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Public Health 101 Outbreak Exercises

Learn outbreak investigation tactics in a nursing home and luncheon setting, including case definitions, attack rates, and hypothesis formulation. Evaluate infection control measures and study designs in this interactive exercise.

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Public Health 101 Outbreak Exercises

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  1. Public Health 101Outbreak Exercises Danae Bixler, MD, MPH

  2. Exercise I Outbreak in a Nursing Home

  3. Introduction • A nursing home calls . . . • They have an outbreak of vomiting and diarrhea. • They supply some information: the illness is characterized by acute onset of vomiting and diarrhea and rapid recovery. A few residents have low-grade fever.

  4. Exercise I, Part I • Review line listing and map. • Develop a case definition • Calculate an attack rate • Summarize data by person, place and time. • Formulate hypotheses regarding the source of the outbreak, and justify your conclusions. • Make a list of recommendations for the nursing home. • Be prepared to report to the group.

  5. Exercise I, Part II • Review the infection control measures that the nursing home put in place. • Were the measures effective? • Justify your conclusions • What, if anything, would you do in addition?

  6. Exercise II Outbreak After a Luncheon

  7. Introduction • An elderly woman calls to complain that she and ‘everyone she knows’ got ill after eating lunch. She has already called the newspaper. • She gives you the names of her friends who got ill and the name of the organization that sponsored the luncheon.

  8. Exercise II, Part I • Review the interviews done by the regional epidemiologist, and summarize the data by person, place and time. • Based on the data, what would you do next? • What else should be going on, as you pursue the epi investigation?

  9. Exercise II, Part II • You obtain a copy of the menu and a list of all 232 people who attended the luncheon. • Construct a questionnaire. • What study design would be appropriate? • What resources would you need to complete the study?

  10. Exercise II, Part III • 30 interviews have been completed and faxed to you. • What foods, if any, are associated with illness? • What else should be done at this stage?

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