Institutional gastroenteritis outbreaks and time to notify public health services.

AIM: We report a quantification and visualisation of the association between the time to notify public health service (PHS) and the duration and size of institutional gastroenteritis outbreaks, and explore the seasonality and trend of the outbreaks. METHOD: Descriptive analysis was performed on institutional gastroenteritis outbreak data from a North Island PHS (1 January 2009-31 December 2014). Time-series analysis was used to explore the seasonality and trend of outbreaks. Multivariate analyses were performed to quantify the association between the time to notify PHS and the duration and size of outbreaks. RESULTS: One hundred and seventy-five gastroenteritis outbreaks (from 58 facilities) were included in descriptive analyses. A significant increasing trend (p=0.01) without seasonal pattern was confirmed by time-series analysis. Shorter notification time was associated with shorter duration and smaller size of outbreaks, eg, duration of outbreaks when time to notify was ≥7 days, was 3.4 days (p=0.001, 95% CI=3.1-3.7) longer than baseline time to notify (0-1 day). CONCLUSION: Prompt notification to the PHS appears to be a factor associated with reduced outbreak duration and size.

A Retrospective Cohort Study of an Outbreak of Cryptosporidiosis among Veterinary Students.

An outbreak of gastrointestinal illness occurred among a cohort of 56 veterinary technology and 100 veterinary science students at Massey University over an eight-week period in 2013. This coincided with calving in New Zealand's seasonal dairy farming system and a time when calves with diarrhoea are commonly seen by veterinarians. Laboratory and epidemiological investigations were instigated by MidCentral Public Health Service (MCPHS) in conjunction with the Institute of Veterinary, Animal and Biomedical Sciences (IVABS) at Massey University. Eighty students responded to a questionnaire of which 19 met the case definition, a 24% attack rate. Faecal specimens from seven students contained Cryptosporidium oocysts and Cryptosporidium parvum IIa A18G3R1 was identified from one of the specimens. The inferred median incubation period was five days (range 1-12 days). All of the cases were self-limiting, characterized by diarrhoea, abdominal cramps, and in some cases vomiting, headache, and fever. Having contact with calves with diarrhoea was significantly associated with increased adjusted odds of being a case (OR 10.61, 95% CI 1.87-108.29 for one week of contact; OR 55.05, 95% CI 3.80-1931.18 for two weeks of contact). Outbreaks of cryptosporidiosis had occurred previously among veterinary students at Massey University, but the extremely high infectivity of C. parvum resulted in student illness despite enhanced hygiene precautions.