BBQ Event at Senior Community First case (HUS) reported by provider Multiple illnesses reported from community Online survey link distributed via Community residents advised to destroy leftover food Food and stool specimens submitted for testing Online survey closed Preliminary data analysis completed Follow up phone survey deployed Food sample positive for C. perfringens Final data analysis completed Phone survey closed Use of an Online Survey During an Outbreak of Clostridium perfringens in a Retirement Community, Arizona 2012 Discussion  We present an outbreak investigation in a retirement community of 3,000 residents with more than 66 cases of GI illness caused by beef contaminated with Clostridium perfringens  Investigation conducted using an online survey; allowed rapid deployment, data analysis, implementation of public health intervention, and dissemination of information to stakeholders  Investigation confirms findings from prior studies which demonstrates distinct advantages of online surveys used by local public health  Decreased staff time  Faster data analysis  Concerns for the validity of using in this population led to follow up survey  Follow up survey demonstrates widespread internet use in this retirement community Conclusion This Clostridium perfringens outbreak in a retirement community demonstrated the utility of an online survey to rapidly collect information and respond to a foodborne outbreak among an older demographic. Introduction On March 12, 2012, an 85-year-old male with hemolytic uremic syndrome was reported to Maricopa County Department of Public Health (MCDPH). On March 7, he had consumed food at a BBQ attended by 2,300 retirement community residents. On March 10, a BBQ attendee with gastrointestinal illness was reported to MCDPH. An environmental assessment and outbreak investigation ensued to determine the cause of the outbreak and implement control and prevention activities. Seema Yasmin, MD 1, Kristen Pogreba-Brown,PhD 2, Jennifer Stewart, MS 3, Rebecca Sunenshine, MD 3,4 1 CDC EIS Officer, 2 University of Arizona SAFER Coordinator, 3 Maricopa County Department of Public Health Division of Disease Control, 4 CDC, Office of Public Health Preparedness and Response Rationale for Online Survey Use  Useful tool for rapid investigation of outbreaks  Less time consuming versus traditional phone interviews  Rapid preliminary data analysis possible  listserv available for community  Little information exists on:  Utility and acceptability in older populations  Amount of computer literacy available in this population Methods  A retrospective cohort study was conducted utilizing an online survey distributed through the community listserv.  To assess internet access and computer-literacy amongst this population, a follow-up telephone survey targeting 552 persons was conducted  Approximately 1,000 residents on listserv Results  370/2,300 (16%) retirement community residents responded to the online survey  66 (17.8%) reported gastrointestinal illness following the BBQ (median incubation period 9.5 hours)  63 cases (95%) reported diarrhea and 5 (8%) reported vomiting  Leftover beef from an attendee’s refrigerator grew Clostridium perfringens  Access to internet and capabilities of respondents:  101 (89%) reported the ability to send and receive  82 (72.5%) checked daily  28 (24.7%) checked on a handheld device ID # /7/12 3/12/12 3/14/12 3/15/12 3/16/12 3/20/12 3/21/12 3/27/12 3/30/12 4/1/12 4/26/12 Limitations :  Likely selection bias – original survey had an attack rate of 18%, with the follow up survey estimating an attack rate of 3%  Ill individuals more likely to participate in a voluntary survey  Not enough ill individuals in follow up survey to accurately characterize incubation period and attack rate  Response rate for telephone survey sub- optimal Table 1. Results of Online and Telephone Survey Among Retirement Community Residents following an Outbreak of GI Illness, Maricopa County, Arizona Online Survey Telephone Survey Number of Responses Response Rate37%20.5% Male38.7%37% Female61.3%63% Median Age Median Incubation Period (Hours)9.5* Attack Rate17.8%3% Average Time for Survey Completion (minutes) **1411 *Number ill was too small to accurately calculate incubation period ** Note that surveys were of different lengths Figure 1. Timeline of Events following BBQ at Retirement Community, Maricopa County, AZ