title: Dose response for infection by Escherichia coli O157:H7 from outbreak data.
abstract: In 1996, an outbreak of E. coli O157:H7-associated illness occurred in an elementary school in Japan. This outbreak has been studied in unusual detail, making this an important case for quantitative risk assessment. The availability of stored samples of the contaminated food allowed reliable estimation of exposure to the pathogens. Collection of fecal samples allowed assessment of the numbers infected, including asymptomatic cases. Comparison to other published dose-response studies for E. coli O157:H7 show that the strain that caused the outbreak studied here must have been considerably more infectious. We use this well-documented incident as an example to demonstrate how such information on the response to a single dose can be used for dose-response assessment. In particular, we demonstrate how the high infectivity limits the uncertainty in the low-dose region.
authors.affiliation: National Institute for Public Health and the Environment, Bilthoven, the Netherlands. Peter.Teunis@rivm.nl
authors.forename: Peter
authors.initials: P
authors.lastname: Teunis
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Takumi
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shinagawa
mesh_terms: D000328:Adult; D002648:Child; D015169:Colony Count, Microbial; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology*; D019453:Escherichia coli O157 / Q000302:isolation & purification; D005260:Female; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008954:Models, Biological; D015233:Models, Statistical