L-Tryptophan and Eosinophilia-Myalgia Syndrome ("EMS")

National epidemic of new syndrome in 1989 quickly traced to a commercial product. Case study addresses surveillance, bias, criteria for causation.

 

Objectives:

  • Discuss issues related to rapid establishment of national surveillance for a newly recognized and little understood disorder;
  • Discuss development of case definitions;
  • Describe the elements of design and the advantages and disadvantages of case‑control versus cohort studies;
  • Discuss some of the biases that might have affected these studies;
  • Calculate and interpret a relative risk, odds ratio, and attributable risk percent;
  • List and evaluate the criteria for causation.
Investigation: 
Outbreak
Country: 
United States
Year: 
1990
Author (s): 

Leslie Swygert and Richard Dicker

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