{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:31:18Z","timestamp":1791401478349,"version":"4.3.3"},"reference-count":15,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2006,11,1]],"date-time":"2006-11-01T00:00:00Z","timestamp":1162339200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2006,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective.<\/jats:title>\n                    <jats:p>Ciguatera fish poisoning is a potentially life-threatening disease caused by eating coral reef fish contaminated with ciguatoxins and is the most common marine poisoning. However, existing surveillance systems capture few cases. To improve regional ciguatera surveillance in South Florida, this study compared ciguatera illnesses in the Florida Poison Information Center\u2013Miami (FPICM) call database to ciguatera cases in the Florida Department of Health (FDOH) disease surveillance systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>Univariate and multivariate logistic regression were used to identify predictors of when FPICM reported ciguatera illnesses to FDOH and whether FDOH confirmed reported ciguatera cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>FPICM staff preferentially reported ciguatera illnesses that were of shorter duration (adjusted odds ratio [AOR]=0.84 per additional illness day; 95% confidence interval [CI] 0.74, 0.97); outbreak-associated (AOR=7.0; 95% CI 2.5, 19.5); and clinically more severe (AOR=21.6; 95% CI 2.3, 198.5). Among ciguatera illnesses reported to FDOH, outbreak-associated illnesses were more likely than single, sporadic illnesses to become confirmed surveillance cases (crude OR=11.1; 95% CI 2.0, 62.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>The over-representation of outbreak-associated ciguatera cases underestimates the true contribution of sporadic illnesses to ciguatera disease burden. This bias should be considered when evaluating surveillance systems that include both outbreak-associated and sporadic illness reports.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/003335490612100605","type":"journal-article","created":{"date-parts":[[2017,7,5]],"date-time":"2017-07-05T16:24:16Z","timestamp":1499271856000},"page":"658-665","source":"Crossref","is-referenced-by-count":17,"title":["Outbreak Bias in Illness Reporting and Case Confirmation in Ciguatera Fish Poisoning Surveillance in South Florida"],"prefix":"10.1177","volume":"121","author":[{"given":"Elizabeth M.","family":"Begier","sequence":"first","affiliation":[{"name":"Preventive Medicine Residency Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine C.","family":"Backer","sequence":"additional","affiliation":[{"name":"National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard S.","family":"Weisman","sequence":"additional","affiliation":[{"name":"Florida Poison Information Center-Miami, Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta M.","family":"Hammond","sequence":"additional","affiliation":[{"name":"Bureau of Environmental Epidemiology, Florida Department of Health, Tallahassee, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lora E.","family":"Fleming","sequence":"additional","affiliation":[{"name":"National Institute of Environmental Health Sciences Marine and Freshwater Biomedical Sciences Center, University of Miami, Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Blythe","sequence":"additional","affiliation":[{"name":"National Institute of Environmental Health Sciences Marine and Freshwater Biomedical Sciences Center, University of Miami, Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2006,11,1]]},"reference":[{"key":"bibr1-003335490612100605","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(05)70041-7"},{"key":"bibr2-003335490612100605","first-page":"885","volume":"69","author":"Perkins RA","year":"2004","journal-title":"Am Fam Physician"},{"key":"bibr3-003335490612100605","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03720180066035"},{"key":"bibr4-003335490612100605","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.6.873"},{"key":"bibr5-003335490612100605","unstructured":"Centers for Disease Control and Prevention (US). National foodborne outbreak surveillance [cited 2005 Jul 11]. Available from: URL: http:\/\/www.cdc.gov\/foodborneoutbreaks\/us_outb.htm."},{"key":"bibr6-003335490612100605","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-120026512"},{"key":"bibr7-003335490612100605","first-page":"1","volume":"49","author":"Olsen SJ","year":"2000","journal-title":"MMWR Surveill Summ"},{"key":"bibr8-003335490612100605","first-page":"451","volume-title":"Harmful algal blooms 2000","author":"McKee D","year":"2001"},{"key":"bibr9-003335490612100605","volume-title":"Stata Statistical Software: Release 7.0","author":"StataCorp","year":"2001"},{"key":"bibr10-003335490612100605","doi-asserted-by":"publisher","DOI":"10.1097\/00124784-199623000-00017"},{"key":"bibr11-003335490612100605","first-page":"31","volume":"99","author":"Konowitz PM","year":"1984","journal-title":"Public Health Rep"},{"key":"bibr12-003335490612100605","first-page":"95","volume":"106","author":"Schramm MM","year":"1991","journal-title":"Public Health Rep"},{"key":"bibr13-003335490612100605","unstructured":"Washington GR. Identification of potentially ciguatoxic hot spots using the Florida Poison Information Center-Miami [master's thesis]. Miami: University of Miami; 1999."},{"key":"bibr14-003335490612100605","first-page":"321","volume":"51","year":"2002","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr15-003335490612100605","doi-asserted-by":"publisher","DOI":"10.3201\/eid0505.990502"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/003335490612100605","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/003335490612100605","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:25:54Z","timestamp":1777627554000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/003335490612100605"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,11]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2006,11]]}},"alternative-id":["10.1177\/003335490612100605"],"URL":"https:\/\/doi.org\/10.1177\/003335490612100605","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,11]]}}}