Health education for food handlers and outbreak control measures (such as hand washing, which has been shown to reduce episodes by 30%%) [ 23, 24] should be stressed in order to reduce the incidence of outbreak-related cases and in turn, their cost.
Both these may have resulted in underestimation of the incidence of outbreaks for the 2002 2009 period.
At the outset, the incidence of outbreaks was entirely unknown and the program design called for outbreak search and containment.
From late 2003 to 2006 in Vietnam, the incidence of outbreaks in poultry was particularly high in regions of the Red and Mekong river deltas.
Incidence of outbreaks caused by nonpasteurized dairy products was higher in states that permitted the sale of nonpasteurized dairy products than in states that prohibited such sale.
The increased incidence of outbreaks due to Norovirus may be attributable to enhanced detection or reporting; however, similar increases were noted in North Carolina, New York and Wisconsin [ 34].
Indeed, other norovirus outbreaks have previously been reported in the summer season (1, 3 ).The alternating trend of high and low incidence of outbreaks may be related to several factors, some of which may have been implicated in these outbreaks.
Comparative analysis of outbreaks in neighboring countries over the past 15 years showed a high incidence of outbreaks at 2- to 5-year intervals (2000, 2005, 2010 2011, and 2013).
It is difficult to determine the incidence of outbreaks on ICUs because standard outbreak detection methods rely heavily on simple rule-based criteria and typically focus on only a few organisms [ 22, 23].
Because consumption of nonpasteurized dairy products is uncommon in the United States, the high incidence of outbreaks and outbreak-associated illness involving nonpasteurized dairy products is remarkable and greatly disproportionate to the incidence involving dairy products that were marketed, labeled, or otherwise presented as pasteurized.
