Outbreak
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OUTBREAK!. Portrait of an Epidemic. http://phil.cdc.gov/Phil/details.asp. THE BLACK DEATH. 25 million dead over 5 years One-third of Europe’s population “Victims often had lunch with their friends and dinner with their departed ancestors”. WHAT CAUSES DISEASE. Basically, 4 causes:

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Outbreak

OUTBREAK!

Portrait of an Epidemic

http://phil.cdc.gov/Phil/details.asp


The black death

THE BLACK DEATH

  • 25 million dead over 5 years

  • One-third of Europe’s population

  • “Victims often had lunch with their friends and dinner with their departed ancestors”


What causes disease

WHAT CAUSES DISEASE

  • Basically, 4 causes:

    • Bacteria

    • Viruses

    • Parasites

    • Prions

http://phil.cdc.gov/Phil/details.asp


Bacteria

BACTERIA

http://phil.cdc.gov/Phil/details.asp

  • Not all cause disease

  • Koch’s Postulates

    • Show the bacterium is present in every case of the disease

    • Isolate the bacterium from the infected individual and grow it outside the individual

    • Infect a healthy individual with the bacterium and have it produce the same symptoms

    • Recover the bacterium from the newly sick individual


Outbreak

E. coli

commtechlab.msu.edu

http://www.lbl.gov/

www.nasa.gov

www.geocities.com/avinash_abhyankar/

Salmonella


Outbreak

www.life.umd.edu/classroom/bsci424

Streptococcus

Causes strep throat

Round

phil.cdc.gov/Phil/

www.uiowa.edu/~cemrf/

Borrelia

Causes Lyme disease

Spiral-shaped

phil.cdc.gov/Phil/


Outbreak

phil.cdc.gov/Phil/details.asp

Bacillus anthracis


Viruses

Viruses

  • Not really alive?

  • Require host to reproduce

www.nsf.gov/od/lpa/


Outbreak

Influenza Virus

Avian Influenza

phil.cdc.gov/Phil/


Outbreak

www.cdc.gov/ncidod

www.aids-info.ch/bilder/schule_aids


Outbreak

phil.cdc.gov/Phil/details.asp


Parasites

PARASITES

  • Protists

    • Malaria

    • African sleeping sickness

  • Other parasites

    • Hookworms

    • Wuchereria bancroftii

phil.cdc.gov/Phil/


Prions

PRIONS

  • Bits of self-replicating protein

  • Mad cow disease

  • Creutzfeldt-Jakob

  • Spongiform encephalitis

picasso.ucsf.edu/~ulyanov/Structures/prion.html

phil.cdc.gov/Phil


Investigating an outbreak center for disease control cdc

INVESTIGATING AN OUTBREAKCenter for Disease Control (CDC)

  • Prepare for field work

  • Establish the existence of an outbreak

  • Verify the diagnosis

  • Define and identify the cases

  • Describe and orient the data in terms of time, place, and person

  • Develop hypotheses

  • Evaluate hypotheses

  • Refine hypotheses and carry out additional studies

  • Implement control and prevention measures

  • Communicate findings


Investigating an outbreak center for disease control cdc1

INVESTIGATING AN OUTBREAKCenter for Disease Control (CDC)

  • Prepare for field work

  • Establish the existence of an outbreak

  • Verify the diagnosis

  • Define and identify the cases

  • Describe and orient the data in terms of time, place, and person

  • Develop hypotheses

  • Evaluate hypotheses

  • Refine hypotheses and carry out additional studies

  • Implement control and prevention measures

  • Communicate findings


Outbreak

  • Is the incidence of the disease greater than what is normal for the area and time?


Investigating an outbreak center for disease control cdc2

INVESTIGATING AN OUTBREAKCenter for Disease Control (CDC)

  • Prepare for field work

  • Establish the existence of an outbreak

  • Verify the diagnosis

  • Define and identify the cases

  • Describe and orient the data in terms of time, place, and person

  • Develop hypotheses

  • Evaluate hypotheses

  • Refine hypotheses and carry out additional studies

  • Implement control and prevention measures

  • Communicate findings


Outbreak

INITIALS: CASE #:_______ SEX: ILL? (YES/NO)


Investigating an outbreak center for disease control cdc3

INVESTIGATING AN OUTBREAKCenter for Disease Control (CDC)

  • Prepare for field work

  • Establish the existence of an outbreak

  • Verify the diagnosis

  • Define and identify the cases

  • Describe and orient the data in terms of time, place, and person

  • Develop hypotheses

  • Evaluate hypotheses

  • Refine hypotheses and carry out additional studies

  • Implement control and prevention measures

  • Communicate findings


Outbreak

SGOT 

Alt

SGOT

S*=Sclera;, N=Nausea; V=Vomiting; A=Anorexia; F=Fever; DU=Dark urine; J=Jaundice; HAIgm=Hepatitis AIgM antibody test


Investigating an outbreak center for disease control cdc4

INVESTIGATING AN OUTBREAKCenter for Disease Control (CDC)

  • Prepare for field work

  • Establish the existence of an outbreak

  • Verify the diagnosis

  • Define and identify the cases

  • Describe and orient the data in terms of time, place, and person

  • Develop hypotheses

  • Evaluate hypotheses

  • Refine hypotheses and carry out additional studies

  • Implement control and prevention measures

  • Communicate findings


Legionellosis

LEGIONELLOSIS

  • What Is It? A type of pneumonia caused by the bacterium Legionella pneumophila.

  • Source: Contaminated water sources, such as showers, fountains, cooling systems, humidifiers, hot tubs and spas

  • Cause of Spread: Spray from contaminated sources

  • Normal Incidence: For Virginia, a 5-year average of 20 cases per year (about 2/month).

  • Historical Relevance: 1996 outbreak in the Lynchburg, VA, region. 23 confirmed cases with 2 deaths.

phil.cdc.gov/Phil


Investigating an outbreak center for disease control cdc5

INVESTIGATING AN OUTBREAKCenter for Disease Control (CDC)

  • Prepare for field work

  • Establish the existence of an outbreak

  • Verify the diagnosis

  • Define and identify the cases

  • Describe and orient the data in terms of time, place, and person

  • Develop hypothesis

  • Evaluate hypothesis

  • Refine hypothesis and carry out additional studies

  • Implement control and prevention measures

  • Communicate findings


Calculate an odds ratio

CALCULATE AN ODDS RATIO

(a)(d)/(b)(c) = 5.8


Attack rates by items served at a church supper oswego new york april 1940

Attack Rates by Items Served at a Church Supper,Oswego, New York, April 1940


Investigating an outbreak center for disease control cdc6

INVESTIGATING AN OUTBREAKCenter for Disease Control (CDC)

  • Prepare for field work

  • Establish the existence of an outbreak

  • Verify the diagnosis

  • Define and identify the cases

  • Describe and orient the data in terms of time, place, and person

  • Develop hypothesis

  • Evaluate hypothesis

  • Refine hypothesis

  • Implement control measures

  • Communicate findings


Outbreak at middlin high

OUTBREAK AT MIDDLIN HIGH

  • Students are getting sick …. Why?

  • 15 sick, so far

  • Began getting sick Sunday.

  • It’s now Wednesday… is the epidemic over?


Outbreak

Activity Summary Data Table


You are a cdc investigator

YOU ARE A CDC INVESTIGATOR

  • Your group is a CDC team

  • Your assignment is to investigate the illness, determine its source, and recommend action

  • You must follow the proper CDC steps as previously discussed


Treatments

TREATMENTS

  • Antibiotics

    • Only for bacteria

    • Resistance becoming a problem

  • Innoculations


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