title: The pioneering use of a questionnaire to investigate a food borne disease outbreak in early 20th century Britain.
abstract: 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.
authors.affiliation: Division of Clinical Epidemiology, Geneva University Hospitals, 25 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. Alfredo.Morabia@hcuge.ch
authors.forename: Alfredo
authors.initials: A
authors.lastname: Morabia
authors.forename: Anne
authors.initials: A
authors.lastname: Hardy
mesh_terms: D000818:Animals; D004196:Disease Outbreaks / Q000266:history*; D004739:England / Q000453:epidemiology; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology / Q000209:etiology / Q000266:history*; D049673:History, 20th Century; D006801:Humans; D010125:Ostreidae / Q000382:microbiology; D011634:Public Health / Q000266:history* / Q000379:methods; D011795:Surveys and Questionnaires; D014435:Typhoid Fever / Q000453:epidemiology / Q000266:history* / Q000635:transmission