E-mail surveys assist investigation and response: a university conjunctivitis outbreak

Abstract

A conjunctivitis outbreak affecting more than 200 individuals occurred on a university campus in Evanston, Illinois, USA, in spring 2002. An investigation was conducted jointly by the Evanston Department of Health and the Illinois Department of Public Health. A combination of e-mail and traditional telephone-based surveys demonstrated that wearing contact lenses was a risk factor for any conjunctivitis and bilateral conjunctivitis, whereas using glasses was protective. Laboratory and epidemiological evidence suggested that the outbreak was caused by a viral pathogen that eluded characterization despite extensive culture and PCR-based laboratory testing. Enhanced laboratory surveillance could help clinicians and public-health officials to identify relevant secular changes in the spectrum of causes of conjunctivitis. During institutional outbreaks, e-mail surveys can help public-health officials to efficiently access information not easily collected by traditional case-control studies, and can provide an effective conduit for providing prevention recommendation, such as the need for improved hand and contact-lens hygiene during outbreaks.

Using the internet for rapid investigation of an outbreak of diarrhoeal illness in mountain bikers

“…This was our first experience of using the internet in this way and was prompted by the evident computer literacy of the event participants. In common with other authors we believe our work has demonstrated that efficiency and timeliness are the most significant strengths of the method [12,13,15,16,18]. The use of email invitations and an internet-based questionnaire allowed us to rapidly and efficiently access the geographically dispersed population at minimal cost [19].…”

“…While some investigators have managed to obtain higher response rates using internet-based methods, these have often, but not exclusively, been on relatively small, well defined or easily accessible groups [5, 12, 13, 17, 18]. In contrast, other outbreak investigations involving larger community-based populations have obtained lower response rates than we achieved, with some as low as 11% [14, 15]. Although it is therefore possible that we have obtained biased estimate of the risks in this outbreak, we believe that the numbers involved in our investigation are sufficiently large for the overall findings to be robust.…”

“…The most frequently reported symptoms were tiredness (159), diarrhoea (151) and abdominal pain (131). Other symptoms included fever (94), nausea (91), vomiting (31) and blood in stool (15). Ten riders reported having stool samples which were positive for Campylobacter and one reported a 'virus '.…”

“…The internet is still a relatively novel tool for conducting outbreak investigations, although its use is increasing [12][13][14][15][16][17]. This was our first experience of using the internet in this way and was prompted by the evident computer literacy of the event participants.…”