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1999 Methods and Tables

Table 5a. Data sources used to estimate illnesses, hospitalizations, and deaths due to known foodborne pathogens in the United States, 1999 (from Mead et al.)
Data Source Data Pathogen(s) Geographic Coverage Time Frame Adjustments
Foodborne Diseases Active Surveillance Network (FoodNet) Number of laboratory-confirmed illnesses, proportion hospitalized, proportion who died Campylobacter spp.; Cryptosporidium parvum; Cyclospora cayetanensis; Shiga toxin-producing Escherichia coli O157:H7; Listeria monocytogenes; non-typhoidal Salmonella; Shigella spp.; Vibrio, other spp.; and Yersinia enterocolitica FoodNet sites1 1996–1997 Geographical coverage
Foodborne Disease Outbreak Surveillance System (FDOSS) Number of foodborne outbreak-associated illnesses Bacillus cereus; Clostridium perfringens; Staphylococcus aureus; and Streptococcus spp., Group A United States

1988–1992

(1983–1987 for Staphylococcus aureus)
Underreporting
Proportion hospitalized and proportion who died in foodborne outbreaks Bacillus cereus; Brucella spp.; Clostridium botulinum;  Clostridium perfringens; Staphylococcus aureus; Streptococcus spp., Group A; and Trichinella spiralis United  States 1988–1992 Underreporting
Gulf Coast States Vibrio Surveillance System Number of case-patient reports, proportion hospitalized, proportion who died Vibrio cholera and Vibrio Vulnificus 4 Gulf Coast states 1989 Underreporting;

National Electronic Telecommuni-cations System for Surveillance (NETSS)

Number of case-patient reports Trichinella spiralis United States (not all states report to NETSS; those who don’t report through Public Health Laboratories Information System) 1995–1998 Underreporting
National Health and Nutrition Examination Survey (NHANES) Seroprevalence

Toxoplasma gondii

United States 1994 Rate of infection over time and percentage symptomatic
National Notifiable Diseases Surveillance System (NNDSS)2 Number of case-patient reports Clostridum botulinum; Brucella spp.; Hepatitis A, Salmonella Typhi United States 1992–1997 Underreporting
Various acute gastroenteritis data sources (see Table 5b) Acute gastroenteritis illnesses, hospitalizations, and deaths Norovirus See Table 5b See Table 5b Fraction of acute gastroenteritis attributable to norovirus

1 FoodNet conducts population-based active surveillance for selected foodborne infections in 8 sites with a total population catchment area of 20.5 million Americans.

2 Passive surveillance data reported by physicians and laboratories

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Table 5b. Data sources used to estimate illnesses, hospitalizations, and deaths due to acute gastroenteritis foodborne pathogens in the United States, 1999 (from Mead et al.)
Data source Data Definition Geographic coverage Time frame
FoodNet  Population  Survey Rate of illnesses  Average annual rate of diarrheal illness derived by multiplying the average monthly prevalence by 12, where an episode of acute diarrheal illess was defined as diarrhea (≥3 loose stools in 24 hours) lasting >1 day or resulting in restricted daily activities or vomiting in the past month. FoodNet sites1 1996–1997
Monto &  Koopman, 1980 Rate of illnesses

Vomiting and respiratory symptoms

850 households in Tecumseh, Michigan

1965–1971

Dingle et al., 1964 Rate of illnesses Vomiting and respiratory symptoms 86 families in Cleveland, Ohio

1948­–1957

National  Hospital  Discharge  Survey  (NHDS)

Hospitalization  rate Acute gastroenteritis hospitalizations were identified from discharges with one of the first three listed diagnoses classified by ICD-9-M diagnostic codes 001–008 (infectious gastroenteritis of known cause);  009 (infectious gastroenteritis); 558.9 (other and unspecified noninfectious gastroenteritis and colitis).   Nationally representative sample of discharge records from ~ 475 US hospitals 1992–1996
National Ambulatory Medical Care Survey (NAMCS); National Hospital Ambulatory Medical Care Survey (NHAMCS) Hospitalization rate

Acute gastroenteritis hospitalizations were identified from patient visits to clinical settings, including physician offices, hospital emergency and outpatient departments with a diagnosis of infectious enteritis (ICD-9-CM diagnostic codes 001–008 (infectious gastroenteritis of known cause); 009 (infectious gastroenteritis); and 558.9 (other and unspecified noninfectious gastroenteritis and colitis) and reason for visit classification {RVC} codes 1595, 1530, 1540, for diarrhea, vomiting and gastroenteritis, respectively.

Nationally representative sample of US clinical settings

1996
Multiple-cause-of-death data from the National Vital Statistics System Death rate Acute gastroenteritis deaths were identified from the underlying or contributing cause of death classified by ICD-10 diagnostic codes A00.9–A08.5 (infectious gastroenteritis of known cause) A09 (diarrhea & gastroenteritis of presumed infectious origin); and  K52.9 (noninfectious gastroenteritis and colitis, unspecified) United States 1998

1FoodNet conducts population-based active surveillance for selected foodborne infections in 8 sites with a total population catchment area of 20.5 million Americans.

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