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The key ingredients to a successful disease cluster investigation include the following. It is important to have pre-determined investigational protocols established which describe the exact steps that need to be taken to investigate a disease cluster, whether traditional or occupational. The US Centers for Diseases Control and Prevention (CDC) has published literature which sets out protocols for the investigation of disease clusters from the point of view of public health authorities. Knowledge of existing databases which can rapidly provide baseline rates of particular causes of morbidity and mortality is essential. Such databases include cancer registries and local public health statistics. In addition, use of Geographic Information Services (GIS), is a useful tool to modeling time and space information, especially for traditional environmental or community disease clusters.

Finally, constant communication with the affected populations is crucial. It is important to communicate the investigational protocols and the limited outcome to be expected from disease cluster investigations. In particular, it is particularly important to communicate the issues of chance and hypothesis generation. It is also recommended that the target populations for communication be identified early and broadly. For example, in an occupational cluster investigation this could include: the workers, the union, management, the press, the community, and the regulatory agencies.

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