RESUMO
We reviewed timeline information for a sample of Salmonella spp., Shigella spp., Campylobacter spp., and Escherichia coli O157:H7 cases and all confirmed foodborne outbreaks reported in 6 states during 2002. Increasing the timeliness of case follow-up, molecular subtyping, and linkage of results are critical to reducing delays in the investigation of foodborne outbreaks.
Assuntos
Surtos de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/microbiologia , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Vigilância da População/métodos , Técnicas de Tipagem Bacteriana , Campylobacter/classificação , Campylobacter/isolamento & purificação , Escherichia coli O157/classificação , Escherichia coli O157/isolamento & purificação , Humanos , Saúde Pública , Salmonella/classificação , Salmonella/isolamento & purificação , Shigella/classificação , Shigella/isolamento & purificação , Fatores de Tempo , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Lyme disease is the most commonly reported vectorborne illness in the United States and is endemic in many counties in the Northeast, including counties in New Hampshire. Previous studies conducted elsewhere on Lyme disease have indicated substantial differences between physician practices and published consensus guidelines for diagnosis and treatment. METHODS: During 1999, we mailed a 21-item questionnaire to 600 randomly selected family practice physicians, internists, and pediatricians in New Hampshire. RESULTS: Respondents answered a median of 10 (76.9%) of 13 knowledge items correctly. Most physicians (73.6%) underestimated the incidence of erythema migrans among Lyme disease patients, and 41.2% would either test or offer treatment to an asymptomatic patient with deer-tick bite. When surveyed, most respondents (72.4%) planned to recommend Lyme disease vaccine to high-risk persons. Approximately one half (44.8%) reported giving empiric antibiotic treatment of Lyme disease solely because of patient concern. CONCLUSIONS: New Hampshire primary care physicians indicated good knowledge about Lyme disease. Lack of awareness about Lyme disease diagnostic criteria, however, could contribute to misdiagnosis through overreliance on laboratory testing. Lyme disease vaccine appeared to be well accepted by physicians, although the vaccine has since been withdrawn from the US market. Both inappropriate management of tick bite and empiric treatment of unsubstantiated Lyme disease diagnoses were common.