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William E. Keene, PhD, MPH

JAMA. 1999;281:1845-1847.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In this issue of THE JOURNAL, Cody and colleagues¹ describe investigations of 2 overlapping outbreaks of salmonellosis that affected residents of northern California; Villar and colleagues² describe a similar epidemic in Washington State. All 3 outbreaks were traced to the consumption of Mexican-style soft cheese (queso fresco) made from unpasteurized (raw) milk. These 2 articles provide vivid examples of the importance of outbreak investigation, as well as the challenges to reducing the incidence of foodborne illness.

The vast majority of enteric infections reported to public health agencies are not linked to recognized common-source outbreaks. Even the proportion that are foodborne is not known with any certainty, although it certainly varies by disease from fairly low (eg, giardiasis) to fairly high (eg, salmonellosis). Most acute gastroenteritis is never specifically diagnosed or reported.

Although involving only a minority of case reports, outbreak investigations contribute disproportionately . . . [Full Text of this Article]

Author Affiliation: Acute and Communicable Disease Program, Oregon Health Division, Portland.

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