Sammendrag
In 2006, Norway experienced an outbreak of hemolytic uremic syndrome caused by enterohemorrhagic
Escherichia coli O103. A total of 17 patients from 16 households were identified from January to March.
The outbreak investigation was complicated and it took 4 weeks from the alert was raised until cured
sausage was identified as the source of the outbreak. The aim of this study was to develop a tool that analyze
information on patient distribution and distribution of food products to give a quantitative measure for rating
the food productsaccording to their probability of being the source of the outbreak. The study used data
from the HUS outbreak in 2006. A tool for calculating measures of association between the distribution of
human cases in a food borne outbreak and the distribution pattern of food products being potential sources
of the outbreak was developed. The tool uses the geographical location and time of the human cases and
information on when and where the food productswere delivered to retail shops as input data. All analysis
was performed with municipality as the unit of concern. Two measures for association were applied, the
first were based on Pearson’s correlation, the second on the amount of product delivered to municipalities
associated with HUS-cases. Thereafter an index value based on both measures was calculated. The model
ranked the source product among the 5% most probable products. This type of analyses is useful in order
to focus the outbreak investigation on the most probable products, and exclude products that are unlikely
to be the source based on time and geographical distribution.Further work should be done in this area to
refine the model and test on other outbreaks.
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