PubH 6003 CASE STUDY “AN OUTBREAK OF HEMORRHAGIC FEVER IN AFRICA”

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George Washington University PUBH 6003 PubH 6003 CASE STUDY “AN OUTBREAK OF HEMORRHAGIC FEVER IN AFRICA” AN OUTBREAK OF HEMORRHAGIC FEVER IN AFRICA OBJECTIVES After completing this case study... , the student should be able to: 1. List the criteria for deciding whether a field investigation is warranted; 2. Describe the key tasks involved in investigating an epidemic of unknown cause, and, given a real outbreak, perform each step; 3. Describe the components of a case definition, and develop a case definition for a new disease; 4. Given the appropriate data, perform descriptive epidemiology and explain the importance of this step. THERE ARE A TOTAL OF 63 POINTS FOR THIS CASE STUDY Question 1a: What is the first question you need to answer before considering conducting a field investigation? (1 pt) Question 1b: What are some of the other criteria you might use in deciding whether or not to launch a field investigation of an apparent outbreak? (2 pts) Name Question 2: Before considering an exact course of action, what other information might be useful to have? (2 pts) Question 3 (4 pts.): Before departing, list and very (a few words only) briefly describe the accepted steps of an outbreak investigation. Question 4 (2 pts.): At this time, what broad categories of disease would you be considering? 4 October 1976 Question 5 (2 pts.): What modes of transmission of illness should be considered in light of this information? List at least 4 things… 13-20 October 1976 Question 6 (4 pts): Given this spectrum of disease, how would you define a case? (i.e., develop a case definition) 5 Question 7 (2 pts.): How would you proceed with the investigation at this point? 7 Question 8 (6 pts.): Draw an epidemic curve. Indicate those cases which were fatal and those which survived. (either use Excel or draw on a separate sheet of graph paper). Be sure and label your x and y axes. Always use a histogram in drawing your epi curve. Make sure that you choose the appropriate units of time for your x axis. Question 9 (4 pts.): Describe the epidemic curve. What does it suggest about the nature of the disease Question 10 (4 pts.) : As mentioned earlier in the exercise, the Yambuku hospital had closed on September 30 following the death of 13 of the 17 staff members. Mark the date of hospital closing with an arrow on your epidemic curve and calculate the case-fatality rates through September 29, then for September 30 on. How would you interpret these data? he following table lists the number of proven and probable cases according to sex and age: Table 2: Distribution of Hemorrhagic Fever by Age and Sex, Zaire, 1976 Question 11 (4 pts.): What conclusions can you draw from this table? Question 12 (2 pts.): What additional information, if any, would help you to analyze these data? Table 3: Population in the Epidemic Zone By Age and Sex, Zaire, 1976 9 Question 13 (9 pts.): Using the data in Tables 2 and 3, calculate age- and sex- specific attack rates (per 1000) for each group in Table 4. What conclusions can you draw from this information? Question 14 (2 pts.): What conclusions regarding place of onset and risk of disease seem warranted? Question 15 (4 pts.): Summarize the information regarding time, place and person and risk of disease. Question 16 (2 pts.): At this point in the investigation, what hypotheses would you consider regarding mode of transmission of this illness? Question 17 (2 pts.): How would you investigate these hypotheses? [Show More]

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