Communicable Disease Control Handbook, 2nd edition by Jeremy Hawker, Norman Begg, Iain Blair, Ralf Reintjes,

By Jeremy Hawker, Norman Begg, Iain Blair, Ralf Reintjes, Julius Weinberg

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Fig. 2 Seasonal distribution of GI pathogens, 1999–2003, England and Wales (3-week rolling averages). 3 Clues as to whether an outbreak of gastroenteritis could be food-borne or spread person to person May suggest food-borne Dates of onset (epidemic curve) clustered indicating a point source outbreak. May suggest person to person Dates and times of onset do not cluster but occur in waves coinciding with the incubation period of the responsible pathogen. All wards, classes, buildings or units supplied by the kitchens or food supplier are affected.

Iv) Examination of records of key controls, such as temperature and pest controls. (v) Whether samples of food are available for examination/analysis and whether environmental swabbing or water sampling is appropriate. • General control measures to prevent spread from those affected can be instituted early, as can addressing important problems identified in the environmental investigation. This further exposure to a source of E. g. g. inadequate temperature control in a Bacillus cereus outbreak).

Ear or upper respiratory infection. May complicate influenza infection. More common in nursing homes. Mostly affects children and immunocompromised. Para 1 and 2 more common in autumn or early winter (but para 3 endemic) Possible link to birds. May be severe. Mostly adults, more often males. May be seasonal community epidemic. Affects the unvaccinated. Possible link to sheep, other animals or animal products. May increase in April–June. Male excess, rare in children. Peaks every December and January.

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