Using NORS Dashboard

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.

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:

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.

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.”

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 >>

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.

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.”

To see case counts by state for an outbreak:

1. Click on the “Tabular” view link on the upper right side of the screen:
   
2. Scroll down to see data based on your search criteria displayed on a table:
   
3. Click on the “Multistate” link in the “State” column for the outbreak of interest:
   
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.
   

   

   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.

   

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

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.

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.

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 >>

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.

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.

This field indicates whether waterborne disease outbreak report data has been “cleaned” or “reviewed,” as defined below. This field is available on downloaded search data. The information is not displayed in the dashboard or tabular views.

• “Cleaned”: CDC works with local, state, and territorial health departments to fill in missing information or correct possible errors before updating NORS Dashboard. This process occurs for all types of outbreaks reported in NORS Dashboard. Waterborne disease outbreak reports that have undergone this process are classified as “cleaned.”
• “Reviewed”: CDC and the U.S. Environmental Protection Agency periodically review and publish national waterborne disease outbreak data. The review process may result in additional changes to report data through consultation with U.S. states and other reporting jurisdictions. Waterborne disease outbreak reports that have undergone this process are classified as “reviewed.”

• 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.

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.

To obtain a NORS dataset for publication — including data for use in scientific publications —email the NORS Dashboard mailbox.

Please use the following suggested citation to reference NORS Dashboard data:

Centers for Disease Control and Prevention (CDC). National Outbreak Reporting System Dashboard. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC. Last accessed <date, e.g., 05Jan2018>. Available from URL: wwwn.cdc.gov/norsdashboard.