Outbreak Investigation Exercise

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PUBLIC HEALTH 601

CLASS #2

OUTBREAK INVESTIGATION

GROUP EXERCISE

1.An outbreak of food poisoning occurred at a Coast Guard training station a few hours after the communal breakfast meal. The symptoms were mainly nausea, vomiting and diarrhea. An investigation revealed the findings listed in the table below.

Consumed FoodDid Not Consume Food

Type ofNo. ofNumber AttackNo. of Number Attack Risk

FoodPersonsIllRate (%)PersonsIll Rate % Ratio

Tomato2044726321 _ _____

Juice

Cantaloupe2905317715 _____ _____

Chipped147603208 _____ _____

Beef w/

sauce

Potatoes1614430624 _____ _____

Eggs1693929829 _____ _____

Pastry2043426334 _____ _____

Toast2384622922 _____ _____

Milk3015016618 _____ _____

Calculate the attack rates for each food for those who consumed and those who did not consume each food item.

Which food has the highest risk ratio for eaters compared to non-eaters? Is this food the most likely cause of this “common source” epidemic? Explain your choice.

What additional investigations could be done to determine the source of the likely microorganism?

How can such food poisoning epidemics be prevented in the future?

2.Twelve persons attended a church supper on July 4th, 2007 in Cleveland Ohio. The following table describes what each person ate and whether or not they got sick

Person Age Sex Sick? Ham Spinach Cake Ice Cream Fruit salad
1 11 M NO       X  
2 52 F YES X X   X  
3 65 M YES X X   X X
4 59 F YES X X X    
5 13 F NO     X X  
6 63 F YES X X X X  
7 70 M NO X X     X
8 40 F NO   X X   X
9 55 F YES   X X X X
10 22 M NO X   X X  
11 65 M YES X X      
12 39 F YES     X X X

Consumed FoodDid Not Consume Food

Type ofNo. ofNumber AttackNo. of Number Attack

FoodPersonsIllRate (%)PersonsIllRate

Ham_____________________________________

Spinach_____________________________________

Cake_____________________________________

Ice Cream_____________________________________

Fruit Salad_____________________________________

Calculate the attack rates for each food for those who consumed and those who did not consume each food item.

Which food has the highest risk ratio for eaters compared to non-eaters? Is this food the most likely cause of this “common source” epidemic? Explain your choice.

What additional investigations could be done to determine the source of the likely microorganism?

How can such food poisoning epidemics be prevented in the future?

3. Tonight, all the members of your group have been assigned the same profession. You are all upper

management representatives of your profession and recognize that you and those you supervise

may be called upon to respond in the event of a community outbreak investigation.

At 5:30 on a quiet 75 degree summer evening, there is a report that more than 100 people

attending an event at PetCo Park have reported having difficulty breathing. Some have fainted,

and many are not able to walk on their own or respond effectively to questions. There are also

reports of nausea and blurred vision. One hour later, reports are received that over 150 people

attending a summer concert in Balboa Park are stricken with the same types of symptoms.

As a member of the profession assigned to your group, please answer the following questions:

What is the role of your profession in this situation? What type of activities would you be

responsible for?

Below is a list of other professionals who may also be responding to this event. Which of these professional groups do you think you will need to communicate with to effectively respond to this event? Among those you think you will need to communicate with, please rank them from most important to least important for you to communicate with.

______Public Health/Epidemiologists_______Hospital/Trauma Centers

______Law Enforcement_______Media/Journalists

______Red Cross_______Elected Officials

______Emergency Responders/EMTs_______Hazmat Team

______Stadium Officials_______Communication providers

______Transportation providers_______FBI




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