Hierarchical dose response of E. coli O157:H7 from human outbreaks incorporating heterogeneity in exposure

P. F. M. Teunis, I. D. Ogden, N. J. C. Strachan

Research output: Contribution to journalArticlepeer-review

128 Citations (Scopus)


The infectivity of pathogenic microorganisms is a key factor in the transmission of an infectious disease in a susceptible population. Microbial infectivity is generally estimated from dose-response studies in human volunteers. This can only be done with mildly pathogenic organisms. Here a hierarchical Beta-Poisson dose-response model is developed utilizing data from human outbreaks. On the lowest level each outbreak is modelled separately and these are then combined at a second level to produce a group dose-response relation. The distribution of foodborne pathogens often shows strong heterogeneity and this is incorporated by introducing an additional parameter to the dose-response model, accounting for the degree of overdispersion relative to Poisson distribution. It was found that heterogeneity considerably influences the shape of the dose-response relationship and increases uncertainty in predicted risk. This uncertainty is greater than previously reported surrogate and outbreak models using a single level of analysis. Monte Carlo parameter samples (alpha, beta of the Beta-Poisson model) can be readily incorporated in risk assessment models built using tools such as S-plus and @ Risk.
Original languageEnglish
Pages (from-to)761-770
Number of pages10
JournalEpidemiology and Infection
Issue number6
Early online date3 Aug 2007
Publication statusPublished - Jun 2008


  • Adult
  • Child
  • Disease Outbreaks
  • Escherichia coli Infections
  • Escherichia coli O157
  • Great Britain
  • Host-Pathogen Interactions
  • Humans
  • Japan
  • Models, Statistical
  • Monte Carlo Method
  • Risk Assessment
  • United States


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