National Outbreak Reporting System NORS Irina Cody MPH

National Outbreak Reporting System ~NORS~ Irina Cody, MPH Epidemiologist, Infectious Disease Control Unit DSHS Austin, Texas

Flow of outbreak information to NORS.

NORS, what to report. Outbreak is two or more cases of similar illness associated with a common exposure. Single cases Not reported in NORS.

How to request NORS account. Outbreak reporting. Request a NORS account: FOODBORNETEXAS@dshs. state. tx. us o Email Subject: “NORS User Account Request” o Name: o Email: o Agency: Enter outbreaks into NORS online reporting system at https: //wwwn. cdc. gov/nors/login. aspx Forms, training materials, and other resources are available at http: //www. cdc. gov/nors/

State Report ID (State NORS ID) • State Report ID is a self-assigned report identification number that we use to name an outbreak in NORS. • The same policy as naming an outbreak in NBS. • Organism/date/Location/Accession number. • Date is in mmyy format; location is HSR#, County, or City; accession number is a two-digit number for outbreaks with the same condition month, and location starting with 01 for the first. Salmonella/0105/Amarillo/02 Unknown. GI/0415/El. Paso/01

Pull the reports

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2011 -2015 NORS report by types of transmission (preliminary) Type of transmission Environmental contamination other than food/water Food Indeterminate/Other/Unknown Person-to-person Grand Total Counts 3 (0. 8%) 134 (35. 3%) 79 (20. 8%) 164 (43. 2%) 380

2011 -2015 NORS report by settings (preliminary) SETTING Camp Child day care COUNTS 2 28 Event space 3 Hospital 2 Hotel/motel 2 Long-term care/nursing home/assisted living facility 63 Office/indoor workplace 1 Other healthcare facility 1 Other, specify 12 Prison/jail 1 Private home/residence 5 Religious facility 1 Restaurant 9 School/college/university 43 Grand Total 173

2015 NORS report by types of transmission (preliminary) TYPE OF TRANSMISSION COUNTS Environmental contamination other than food/water 1 (0. 8%) Food 31 (24. 4) Indeterminate/Other/Unknown 40 (31. 5%) Person-to-person 55 (43. 3%) TOTAL 127

2015 NORS report by settings (preliminary) SETTING Camp Child day care Event space Hospital Hotel/motel Long-term care/nursing home/assisted living facility Office/indoor workplace Other healthcare facility (rehab) Other, specify (community-wide, waterpark, food truck) Prison/jail Private home/residence Restaurant School/college/university *(mostly ES) Total COUNTS 1 14 3 2 1 34 1 1 5 1 1 8 19 97

2015 NORS report by pathogen (preliminary) PATHOGEN COUNTS Campylobacter 4 Cryptosporidium 1 Cyclospora* (94 lab confirmed cases) 1 Norovirus 30 Salmonella 9 Shigella* (87. 5% - sonnei) Grand Total 32 78

14 12 Number of cases per outbreak 10 8 6 4 2 0 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 19 21 22 25 26 29 30 33 34 35 36 37 42 43 45 48 50 54 66 72 77 86 90 94 100 114 # of outbreaks Number of Cases in reported Outbreaks, Texas 2015 (preliminary) # of cases in outbreak

Number of outbreaks per month, Texas 2015 (preliminary) 30 25 25 22 Number of outbreaks 20 15 14 11 10 10 10 8 7 7 6 5 5 4 0 January February March April May June July month onset of first ill August September October November December

Most common errors in data entering in NORS. ~ Naming the outbreaks (Outbreak name=NORS ID) Old way New preferred way o 48 o Unknown. GI/0415/El. Paso/01 o HOU 04242015 o Campylobacter/1215/Harris/01 o ATXGICYCLO 061915 o OYSTERNOROFEB 2015 To add an outbreak name in NEDSS, please email NEDSS@dshs. state. tx. us

~ Data error Wrong An “Etiology” is listed as “confirmed”, but has 0 or 1 lab Confirmed case. EXPLANATION An “Etiology” is confirmed if we have 2 or > lab-confirmed cases. p. s. “Etiology” section Right

~ Data error Less than 2 “Estimated total primary cases” EXPLANATION For NORS reporting purposes, an outbreak is defined as the occurrence of 2 or > cases of a similar illness resulting from exposure to a common source. *if there was only 1 case and it was a part of a multi-state outbreak, check the “Exposure occurred in multiple states” box (General Section: Geographic location). right

~ Data error Confirmed norovirus outbreak without genotype and genogroup. If norovirus is listed as lab-confirmed etiology, enter the genotype and genogroup information. If genogroup could not be determined, enter “Unknown” in the “Species” field (Etiology section). If genogroup is known but genotype unknown, enter the appropriate genogroup in the “Species” field and “Unknown” in the “Serotype” field.

• www. cdc. gov/foodborneoutbreaks FOOD Tool

Questions ?