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

G. Kafatos*, P. Mook, Andre Charlett, E. Rees, Richard Elson, Thomas Inns, S. Kanagarajah, Nicholas Andrews

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Downloads (Pure)

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.

Original languageEnglish
Article numbere60
JournalEpidemiology and Infection
Volume148
DOIs
Publication statusPublished - 21 Feb 2020

Bibliographical note

Financial Information: This research received no specific grant from any funding
agency, commercial or not-for-profit sectors.
GK was an employee of PHE at the time the work of this manuscript was initiated. Since June 2013 he has been an employee of Amgen and owns shares of Amgen. All other authors declare no conflict of interest. No funding was received as part of this work.

Open Access: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright: © Crown Copyright, 2020. Published by Cambridge University Press.

Citation: Kafatos G, Mook P, Charlett A, Rees E, Elson R, Inns T, Kanagarajah S,
Andrews NJ (2020). Retrospective assessment of rapid outbreak investigation for
gastrointestinal diseases using only cases and background exposure data. Epidemiology and Infection 148, e60, 1–8.

DOI: https://doi.org/10.1017/S0950268820000527

Keywords

  • Outbreak
  • case-background
  • epidemiology
  • gastrointestinal
  • trawling

Fingerprint

Dive into the research topics of 'Retrospective assessment of rapid outbreak investigation for gastrointestinal diseases using only cases and background exposure data'. Together they form a unique fingerprint.

Cite this