Retrospective assessment of rapid outbreak investigation for gastrointestinal diseases using only cases and background exposure data

Kafatos, G, Mook, P, Charlett, A, Rees, E, Elson, R, Inns, T ORCID: 0000-0002-1218-958X, Kanagarajah, S and Andrews, NJ (2020) Retrospective assessment of rapid outbreak investigation for gastrointestinal diseases using only cases and background exposure data. Epidemiology and Infection, 148. e60-.

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Official URL: http://dx.doi.org/10.1017/s0950268820000527

Abstract

For outbreaks of gastrointestinal disease, rapid identification of the source is crucial to enable public health intervention and prevent further cases. Outbreak investigation comprises analyses of exposure information from cases and, if required, undertaking analytical epidemiological studies. Hypothesis generation has been reliant on empirical knowledge of exposures historically associated with a given pathogen. Epidemiology studies are resource-intensive and prone to bias, one of the reasons being the difficulties in recruiting appropriate controls. For this paper, the information from cases was compared against pre-defined background exposure information. As exemplars, three past outbreaks were used, one of common and two of rare exposures. Information from historical case trawling questionnaires was used to define background exposure having removed any exposures implicated with the outbreak. The case-background approach showed good sensitivity and specificity, identifying correctly all outbreak-related exposures. One additional exposure related to a retailer was identified and four food items where all cases had been exposed. In conclusion, the case-background method, a development of the case-case design, can be used to assist with hypothesis generation or when a case-control study may not be possible to carry out.

Item Type:	Article
Uncontrolled Keywords:	Case-background, epidemiology, gastrointestinal, outbreak, trawling
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	10 Jun 2021 08:34
Last Modified:	18 Jan 2023 22:35
DOI:	10.1017/S0950268820000527
Open Access URL:	https://www.cambridge.org/core/journals/epidemiolo...
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3125832