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Using NORS Dashboard

 

Q: Does NORS Dashboard include information on all disease outbreaks in the United States?

A: No. NORS Dashboard does not have information on all disease outbreaks for several reasons:

  • NORS collects information only on disease outbreaks of enteric illness, except for some non-enteric illness outbreaks spread through contaminated food or water.
  • NORS does not collect information on disease outbreaks that result from an exposure in a non-U.S. location. For example, an outbreak linked to people who became ill after eating a contaminated meal when traveling outside the country, even if the person became ill after returning to the United States.
  • Health departments might not report all foodborne, waterborne, or enteric disease outbreaks to NORS.
    • Some outbreaks are never identified.
    • Some outbreaks are not investigated.
    • Some outbreak investigations cannot be completed.
  • NORS Dashboard contains only information reported to NORS that CDC has reviewed.

 

Q: How can I customize my search?

A: The default view for NORS Dashboard shows data for all types of outbreaks reported to NORS.

You can customize your search in several ways. You can select the type or types of outbreaks you would like to include:

Main list from the NORS application.
Dropdown list from the NORS application.

Use the dropdown boxes in “Search Options” to make additional customizations:

  • Year: Specify a date range.
  • State: Choose individual states, or choose to include multistate or single state outbreaks only.
  • Etiology (Cause): Select which agents to include, such as Salmonella or norovirus.
  • Setting: Select specific settings, such as nursing homes or restaurants.

For foodborne disease outbreaks, you can search by:

  • Food/Ingredient: Search by food, including those with more than one ingredient, and ingredients. Learn more >>

For waterborne disease outbreaks, you can select:

  • Water Exposure: Select one or more water exposures, such as treated recreational water or drinking water.
  • Water Type: Select types of venues or systems to include. Learn more >>

 

Q: What’s the difference between “Dashboard” and “Tabular” views?

A: Dashboard view displays information in a custom array of interactive graphs, maps, and charts. Tabular view displays information in a table that you can sort by numeric or alphabetical order by clicking on the column headers.

Both views display the search box, Quick Stats, and links to download data.

Dashboard and Tabular views

 

Quick stats screenshot from NORS application.

Q: What information does “Quick Stats” provide?

A: In “Quick Stats — Overall,” you’ll find the number of outbreaks, illnesses, hospitalizations, and deaths for all outbreaks in NORS Dashboard. If you perform a search, you’ll see customized numbers for your search in “Quick Stats — Current Search.”

 

Q: How does NORS Dashboard display data on multistate outbreaks?

A: A multistate outbreak is defined as an outbreak in which exposures to the implicated source (such as a food item or drinking water supply) occurred in more than one state.

When a user searches NORS Dashboard for outbreaks in a particular state, NORS Dashboard shows all single state outbreaks and multistate outbreaks in which that state was involved. The number of illnesses listed for each multistate outbreak represents the total number in all states involved in the outbreak. Similarly, the number of hospitalizations and deaths includes those for all states with cases in the multistate outbreak.

Learn about selected multistate foodborne outbreak investigations involving CDC since 2006 >>

 

Q: What are single-state outbreaks?

A: In a single-state outbreak, exposure to an outbreak source, such as a food or swimming pool water, occurs in only one state. However, ill people may live in states other than the one where they got infected.

 

State drop down list from the NORS application.

Q: Can I search for only multistate outbreaks or only single-state outbreaks?

A: Yes. To search for multistate outbreaks only, click “State” in the search box, and select “Multistate outbreaks only.” You also have the option to view “Single-state outbreaks only.”

 

Q: How do I find out the number of cases in each state involved in a multistate outbreak?

A: To see case counts by state for an outbreak:

  1. Click on the “Tabular” view link on the upper right side of the screen:
    Dashboard link from the NORS application.
  2. Scroll down to see data based on your search criteria displayed on a table:
    Search criteria from NORS application.
  3. Click on the “Multistate” link in the “State” column for the outbreak of interest:
    Multistate selection from NORS application.
  4. You will then see a pop-up box that displays a U.S. map and a table that lists the states involved in the outbreak and the number of cases each state reported to NORS*. You may also use your mouse to hover over each state highlighted on the map to see the number of cases in those states.
    Pop-up box that displays a U.S. map from NORS application.

    Helpful Hint

    In the “Dashboard” view, you will see a U.S. map titled “Case Counts by State” based on your search criteria and when you select “Multistate outbreaks only.”

    • Use your mouse to hover over each state highlighted on the map to see the total number of cases in that state.
    • Change the map display to “Tabular” to see a table that lists the number of outbreaks each state has been involved in and the cumulative number of cases reported to NORS* by each state.
    Case counts by state.

    *For foodborne outbreaks, case counts by state were not collected until 2009, so outbreaks before 2009 will not have these numbers.

 

Q: What is an etiology?

A: An etiology is the cause of the outbreak. NORS Dashboard lets you select genus or name among bacterial, viral, parasitic, chemical, and toxic agents. You may also select “unknown.” To see all of information available about the etiologies that you select, click on the Tabular view or click on the link to download current search data.

 

Q: How will I know if an etiology is confirmed or suspected?

A: When you download your search results or all NORS Dashboard data or look at data using the “Tabular” view, you can see if the etiology of an outbreak was confirmed or suspected.

In general, NORS reporting sites follow CDC’s “Guide to Confirming an Etiology in Foodborne Disease Outbreak” when determining whether the etiology is confirmed or suspected. However, not all outbreak reports use these definitions. NORS Dashboard’s etiology data reflect what was reported to NORS and reviewed by CDC.

 

Q: How do I search for a specific food?

A: You can type a specific food into the “Food/Ingredient” field in the search options. NORS Dashboard will search both the food and the contaminated ingredient fields for your specified food. However, NORS Dashboard contains more than 2,000 food names and variations, so searching on a single food name may not provide complete information on all outbreaks linked to that type of food. For example, outbreaks linked to contaminated beef in hamburgers could be entered under beef, hamburger, or both. As a result, searching for “beef” alone may not identify all outbreaks linked to beef hamburgers. You should include all relevant variations of a specific food.

To see all of the food variables associated with your search, click on the link to download current search data. This information is not visible in tabular view. When you download search data, you also will see a food category for each food and contaminated ingredient, if available.

Learn more about the Interagency Food Safety Analytics Collaboration (IFSAC) food categories >>

 

Q: What is the difference between the “Food Vehicle” and “Contaminated Ingredient” categories in search returns?

A: A food vehicle is the contaminated food item a person ate before becoming sick. It may contain more than one ingredient. When searching for a food, both of these fields will be included in the search.

If a contaminated ingredient is listed in NORS Dashboard, it is more specific than the food vehicle and is the specific food or ingredient in the food vehicle that was implicated. For example, in August 2010, Michigan reported an outbreak of 41 illnesses caused by Salmonella serotype Javiana. Potato salad was the food vehicle; yellow onion was the contaminated ingredient.

If a contaminated ingredient is not listed in NORS Dashboard, the food vehicle category provides the best information available.

 

Q: What is the difference between the “Water Exposure” and “Water Type” categories in search returns?

A: The water exposure category describes how the people in the outbreak were exposed to contaminated water. For example, the treated recreational water category includes outbreaks that involve people who got ill after swimming in a pool or another water venue.

The five water exposure categories in NORS are:

  • Treated recreational water
  • Untreated recreational water
  • Drinking water
  • Other/Environmental water
  • Undetermined water (for example, when multiple water exposures were suspected and no single exposure was confirmed as the exposure responsible for the outbreak).

The water type category describes the water venue (for example, swimming pool or lake) or water system (such as a public water system or private well) that contained or distributed the contaminated water.

Some waterborne disease outbreaks are caused by germs, such as Legionella, that can grow inside the water pipes of a building. When drinking water outbreaks caused by these germs are reported in NORS, the water type describes the drinking water system that supplied the water to the building. This does not necessarily mean that the water coming into the building was contaminated.

A water type may not be listed in NORS Dashboard, if it was not identified or reported. In that situation, the water exposure category provides the best information available about the source of the contaminated water.

 

Q: What is the difference between “Hospitalizations” and “Deaths” and “Info on Hospitalizations” and “Info on Deaths” when using the “Tabular” view (or looking at downloaded data)?

A:

  • Hospitalizations: The number of hospitalizations reported
  • Info on Hospitalizations*: The number of ill people for whom information on hospitalization is available
  • Deaths: The number of deaths reported
  • Info on Deaths*: The number of ill people for whom information on death is available

Often, outbreak investigators can’t obtain information for all the sick people in the outbreak, so the “Info on Hospitalizations” or “Info on Deaths” numbers may be smaller than the number of illnesses reported.

*These fields are not available for outbreaks that happened before 2009.

 

Q: What happened to the Foodborne Outbreak Online Database (FOOD Tool)?

A: FOOD Tool, the web-based platform for searching CDC’s Foodborne Disease Outbreak Surveillance System, has been replaced by NORS Dashboard. Don’t worry — all of the foodborne disease outbreak information available through FOOD Tool can be accessed through NORS Dashboard.

 

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