CDC: Reporting Delays Occurred in German E. coli Outbreak

In shiga toxin-producing E. coli outbreak, early outbreak detection is crucial

THURSDAY, Aug. 25 (HealthDay News) -- During the outbreak of hemolytic uremic syndrome (HUS) and bloody diarrhea related to shiga toxin-producing Escherichia coli O104:H4 (STEC) in Germany during May and June 2011, there was a median delay of 20 days between symptom onset and reporting the cases, according to a study published in the U.S. Centers for Disease Control and Prevention's October Emerging Infectious Diseases.

Mathias Altmann, Ph.D., from the Robert Koch Institute (RKI) in Germany, and colleagues quantified the timelines of the Germany surveillance system for notifiable diseases for HUS and STEC from 2003 to 2011. Symptom onset, diagnosis, notification, and reporting date were included in the timeline events for 13,400 STEC and 1,394 HUS cases. Intervals between timeline events were calculated for each case from the dates available and assigned to period A (before the outbreak), B (early phase of outbreak), or C (late phase of outbreak).

The investigators found that in HUS cases, the median times from symptom onset to diagnosis and to notification, and interval from notification to local health department to report to the RKI were similar in periods A and B but shorter in period C. A decrease in median time from symptom onset to reporting was seen, with 20 days in period A, to 12 and 8 days in period B and C, respectively. In STEC cases, during period B, there was a longer delay from symptom onset in patients to reporting, but a shorter delay from diagnosis to notification.

"Although reporting occurred faster than required by law, potential for improvement exists at all levels of the information chain," the authors write.

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