OutbreakNet Enhanced 2021 Summary

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OutbreakNet Enhanced (OBNE) is a Centers for Disease Control and Prevention (CDC) program that provides support to state and local health departments to improve their capacity to detect, investigate, control, and respond to enteric disease outbreaks. OBNE started in August 2015 with 11 sites. The program expanded and there are now 29 participating sites.

Program Highlights

In 2021, state and local health departments continued to be significantly impacted by the COVID-19 pandemic. Even as OBNE staff slowly transitioned back to their regular duties, they continued to face the challenge of balancing enteric work with COVID-19 response efforts. Due to limited capacity, many OBNE projects and activities remained paused. OBNE sites had to work to identify innovative ways to conduct routine enteric work by leveraging their enhanced capacity and adapting workflows to navigate the ‘new normal’ of enteric disease investigation during a global pandemic.

OBNE sites continued to utilize student teams to conduct routine outbreak response activities. Twenty-one OBNE sites have student teams, which were critical in assisting both state and local health departments to conduct enteric interviews and helped support their capacity to investigate reports of enteric disease in 2021. Additionally, OBNE sites relied on existing strong partnerships with their regional Integrated Food Safety Centers of Excellence (Food Safety CoEs), which assisted some sites with enteric diseases interviews and training staff new to enteric work, allowing OBNE staff to better balance enteric and other response work.

OBNE sites were able to showcase their annual work and provide updates at virtual national meetings and conferences, including the Council of State and Territorial Epidemiologists (CSTE) Conference and the Integrated Foodborne Outbreak Response and Management (InFORM) Regional Meetings. Additionally, OBNE sites utilized monthly program-wide conference calls to exchange strategies on successfully transitioning back to enteric disease outbreak response. Additionally, OBNE sites, in collaboration with FoodCORE centers, published a success story to document how they leveraged their existing enhanced resources to maximize support for enteric disease investigations while simultaneously responding to the COVID-19 pandemic. OBNE sites also published success stories to highlight OBNE program activities, including: Student Teams Increase Capacity for Enteric Disease Interviews, Improving Outbreak Response Preparedness: Epi-Ready and the Value of In-State Trainings in Kentucky, and Thinking Outside the Box: OutbreakNet Enhanced Sites Get Creative with Public Health Messaging.

Program Performance

OBNE performance metrics have been collected since 2016 to document the burden, timeliness, and completeness of enteric disease outbreak activities. Sites report metrics annually on both laboratory and epidemiologic aspects of outbreak investigations for Salmonella, Shiga toxin-producing Escherichia coli (STEC), and Listeria (collectively referred to as SSL metrics), as well as optional metrics for Shigella and Campylobacter. The metrics are analyzed and revised as needed to best meet program needs.

Select 2021 Metrics for Salmonella, STEC, and Listeria (SSL)

From 2016 to 2021, OBNE sites increased the percentage of primary SSL isolates with WGS testing.

In 2021, the percent of isolates with WGS testing was highest for Salmonella, which also had the highest average number of isolates received per site, 1136.

During 2016-2021, OBNE sites interviewed cases in nearly all outbreak and cluster investigations. Additionally, sites increased the percent of all SSL cases that were interviewed and had a case-patient exposure obtained from 44% in 2016 to 70% in 2021.