Morabia Alfredo, Hardy Anne
Division of Clinical Epidemiology, Geneva University Hospitals, 25 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.
J Epidemiol Community Health. 2005 Feb;59(2):94-9. doi: 10.1136/jech.2004.025700.
This paper describes the investigation by a British local government board inspector in 1902, H Timbrell Bulstrode, into the cause of an outbreak of enteric fever after a mayoral banquet given at Winchester. This investigation helped to confirm the role of oysters as an agent of transmission of typhoid fever. The data are also reanalysed using a modern approach, which confirmed the role of oysters (odds ratio = 11.2, 95% CI 2.5 to 50.1). This episode is illustrative of the role of British public health inspectors at the turn of the 20th century as well as of the conditions in which the technique of investigating outbreaks of food borne diseases using a standardised menu was developed. Current methods of outbreak investigations that differ from Bulstrode's pioneering work are also discussed.
本文描述了1902年英国地方政府委员会检查员H·廷布雷尔·布尔斯特罗德对温彻斯特市长宴会后爆发的伤寒热病因展开的调查。这项调查有助于证实牡蛎作为伤寒热传播媒介的作用。同时,使用现代方法对数据进行了重新分析,结果证实了牡蛎的作用(优势比=11.2,95%置信区间为2.5至50.1)。这一事件说明了20世纪之交英国公共卫生检查员的作用,以及使用标准化菜单调查食源性疾病爆发技术得以发展的条件。文中还讨论了与布尔斯特罗德开创性工作不同的当前爆发调查方法。