assures that the data generated are comparable between all PulseNet labs and meets a high standard of quality. Once certified, the laboratorian can directly submit WGS data to PulseNet Central, CDC, for further analysis that will help detect outbreaks.
- Page last reviewed: February 21, 2017
- Page last updated: February 21, 2017
- Content source: