Timelines and practices in foodborne outbreak investigations: Implications for public health response

This study used CDC surveillance data to investigate the relationship between operational delays and healthcare-seeking behavior during foodborne outbreak investigations. Descriptive statistics and nonparametric tests were used to investigate timelines such as onset to identification and first contact, as well as contextual variables such as establishment type and menu category. The relationships between investigation delays, healthcare utilization, and environmental response measures were investigated using correlation and regression analyses. Longer delays between illness onset and outbreak identification were found to be significantly associated with a higher proportion of people seeking medical attention. A higher number of environmental assessment visits was also associated with increased healthcare-seeking, but no significant associations were found for delays between identification and initial contact. Group comparisons revealed no significant differences in investigation timelines based on establishment or menu type. The model explained a small portion of the variation in healthcare-seeking behavior (R² = 0.083). These findings shed light on the timing and consistency of outbreak responses and highlight the importance of early detection in shaping public health engagement.