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Kentucky Foodborne and Waterborne Outbreak Investigation Manual

Outbreak ManualThis manual provides guidance in investigating outbreaks related to foodborne or waterborne illness. Specific topics include the steps in investigating an outbreak, instructions on the collection of clinical, food and water samples, and directions for preparation of the final report. 

Click here to download a complete copy of the Kentucky Foodborne and Waterborne Outbreak Investigation Manual. Links to each chapter are included below.

Manual Cover

Manual Spine Cover for 1 1/2 Inch Binder

Table of Contents

Chapter 1. Outbreak Definition and Quick Reference Guides

  1. What is an outbreak?
  2. Purpose of the outbreak investigation
  3. Steps in investigating an outbreak
  4. Flowchart of an outbreak investigation
  5. Health care provider guidelines for reporting suspected foodborne outbreak related illness
  6. Health care provider guidelines for reporting suspected waterborne outbreak related illness

Chapter 2. Roles and Responsibilities

  1. Outline of responsibilities
  2. Responsibility flowcharts

Chapter 3. Steps in Investigating an Outbreak

  1. Preparing for an outbreak investigation and field work
  2. Confirm the existence of an epidemic or outbreak
  3. Verify the diagnosis
  4. Define a case and identify and count cases
  5. Describe the data in terms of person, place and time
  6. Develop hypotheses
  7. Evaluate hypotheses (analyze and interpret the data)
  8. Refine hypotheses and carry out additional studies
  9. Implement control and prevention measures
  10. Communicate the findings, write a report and enter into the National Outbreak Reporting System (NORS)

Chapter 4. Development of the Final Report

  1. The report
  2. Purpose of the report
  3. Outbreak report format
  4. Examples of reports

Appendix A:
Contact Agencies
County Personnel Contacts

Appendix B. Kentucky Timeline for Disease Reporting

Appendix C. Kentucky Field Guide for Foodborne and Waterborne Disease

Appendix D. Collection and Submission of Clinical Samples

Appendix E. Collection and Submission of Food Samples

Appendix F. Collection and Submission of Water Samples

Appendix G. Chain of Custody

Appendix H. Record of Complaint and Investigation

Appendix I. KDPH Foodborne/Waterborne Illness Investigation Form

Appendix J. National Outbreak Reporting System (NORS) Forms

Appendix K. Acronyms and Agency Abbreviations

Appendix L. Definitions of Terms

Appendix M. Kentucky Reportable Disease Statutes and Regulations

Appendix N. References


Additional Resources

Kentucky Reportable Disease Desk Reference

KDPH Registered Sanitarian Field Handbook

Council to Improve Foodborne Outbreak Response (CIFOR) Guidelines

CDC's Guide to Confirming a Diagnosis in Foodborne Disease

Food Emergency Pocket Guide produced by the Association of Food and Drug Officials

Bad Bug Book  A website on basic facts regarding foodborne and waterborne pathogens produced by the U.S. Food and Drug Administration (FDA)

Recalls, Market Withdrawals and Safety Alerts of FDA regulated products

Multistate Outbreaks listed by year

Kentucky Reportable Disease Annual Summary


Investigation Tools

GI Outbreak Line List

Epi Curve Directions for Excel 2007 as adapted from Focus on Field Epidemiology produced by the University of North Carolina Center for Public Health Preparedness


Last Updated 1/6/2016