Citrobacter freundii Foodborne Disease Outbreaks Related to Environmental Conditions in Yazd Province, Iran

Background: The aim of this study was to assess associations of Citrobacter freundii foodborne outbreaks with environmental factors in various regions of Yazd Province, Iran, 2012-2016. Methods: The public health surveillance data were used for one period of five years reported foodborne disease outbreaks in various regions of the Province. Multilevel regression statistical method was used to analyze associations of climatic and demographic variables with outbreaks. Significant associations were tested using likelihood ratio tests. Results: Results showed a significant association between C. freundii outbreaks and air dust conditions, age groups and various regional cities. Conclusion: The current study revealed necessity of etiologic agent identification for use in foodborne disease outbreak guidance in future outbreaks. Systemic surveillance schemes can help prevent and control similar scenarios using reports of environmental effects on foodborne disease outbreaks.