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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
slide5

E. coli

commtechlab.msu.edu

http://www.lbl.gov/

www.nasa.gov

www.geocities.com/avinash_abhyankar/

Salmonella

slide6

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/

viruses
Viruses
  • Not really alive?
  • Require host to reproduce

www.nsf.gov/od/lpa/

slide9

Influenza Virus

Avian Influenza

phil.cdc.gov/Phil/

slide10

www.cdc.gov/ncidod

www.aids-info.ch/bilder/schule_aids

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
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
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
slide20

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

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?
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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