Patients were interviewed by using the standard NCDPH salmonellosis reporting form to assess clinical symptoms; travel history; and food, water, and animal exposures.
On April 26, the North Carolina Department of Agriculture and Consumer Services (NCDA&CS) notified NCDPH that salmonellae had been presumptively identified from samples of Brand A tempeh, which had been collected for routine food product testing before this outbreak was reported.
NCDA&CS and NCDPH visited Brand A tempeh's production facility to interview staff, review tempeh production, and obtain food samples.
NCDPH confirmed the association between illness and Brand A tempeh through patient interviews and laboratory testing.
Representatives of the Guilford County Health Department and NCDPH
interviewed practitioner A and conducted inspections of facility A with assistance from CDC, the Food and Drug Administration, the North Carolina Food and Drug Protection Division, the North Carolina Statewide Program for Infection Control and Epidemiology, and the North Carolina Medical Board.
On October 5, NCDPH informed PulseNet ([dagger]) that tests of isolates from three other persons revealed Salmonella Paratyphi B var.
After NCDPH contacted CDC on October 23 about the possible cluster of turtle-associated Salmonella Paratyphi B var.
, in collaboration with CDC, conducted a case-control study to identify risk factors for infection.
NCDPH and CDC developed a modified cluster-sampling method for population-based sampling in post-disaster needs assessments (2,3).
NCDPH and CDC staff entered data and conducted weighted cluster analysis by using EpiInfo.
NCDPH and CDC provided assessment results to local health departments, local emergency operations centers, and the NC emergency operations center.
NCDPH used experience gained during Hurricane Isabel to 1) develop the ability to conduct rapid community health and needs assessments by using in-state resources and 2) enhance logistic operations and methods for data collection.