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The main objective from the current review study is to provide long-term quantitative study of the outbreak pattern and trend through 20 years of record and observation by Center for Disease Control and Prevention (CDC) through National Outbreak Reporting System (NORS) database web-based platform for the most heavily populated states in USA. Thorough analysis was conducted using statistical process control (SPC) software packages after data processing and segregation. Non-normally distributed data for outbreak illness cases tend to show Log-normal or Weibull (3) distribution while rare event mortality cases tend to show Negative Binomial pattern. Box plot diagram and control charts show that outbreaks pattern tends to be low in the number of the affected population with excursions in relatively fewer cases in the number of ill individuals. Excursions in outbreak rates of Massachusetts, New Jersey and Rhode Island are approximately 8, 7 and 12%, respectively. However, Massachusetts mean outbreak trend is significantly higher than that of New Jersey and not significantly different from Rhode Island at α = 0.05. Interestingly, the threshold of out-of-control outbreaks for New Jersey is about 80 illnesses per outbreak while Massachusetts and Rhode Island are 62 and 63, respectively. Norovirus is responsible for most cases of illnesses and deaths in the three states and most outbreak cases occurred in assisted living facilities and long-term care homes among other residences which include elderly and health-compromised individuals. Outbreaks are a persistent health problem in the developed countries with intermittent excursions of illness cases.

journal of food chemistry and nanotechnology

Statistical Analysis Review and Lessons Learned from Recent Outbreak Trends of Highest Population Density States in USA: Massachusetts, New Jersey and Rhode Island