1.
The eleven blue men developed symptoms at different times of the day as listed below;
1st man at eight o’clock, 2nd man at 10:25am, 3rd ,4th and 5th men at 11:05am, 6th and 7th men at 11:20am, 8th and 9th at 11:35am, 10th at around 12:00pm, and the 11th man at around 6:00pm. All had been in misery for at least one hour. The epidemiologist need to know these information on the symptoms timeline framework in order to establish the the incubation period of the suspected disease (Roueché, 1955).
3.
Outbreak investigation was carried out in the following steps;
The outbreak having epidemiological characteristics was reported to the U.S. Department of Health Department as its required by the law and the Department sent two epidemiologists.
The patients admitted were questioned by the two doctors from the Health Department. This investigation began was underway when the last blue man arrived in the hospital.
In the cafeteria they interviewed the cooks, dishwashers, busboy, counterman and the proprietor.
One of the cooks admitted to have wrongly refilled some salt cans with saltpetre instead of the salt but he corrected the mistake immediately. The saltpetre contained sodium nitrite and this was the culprit that caused the outbreak.
4.
Questions asked by doctors
i) What areyou feeling?
ii) What meal did you eat last?
iii) Where did you eat that meal?
The doctors asked the patients these questions in order to establish the symptoms of the medical condition they were in. The doctors also wanted to ascertain why all of them were complaining of painful stomachaces, leading to them question on the food the patients had consumed before they got sick. The place of taking those meals were also more important to make it easy for them to go and get samples of the food for laboratory tests. On doing the tests they will confirm if food poisoning was the cause or not (Wagner et al, 2001).
5.
Questionsasked by epidemiologists
i) Is there any carbon monoxide in your cafeteria?
ii) Is there any food remains of the breakfast prepared?
iii) How much of the oatmeal did you prepere in the morning?
These questions were important in trying to obtain more information about the cause of the medical condition that the eleven blue were experiencing. Epidermiologists had suspected initially that the eleven blue men were suffering from carbon monoxide poisoining and they had to ascertain if the gas existed in the cafeteria. They also had to get food sample of the food that were consumed by the eleven blue men that morning. To top on that they had to know the amount of that food that was prepared in the morning in order to establish the amount of all ingredients that had been used and the number of people it can serve (Hashimoto, et al, 2009).
6.
The final culprit was sodium nitrite. It was discovered by Mr. Pensa a Health Department chemist. He analysed the samples he was given by Dr. Pellitteri and found that the cans that were suppose to be having small salt and sodium nitrate contained sodium nitrite instead. Its toxicity level is above one part of sodium nitrirte per every five thousand parts of the preserved food. On preparing a sample of the oatmeal the doctors and epidermologists found that the sodium nitrite used was in excess of the minimum toxicity level (Roueché, 1955).
7.
These specific men were more affected than the other people who ate in the cafeteria because they were heavy drinkers. Clinical studies have shown that heavy drinkers have subabnormal concentration of sodium chloride in their blood. This can be as a result of them either not eating enough in order to get sufficient salt or they lose it faster compareed to other people or they experience the two scenarios (Roueché, 1955).
References
Hashimoto, S., Murakami, Y., Taniguchi, K., & Nagai, M. (2009). Detection of epidemics in their early stage through infectious disease surveillance. International Journal of Epidemiology, 29(5), 905-910.
Roueché, B. (1955). Eleven Blue Men and Other Narratives of Medical Detection. The American Journal of the Medical Sciences, 229(4), 472.
Wagner, M. M., Tsui, F. C., Espino, J. U., Dato, V. M., Sitting, D. F., Caruana, R. A., & Fridsma, D. B. (2001). The emerging science of very early detection of disease outbreaks. Journal of Public Health Management and Practice, 7(6), 51-59.
