An institutional food-poisoning outbreak

Based on the clinical, epidemiologic, and laboratory findings, the investigation team was of the considered opinion that the cause of the outbreak was food infection rather than intoxication. The grouping of cases in relation to a particular event; the explosive nature of the outbreak; the equal susceptibility of all ages, sexes, and occupational groups; the median incubation period of 13 hours; the clinical picture of gastroenteritis with fever, chills, and headache, the fever being high in range and with an average duration of 2 days; the isolation of the Ballerup-Bethesda group of organisms from stools of some cases; the serologic study which showed significantly higher titer of antibodies among cases than among a control group which was not infected; and the presence of conditions ideal for contamination and subsequent bacterial growth during the preparation of the food items suspected as the probable vehicle of infection all tend to to support the hypothesis of food infectionThe actual source of infections has not been determined with absolute certainly and the manner of contamination and transmission of the causative organisms are only matters of conjecture, because delayed reporting had made their demonstration by direct evidence technically difficult. However, these should not detract from the soundness of the conclusions drawn. After all, epidemiologic investigations in actual working situations are perhaps seldom, if ever, perfect and complete. As Wade Hampton Frost had written, "Epidemiology is something more than the total of its established facts......it includes ......chains of inferences which extend more or less beyond the bounds of direct observation." (Conclusion)

Epidemiology of dental diseases and conditions in an urban population

1. A survey conducted on a representative sample of an urban population showed that the overall df and DMF indices were 1.4 and 5.9, respectively2. The major dental diseases and conditions observed were dental caries, materia alba, inflamation of the gingiva, and abnormal condition of the soft tissue3. Dental caries appeared as the most prevalent disease occurring in 83.2 of the sample and affecting mostly the age group 15-19 years, (10.4) followed by the age group 20-24 years (9.0), with the age group 65 years and over least affected (2.0). As to sex predilection, generally the females are more affected than the males. However, when sex is related to age, it appears that the younger males and the elder females are more prone to this condition4. Material alba has appeared as the second leading condition (26.3) where no age and sex predilection has been observed5. Inflamed gingiva was the third leading dental disease (17.5) which appeared to increase as age advances6. Abnormal conditions of dental soft tissue occurred in both sexes with slight preponderance in the males7. It was observed that in individuals aged 1-4 years, the average number of primary teeth was 19.3 and in individuals aged 5-65 years, the average number of permanent teeth was 20.3. It was noted that the primary teeth start erupting from the age of under 1 year and almost completed at the age of 4 years. The child then starts shedding the primary teeth thereafter. No primary teeth were no longer observed at 20 years and over. On the other hand, the permanent teeth begin to appear at the age of 5 years and are practically all erupted at the age group 20-24 years. From then on, the number of permanent teeth loss becomes more apparent8. Among those examined only 4.2 had the natural teeth of both upper and lower jaws completely absent and these were all over 20 years old9. It appears that when dentures are worn, full dentures in both jaws occur more frequently than dentures on either upper or lower jaw10. The other dental diseases and conditions observed infrequently among the examinees were all natural teeth absent, oral pain, wearing full denture, dentofacial anomalies, flourosis, all remaining teeth for extraction, chewing betel nut and abnormal condition of the bone. (Summary)

A study of the recording and reporting of vital and health statistics at the local level and its significance of public health

A statistical survey to determine the recording and reporting procedures practiced at the local level of the health and civil registry offices was undertaken in four different areas which were randomly selected. It revealed some of the causes of the delay in reporting of vital and health statistics and the degree of accuracy, adequacy, and reliability of such reports. A significant observation is the information that deaths were under-registered by 27.3% in these areas where the people could be considered better informed. Evidences were also presented on why medical certification of cause of death can not be fully relied upon. Ultimately, this survey exposed the urgent need to improve the present system of collection of vital and health statistics in order that the information gathered be useful and meaningful. Suggestions on how to meet part, if not all of this need were offered. Standardization of forms and procedures to render the data sbumitted comparable is called for. That the "analysis is only as good as the data collected" is an indisputable truth. (Summary and conclusions)

An institutional food-poisoning outbreak

Based on the clinical, epidemiologic, and laboratory findings, the investigating team was of the considered opinion that the cause of the outbreak was food infection rather than intoxication. The grouping of cases in relation to a particular event; the explosive nature of the outbreak; the equal susceptibility of all ages, sexes, and occupational groups; the median incubation period of 13 hours; the clinical picture of gastroenteritis with fever, chills, and headache, the fever being high in range and with an average duration of 2 days; the isolation of the Ballerup-Bethesda group of organisms from stools of some cases; the serologic study which showed significantly higher titer of antibodies among cases than among a control group which was not infected; and the presence of conditions ideal for contamination and subsequent bacterial growth during the preparation of the food items suspected as the probable vehicle of infection all tend to support the hypothesis of food infectionThe actual source of infection has not been determined with absolute certainty and the manner of contamination and transmission of the causative organisms are only matters of conjecture, because delayed reporting had made their demonstration by direct evidence technically difficult. However, these should not detract from the soundness of the conclusions drawn. After all, epidemiologic investigations in actual working situations are perhaps seldom, if ever, perfect and complete. As Wade Hampton Frost had written, "Epidemiology is something more than the total of its estblished facts ... it includes ... chains of inferences which extend more or less beyond the bounds of direct observation." (Conclusion)