Fast But Right: Outbreak Surveillance And Foodborne Knowledge Infrastructure

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This dissertation examines knowledge infrastructures for detecting and investigating national outbreaks of foodborne disease. Drawing on archival and ethnographic material from US public health and regulatory agencies, I investigate how officials have built and used surveillance systems to make foodborne outbreaks visible, reflecting the shape of the industrialized food supply. I describe how, in the course of conducting outbreak investigation work, officials confront the challenges of a "balancing act" of needing to be fast but right, facing dilemmas associated with wanting to protect the public health yet minimize economic impact to commercial entities, while grappling with the highly distributed nature of both the food system and a federalist system of public health governance. In the dissertation, I make three core arguments. First, during foodborne outbreak investigations, public health and regulatory officials manage time and uncertainty through systematization. Second, systematization has helped make visible a new kind of public health problem, rooted in the post World War II industrialization of the US food supply-national, diffuse outbreaks caused by contaminated food moving through interstate commerce. Third, despite the importance of and emphasis on systematization in this domain, the numerous and persistent challenges associated with needing to be fast but right preserves a need for expert judgment amidst formal systematization efforts. In addition to examining broader public health infrastructure, the dissertation features analyses of two surveillance systems for foodborne disease: an historical examination of the National Salmonella Surveillance Program from 1962-1976, and an historical and ethnographic study of the current early-warning, real-time system based on molecular subtyping. Through these analyses, I demonstrate how these systems made outbreaks visible not only from a technical perspective, but also from social, political, and economic perspectives as well.
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foodborne; outbreaks; infrastructure
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Hilgartner, Stephen H.
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Pinch, Trevor J
Lynch, Michael E.
Kline, Ronald R
Degree Discipline
Science and Technology Studies
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Ph. D., Science and Technology Studies
Degree Level
Doctor of Philosophy
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Government Document
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dissertation or thesis
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