The Case of the Potluck Poisoning

1. The Case of the Potluck Poisoning

2. Your mission is to solve the Case of the Potluck Poisoning a Food-borne Illness scenario: Use information presented in this presentation Decide from the facts what caused the Potluck Poisoning This is a Health Care activity designed to give you an opportunity to experience what it is like to work in Health Informatics Occupations. GOOD LUCK! Your Mission…

3. Health Informatics Occupations • These occupations collect, manage, organize, and analyze information in the Health Care Field. • These occupations require computer skills and knowledge of health care & office software.

4. Background Information • What does potluck mean? • A meal (usually lunch or dinner) to which many people bring food to share with others • What is food-borne illness? • An illness that more than one person gets as a result of eating contaminated food • What is contaminated? • Something that is unclean or impure as a result of contact or mixture with a bacteria, viruses, or minerals that are harmful to the body

5. Background Information • What are viruses and bacteria? • Bugs or germs that can make a person sick • What is feces? • Human or animal solid waste (poop) • What is an epidemiologist? • Someone who figures out why many people are getting the same type of sickness at the same time. • What is an environmental health specialist? • Someone who tries to identify and eliminate health hazards in our environment

6. You will be exploring these occupations… • The admitting clerk that records the patient’s personal and insurance information. • The epidemiologist that collects all the facts and solves the case.

7. The Community Potluck was organized by 4 individuals: • Molly runs a day care center in her home • Mikeruns the town’s meat packing plant • IsAACis the manager of a fertilizer outlet. • John is a hard-working local dairy farmer.

8. Identify the 4 Contributors • Gather information about key people as you go through the presentation • Match the people to the pictures that represent their part in this scenario by writing the LETTER of the person in the square to the left of the picture • Use Activity #1 Worksheet and the next 4 slides to gather the first pieces of information you will need to solve the case

9. A - Molly • A local housewife that runs a day care center for 9 children, ranging from 1 to 8-years-old • She was asked to cook 15 hams • The day of the potluck, she spent most of the day preparing the hams in her kitchen with the help of 3 of her older day care children • She also has a soft spot for birds and cats; you are told she has 4 birds and 8 cats

10. B - Mike • He runs the town’s meat packing plant • He donated 150 pounds of beef and pork • He cooked over several open pit barbeques • Several flies were on the beef, despite a no-pest strip hanging close by

11. C - Isaac • He is the manager of a fertilizer outlet • Only helped mix the saladhe brought after nobody else would volunteer to do it • He has been ill recently, but he feels fine now • Symptoms of his recent illness include diarrhea, high fever, double vision, and skin lesions

12. D - John • He is a hard-working local dairy farmer • He was asked to bring 100 gallons of red fruit punch • Lacking anything else to bring the punch in, he uses several of his old metal milk cans • The milk cans have recently been welded and solderedto repaircracks, holes, and loose handles

13. The Community Potluck Dinner It could happen anywhere…. • On the evening of September 23, at approximately 8:30 p.m., your phone rings. • Upon answering, a nurse from your local hospital frantically tells you of some 95 people who are, as she describes it, “Lying all over the place.” • They are vomiting, they have diarrhea and some are in such pain that they won’t even move from the hallways of the hospital and the front lawn of the community center. • As an admitting clerk she asks for your help with all the people.

14. From what you can gather at the emergency room, there was a community potluck dinner, which was attended by about 350 people. The dinner began at 8:00 p.m. The first sick patients began arriving at the hospital around 8:25 p.m. The Community Potluck Dinner

15. Explore the duties of the Admitting Clerk <iframe width="560" height="315" src="https://www.youtube.com/embed/mEkFuWpRHB8?rel=0" frameborder="0" allowfullscreen></iframe> • The Admitting Clerk and the Medical Records Technicians have similar duties

16. To continue… • At the hospital, the ambulance driver begins to explain that the patients were at a community potluck dinner with several hundred people. • He says that more people will probably be arriving from the potluck soon. • As you enter, 6 additional patients arrive who are experiencing similar symptoms. • Environmental Health Services tell you that this seems to be a larger than normal outbreak and they have called an epidemiologist.

17. Gather Information • As the Admitting Clerk of the Hospital you are responsible to get personal and medical insurance information from all patients • Family members begin to arrive and you get information from them.

18. Activity #2: Patient Records • Trade packets with your partner, they will write their information in your packet. • Accuracy is required!!! No mistakes. • Work with a partner and fill out their information in YOUR packets.

19. Reasons People Get Sick • Viruses and bacteria may cause infections likes strep throat and influenza (flu). • Some viruses and bacteria can live in food: causing food-borne illnesses such as salmonella, E. coli, and Hepatitis A. • Exposure to excessive amounts of minerals or heavy metals, like lead, can also cause illness.

20. Activity # 3: Classify Illnesses • Use the Activity # 3 chart in your packet as you learn more about 5 illnesses. • Record the cause of each illness • Record the time it takes to get sick • Record what happens to the patient, also called symptoms • The information on the next 5 slides will help you solve the case!

21. Influenza (Flu) • Type of infection: virus in the nose, throat and lungs • Time for symptoms to occur: quickly and suddenly • Symptoms: fever, headache, fatigue, dry cough, sore throat, congested nose, and body aches. • Cause of the illness: This is an air-borne illnessthat is passed from person to person when an infected person sneezes or coughs. • Other Information: Most people will recover in 1 to 2 weeks, but a few people will progress to pneumonia and other complications including death. An average of 35,000 Americans die annually from influenza.

22. Hepatitis A • Type of infection: viral infection that causes liver damage. • Time for symptoms to occur: is within 2 to 4 weeks. • Symptoms: jaundice (yellowing of the skin and eyes), fatigue, abdominal pain, loss of appetite, nausea, and vomiting. • Cause of the illness: This particular virus is transmittedby food or waterthat has been contaminated with feces from an infected person. • This means you should ALWAYS wash your hands after going to the bathroom AND before handling food. • Other Information: There is no cure for Hepatitis A.

23. Salmonella • Type of illness: bacterial infection of the stomach and intestines • Time for symptoms to occur: 1 to 3 daysafter the infection • Symptoms: diarrhea, fever, and stomach pain • Cause of the illness: eating contaminated food, such as raw chicken or raw eggs • Other Information: Some animals, such as reptiles, baby chicks, and baby ducks, may carry salmonella and pass it in their feces. Household animals, like birds, cats, and dogs, can carry salmonella in their feces, as well.

24. Lead (Pb) Poisoning • Type of illness: mineral or heavy metalpoisoning • Time for symptoms to occur: within 30 minutes to 1 hour. • Symptoms: stomach pain, diarrhea, and vomiting. • Prolonged exposure can damage the kidneys, cause mental retardation, coma, seizures, and even death. • Cause of the illness: Lead is a metal that is toxic if ingested or eaten • Other Information: Lead used to be common in paints, and is still found in batteries, metal solder used for repairing metal containers, bullets, and roofing materials.

25. Cadmium Poisoning • Type of illness: mineral or heavy metalpoisoning • Time for symptoms to occur: within30 minutes to an hour. • Symptoms: If cadmium is ingested, it can immediately cause choking attacks, vomiting, abdominal pains, diarrhea, dizziness, and a loss of consciousness. • Cause of the illness: Cadmium is a metal that is toxic if ingested • Other Information: Cadmium is a metal, it is highly corrosion resistant and is desirable in the automotive, electronics, marine, and aerospace industries. It has also been used in soldering and in the production of metal cans.

26. E. Coli • Type of infection: bacteria in the intestines • Time for symptoms to occur: about 7 days • Symptoms: severe crampsand bloody diarrhea, low fever, nausea and vomiting, dehydration, and possible death • Causes of the illness: eating undercooked meat, drinking contaminated liquids, and/or eating produce that has not been properly washed • Other Information: E. Coli is very contagious and can be deadly, especially for the very young and very old.

27. The Epidemiologist Arrives: • 20 minutes later, the epidemiologist arrives at the hospital. • In that time, an additional 20 individuals have arrived - all with similar symptoms. • The epidemiologist sets up his laptop computer and begins to collect information. • In the meantime, 3 Environmental Health Specialists are sent to the potluck to collect samples of the food to be tested for bacteria and viruses.

28. The Epidemiologist • The Environmental Specialists also collect the containers the food and drink were served in. • The Epidemiologist begins to piece together a story from the sick people, which involves: • People at a community dinner become sick displaying nausea, vomiting, diarrhea, severe headache, coughing, but no fever. • By early the next morning, several patients are ready to be interviewed. • TheEpidemiologist interviews people who brought the food and drink.

29. Activity #4 Epidemiologist Chart • Use the spreadsheet portion of the worksheet and complete the chart. • Enter a “x” for what the people ate, and total the percentages at the bottom of the chart. • Use the percentages at the bottom of the Epidemiologist Chart to help you decide what made people sick.

30. Activity #4 Epidemiologist Chart • Enter the information below for people at the community dinner. • TANNER- Did not get sick. He ate the ham & salad. He drank water only. He is on a diet and is limiting his sugar intake. • Ana - Did get sick. She ate the ham, salad and drank the fruit punch. • MEGAN - Did get sick. She ate salad and had the fruit punch. • JIM - Did get sick. He ate the ham, salad, and drank the fruit punch. • BRIANna - Did not get sick. She ate the salad and drank water.

31. Epidemiologist Chart Continued • JUAN- Did Not Get Sick. He ate ham, salad and drank water • Tyson- Did Not get Sick. He Only ate the Salad. • Paul- Did Get Sick. He Ate the Ham and the Salad. He also drank both water and fruit punch • Maria- Did get Sick. She Ate a Salad and drank both water and fruit punch.

32. Complete the bottom of the chart with your partner

33. To be Continued… • Within 24 hours, the first test results on the food came back negative. • None of the food items were contaminated with bacteria or viruses. • The symptoms presented by the patients mimicked those of heavy metal poisoning. • Investigation shifted to mineral or heavy metal poisoning. • The question was: “Where did the mineral or heavy metal poisoning come from?”

34. Activity #5: Fact Review Questions • To complete Activity #5 with your partner, analyze the information found in the following activities in your packet • Activity #1- The Potluck Contributors • Activity #3 - Types of Illnesses • Activity #4 -The Epidemiologist Chart. • As the epidemiologist, answer the questions to help identify the food-borne illness: • What food item made everyone sick? • How did the food become contaminated? • How did it make the people sick?