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The use of a new virtual cohort study design to investigate an outbreak of E. coli O157 linked to a supermarket delicatessen

  • G. McCARTNEY (a1), J. COWDEN (a2), S. MURRAY (a1) and S. AHMED (a1)

Summary

In outbreaks of foodborne disease associated with retail outlets, the outlet often closes as a precaution before the specific food vehicle has been identified. Suspect food vehicles may be named as part of general control measures. A conventional case-control study cannot be performed because both cases and potential controls are likely to be aware of the hypothesis and therefore potentially biased. Modern sales recording systems in many food retail outlets may provide a basis for constructing a virtual cohort and allow a statistical inference to be made about various possible vehicles of infection. In 2007, an outbreak of E. coli O157 infection in Paisley, Scotland, was linked to cooked meat from a supermarket delicatessen using descriptive epidemiology. Construction of a virtual cohort allowed a relative risk and confidence interval to be estimated which supported the hypothesis of cooked beef topside being the vehicle of infection. This novel method could be valuable in the investigation of future outbreaks.

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Copyright

Corresponding author

*Author for correspondence: Dr G. McCartney, Specialist Registrar in Public Health, currently attached to the MRC Social and Public Health Sciences Unit, 4 Lilybank Gardens, Hillhead, Glasgow, G12 8RZ. (Email: Gerry@sphsu.mrc.ac.uk)

References

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1.Stirling, A, et al. An outbreak of Escherichia coli O157 phage type 2 infection in Paisley, Scotland. Eurosurveillance 2007; 12: 3253.
2.Anderson, D. Woman dies in E. coli outbreak linked to Paisley superstores. Evening Times, 14 August 2007.
3.Chouinard, E, Walter, S. Recall bias in case-control studies: an empirical analysis and theoretical framework. Journal of Clinical Epidemiology 1995, 48: 245254.
4.Public Health Department. Report of the E. coli O157 outbreak in Paisley during August 2007. Glasgow, NHS Greater Glasgow and Clyde (Public Health Department), 2007.
5.Hennekens, CH, Buring, JE. Epidemiology in Medicine. Boston: Little, Brown and Company, 1987, pp. 256.
6.Pavlin, JA, Pavlin, JA. Investigation of disease outbreaks detected by ‘syndromic’ surveillance systems. Journal of Urban Health 2003, 80: i107–114.
7.Ethelberg, S, et al. An outbreak of Verocytotoxin-producing Escherichia coli O26:H11 caused by beef sausage, Denmark 2007. Eurosurveillance 2007; 12(22): pii=3208 (http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3208).

Keywords

The use of a new virtual cohort study design to investigate an outbreak of E. coli O157 linked to a supermarket delicatessen

  • G. McCARTNEY (a1), J. COWDEN (a2), S. MURRAY (a1) and S. AHMED (a1)

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