Public Health 101 Outbreak Exercises

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Public Health 101Outbreak Exercises

• Danae Bixler, MD, MPH

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Exercise I

• Outbreak in a Nursing Home

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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.

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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.

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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?

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Exercise II

• Outbreak After a Luncheon

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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.

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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?

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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?

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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?