American Journal of Epidemiology Vol. 152, No. 2 : 171-177
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
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How Many Foodborne Outbreaks of Salmonella Infection Occurred in France in 1995?
Application of the Capture-Recapture Method to Three Surveillance Systems
1 Réseau National de Santé Publique, 14 rue du Val d'Osne, 94410 Saint Maurice, France.
2 Centre National de Référence des Salmonella et des Shigella, Institut Pasteur, 28 Rue du Docteur Roux, 75724 Paris, Cedex 15, France.
Despite control measures, foodborne outbreaks of non-typhi Salmonella infection continue to occur in developed countries. The authors aimed to assess the number of foodborne Salmonella outbreaks that occurred in France in 1995 using a capture-recapture approach. Data from three sources—the National Public Health Network (NPHN), the Ministry of Agriculture (MA), which receives mandatory notification, and the National Salmonella and Shigella Reference Center (NRC)—were collected. Matching algorithms permitted identification of matched outbreaks. The total number of outbreaks was estimated by log-linear modeling taking into account source dependencies and the variable catchability. The final estimate was adjusted for the positive predictive value (66%) of the NRC case definition. The dependence between the NPHN and the MA was also evaluated by means of a qualitative survey. A total of 716 foodborne Salmonella outbreaks were reported to the three sources, and 108 matches were identified. The best-fitting model, taking into account a positive dependence between the NPHN and MA sources, gave an estimate of 757 outbreaks. The sensitivity was 15% for the NPHN, 10% for the MA, and 50% for the NRC. In France, routine mandatory reporting of foodborne Salmonella outbreaks is very incomplete, and it is not representative of the serotype and the type of outbreak.
capture-recapture; disease outbreaks; food poisoning; Salmonella infections
Abbreviations: AIC, Akaike Information Criterion; BIC, Bayesian Information Criterion; CI, confidence interval; DDASS, Direction Départementale des Affaires Sanitaires et Sociales; DSV, Direction des Services Vétérinaires; MA, Ministry of Agriculture; NPHN, National Public Health Network; NRC, National Salmonella and Shigella Reference Center
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