Middaugh JP, Hammond RM, Eisenstein L, Lazensky R
Using the Electronic Foodborne Outbreak Reporting System (eFORS) to improve foodborne outbreak surveillance, investigations, and program evaluation.
Journal of Environmental Health
Challenges exist in comparing foodborne disease outbreaks (FBDOs) across states due to important differences in reporting practices and investigations. Variables such as FBDO size, population size, number of tourists, and suspected etiology are important to consider when interpreting FBDO data. Analysis of eFORS data can be valuable in improving state FBDO investigations. From 2000 to 2005, Florida reported a greater proportion of FBDOs, with two cases per outbreak, than the U.S. as a whole (40.4% in Florida vs. 17.2% in the U.S.). Reporting a higher rate of small FBDOs provided more opportunities for public health interventions but contributed to a lower agent confirmation rate (17.0% in Florida vs. 42.2% in the U.S.). While the Electronic Foodborne Outbreak Reporting System's (eFORS) database brought great improvements in national FBDO surveillance, as with any complex surveillance system, considerable knowledge and specialized expertise is required to properly analyze and interpret the data, especially because there is a large variation in state reports to eFORS.