Part III: Outbreaks in Other States
Would you undertake a case-control or a cohort study to investigate the source of the cyclosporiasis cases in New Jersey? Why?
Would you alert the public of this possible public health threat? Defend your answer.
Part IV: Traceback and Environmental Investigations
Does the traceback information support raspberries as the source of the cyclosporiasis outbreak?
Given what you know about the transmission of cyclosporiasis, on what cultivation or harvesting practices would you focus in the investigation of the raspberry-producing farms?
Part V: Control and Prevention Measures
What specific measures would you suggest to decrease the likelihood of contamination of raspberries from the Guatemalan farms?
Do you believe that the raspberries were the source of the multistate outbreaks of cyclosporiasis? Which of the criteria for causality (i.e., strength of association, biological plausibility, consistency with other studies, exposure precedes disease, and dose–response effect) have been satisfied in the linkage between raspberries and cyclosporiasis? How would you convince others of the validity of these findings?