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CDC discovers delays in reporting disease outbreaks

Hospital Safety Connection, June 5, 2003

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A Centers for Disease Control and Prevention (CDC) report found delays of up to nearly a month before worldwide outbreaks of unusual diseases were identified by local officials, according to the Medical Letter on the CDC & FDA.

The CDC analyzed about 1,100 outbreaks from 1988 to 1999 in which the agency's Epidemic Intelligence Service assisted. It took up to 26 days for health officials to identify an unusual disease outbreak, and an additional six days before the CDC's experts were notified.

Reducing reporting delays is crucial to bioterrorism preparedness efforts, the report said.

In 1999, it took two weeks of increased bird deaths and human encephalitis cases in New York City-the first U.S. West Nile virus cases-before the public health system began acting. It was almost another week before the CDC was called in for assistance.

The CDC found 44 of the outbreaks-which included hoaxes-involved bioterror agents such as anthrax, plague, and botulism. In six cases, the outbreaks were ruled intentional; these included a 1996 Texas shigella outbreak among pastry-eating hospital lab workers and the 1984 salmonella outbreak in Oregon in which 751 fell ill after a religious cult contaminated salad bars.

In addition, officials never found the cause of 41 other outbreaks. The more unusual the disease, the more likely it could have been caused intentionally, or it could have come from a bioengineered germ that defies the rules of conventional diseases.

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