Use of an Online Survey During an Outbreak of Clostridium Perfringens in a Retirement Community—Arizona, 2012

BACKGROUND:   Local health departments are increasingly resource-constrained and outbreak investigations consume considerable personnel-time and resources. On March 9, 2012, an 85 year old male with hemolytic uremic syndrome was reported to Maricopa County Department of Public Health (MCDPH). The patient had consumed food at a BBQ attended by 2,300 residents of a retirement community. The following day, a BBQ attendee with gastrointestinal illness was reported to MCDPH. An online survey was emailed to retirement community residents. In order to assess the utility of an online outbreak survey in this population, a follow-up telephone interview was conducted to determine internet access and computer-literacy amongst retirement community residents.

METHODS: A retrospective cohort study was conducted utilizing an online survey distributed through the retirement community email listserv. A random selection of 552 residents were later contacted by telephone to determine computer-literacy and internet access. 

RESULTS:   370 retirement community residents responded to the online survey (median age 70 years, 38.7% male); 113 (30.5%) completed the online survey within the first day. Sixty-six (17.8%) reported gastrointestinal illness following the BBQ (median incubation period 9.5 hours). Leftover beef from an attendee’s refrigerator grew Clostridium perfringens. Of 113 follow-up telephone survey respondents, (median age 71.5 years, 37% male), 101 (89.4%) reported the ability to send and receive email, 82 (72.6%) checked email daily and 28 (24.8%) checked email on a handheld device.

CONCLUSIONS:   This outbreak in a retirement community demonstrated the utility of an online survey to rapidly collect information and respond to a foodborne outbreak among an older demographic. Use of the online survey increased the speed with which the local health department collected information and responded to the outbreak.