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    Outbreak Investigation

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    Nathnael Geb
    This document outlines the process for investigating disease outbreaks. It defines key terms like epidemic and outbreak and describes the two types of epidemics: common source and propagated. For common source outbreaks, it distinguishes between point source and continuing source exposures. The aims of an outbreak investigation are to determine the cause, prevent further spread, and explain future prevention. Key steps include establishing the outbreak, verifying diagnoses, defining cases, describing patterns, developing hypotheses, evaluating hypotheses, implementing control, and communicating findings.

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    Outbreak Investigation

    Uploaded by

    Nathnael Geb
    19 views17 pages
    This document outlines the process for investigating disease outbreaks. It defines key terms like epidemic and outbreak and describes the two types of epidemics: common source and propagated. For common source outbreaks, it distinguishes between point source and continuing source exposures. The aims of an outbreak investigation are to determine the cause, prevent further spread, and explain future prevention. Key steps include establishing the outbreak, verifying diagnoses, defining cases, describing patterns, developing hypotheses, evaluating hypotheses, implementing control, and communicating findings.

    Original Title

    9. Outbreak Investigation

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    This document outlines the process for investigating disease outbreaks. It defines key terms like epidemic and outbreak and describes the two types of epidemics: common source and propagated. For common source outbreaks, it distinguishes between point source and continuing source exposures. The aims of an outbreak investigation are to determine the cause, prevent further spread, and explain future prevention. Key steps include establishing the outbreak, verifying diagnoses, defining cases, describing patterns, developing hypotheses, evaluating hypotheses, implementing control, and communicating findings.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    19 views17 pages

    Outbreak Investigation

    Uploaded by

    Nathnael Geb
    This document outlines the process for investigating disease outbreaks. It defines key terms like epidemic and outbreak and describes the two types of epidemics: common source and propagated. For common source outbreaks, it distinguishes between point source and continuing source exposures. The aims of an outbreak investigation are to determine the cause, prevent further spread, and explain future prevention. Key steps include establishing the outbreak, verifying diagnoses, defining cases, describing patterns, developing hypotheses, evaluating hypotheses, implementing control, and communicating findings.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 17

    CHAPTER 9

    Approach to Outbreak
    Investigations
    Definitions

    • Epidemic is the occurrence of disease


    cases or deaths clearly in excess of
    normal expectation
    • Outbreak is the occurrence of disease
    cases or deaths limited to a specified
    group during a short period of time clearly
    in excess of normal expectation
    Cont…
    • There are two types of epidemics
    – Common source
    – Propagated
    I. Common source

    • An outbreak resulting from the direct or


    indirect exposure of a group to the same
    disease causing agent (the source)
    • There are two types
    – Point source
    – Continuing source
    1. Point source

    • Cases were all exposed to the same


    source during a brief period of calendar
    time
    2. Continuing source (or
    intermittent point-source)
    • Cases were exposed to the same source
    during more than a brief period of calendar
    time
     May be caused by an infectious organism,
    or a noxious agent in the environment
     The disease agent does not undergo an
    incubation period in a susceptible host as
    part of the transmission cycle
    II. Propagated
    • An outbreak resulting from transmission of an infectious
    agent from one susceptible host to another
    • The disease agent undergoes an incubation period in a
    susceptible host as part of the transmission cycle
    AIMS OF AN OUTBREAK
    INVESTIGATION
    To determine the cause of the outbreak

    To prevent further immediate spread of the


    outbreak

    To explain how to prevent similar outbreaks in


    the future
    Potential risk factors or high risk
    situations
    • Environmental and food sanitation practices
    • Immunological susceptibility
    • Sources of exposure vulnerable to effects of
    infectious or chemical agent
    NECESSARY KNOWLEDGE FOR
    OUTBREAK INVESTIGATIONS
    1. Diseases
    • Clinical signs and symptoms
    • Pathological changes
    2. Etiologic agents
    • Types of agents and diseases caused by
    agents
    • Laboratory tests to assess presence of agents
    3. Outbreak characteristics for specific diseases
    • Period from contact with agent to onset of
    overt disease
    • Mode of transmission
    • Socio-demographic susceptibility
    Steps of Outbreak Investigation (CDC)
    1. Prepare for fieldwork
    – Research the disease
    – Make administrative arrangements
    – Clarify your role
    2. Establish the existence of an outbreak
    – Does the observed number of cases exceed the
    expected number?
    Cont…
    3. Verify the diagnosis
    – Speak directly with persons who are affected

    4. Define and identify cases


    – Establish a case definition
    – Identify and count cases
    • Line listing
    Cont…
    5. Describe the data in terms of time, place and
    person
    – Outbreak curve
    – Map
    – Identify demographic and other characteristics of
    persons at risk
    6. Develop hypotheses
    – Open-ended and wide-ranging interviews with a few
    people
    Cont…
    7. Evaluate hypotheses
    – Comparison: hypotheses with established
    facts
    – Analytic epidemiology
    • Cohort studies (RR; 95% CI)
    • Case-control studies (OR; 95% CI)
    8. Refine hypotheses and carry out
    additional studies
    Cont…
    9. Implement control and prevention measures
    – Should occur as soon as information is available
    10. Communicate findings
    • Written outbreak report distributed with laboratory
    results approximately one month later to:
    – Local Health Department
    – Clinic Director
    – Environmental Health
    – Regional Epidemiologist
    – National level
    Limitations
    • Incomplete response rate on the
    cohort study
    Conclusions
    • 10 steps of outbreak
    investigation
    – Conceptual
    • Provide a logical progression for the
    investigation
    – Can / should be taken out of order
    (with caution)

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