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Hepatitis A Step 2: Establish existence of an outbreak Contacts 1 st case- 2 contacts 2 nd case- 3 contacts 3 rd case- Sexual contacts 3 current boyfriends & fmr.boyfriend - Household contacts Son Mother & Father A Gentleman and Lady & 2 Kids Sister & Boyfriend & 2 Kids

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Step 2 establish existence of an outbreak l.jpg
Step 2: Establish existence of an outbreak

  • Contacts

    • 1st case- 2 contacts

    • 2nd case- 3 contacts

    • 3rd case- Sexual contacts

      • 3 current boyfriends & fmr.boyfriend

        - Household contacts

      • Son

      • Mother & Father

      • A Gentleman and Lady & 2 Kids

      • Sister & Boyfriend & 2 Kids

      • 1 Contact


Slide3 l.jpg

4/30/03

Mother 2/21

Child 2/21

StepFather

S+ 1/15

Girlfriend Sister

T + 2/13

Mother

Girlfriend Sister

Boyfriend

M + 3/25

Hepatitis A Outbreak

Fmr.Boyfriend

Boyfriend

M -

J+ 3/21

F -

Boyfriend

Sister’s Boyfriend

Boyfriend

Sister

Contact

IG Given

Child

IgM +

C

Child

GS JW

J

Household contact

Child


Step 3 verify diagnosis l.jpg
Step 3: Verify Diagnosis

  • 8 individuals with HAV-IgM +

  • All 8 showed signs and symptoms (i.e. jaundice)


Step 4 define identify cases l.jpg
Step 4: Define & Identify Cases

  • Clinical case definition:

    • Discrete onset of symptoms and

    • Jaundice or elevated serum aminotransferase levels

  • Laboratory criteria

    • Immunoglobulin M (IgM) antibody to hepatitis A (anti-HAV) positive


Step 4 define identify cases6 l.jpg
Step 4: Define & Identify Cases

  • Confirmed Case: A case that meetsthe clinical case definition and is laboratory confirmed or for hepatitis A, a case that meets the clinical case definition and occurs in a person who has an epidemiological link with a person who has laboratory-confirmed hepatitis A (i.e. household or sexual contact with an infected person during the 15-50 days before onset of symptoms)

  • 8 Cases of acute hepatitis A



Step 6 develop hypotheses l.jpg
Step 6: Develop Hypotheses

  • M was the index case

    • Did not seek medical care or treatment

  • S wanted to hide his sexual preference and did not expose M

  • Positive individuals did not reveal contacts to LHD thus number of cases increased


Step 9 implement control preventive measures l.jpg
Step 9: Implement Control/Preventive Measures

  • Letter was sent to students of school

  • Prevention messages

    • Always wash your hands after using the bathroom.

    • Always wash your hands after cleaning the toilet.

    • Always wash your hands after changing diapers.

    • Always wash your hands after handling soiled towels or linens.

    • Always wash your hands before fixing food or eating.

    • If exposed to hepatitis A, ask your doctor about immune globulin.


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