The study found that the top ten highest-reporting states reported four times more outbreaks than the ten lowest-reporting states. Additionally, the widest gap in outbreak reporting was for norovirus outbreaks. Low-reporting states were also more likely to report large outbreaks caused by reportable conditions, and were less likely to identify a setting or food vehicle in an outbreak.

The most notable characteristic associated with levels of outbreak reporting was funding for epidemiology and laboratory capacity for the prevention and control of emerging infectious diseases. High-reporting states received approximately three times more funding for public health programs than low-reporting states. According to the researchers, each jurisdiction’s established surveillance systems affect outbreak reporting rates, which are driven by the resources available to jurisdictions. Many jurisdictions lack the personnel to investigate outbreaks of less severe illness.

The researchers concluded that investments in state public health programs significantly affect outbreak reporting. The next step will be to analyze if states that expanded their funding over the ten-year period successfully increased their ability to report outbreaks.