What are the ten steps to an outbreak investigation? - Answer 1) Prepare for field work
2) Establish the existence of an outbreak
3) Verify the diagnosis
4) Define and Identify Cases
5) Perform descriptive epidemiology
6) Develop hypotheses
7) Hypothesis Evaluation
8) Compare and reconcil...
Disease detective 2C: Outbreak
investigation Prep Exam Questions And
Complete Answers.
What are the ten steps to an outbreak investigation? - Answer 1) Prepare for field work
2) Establish the existence of an outbreak
3) Verify the diagnosis
4) Define and Identify Cases
5) Perform descriptive epidemiology
6) Develop hypotheses
7) Hypothesis Evaluation
8) Compare and reconcile with laboratory and/or environmental studies
9) Surveillance and control
10) Communicate finding
What is the first step in an outbreak investigation? - Answer Determine if the observed numbers of
cases exceed the expected level or baseline (i.e. establish existence of an outbreak)
Step 1: Prepare for Field Work - Answer research, gather supplies and equipment to collect data, make
official administrative and personal travel arrangements, establish local contacts, and follow protocol
Step 2: Establish the existence of an outbreak - Answer use records as health dept., hospital records,
death records, physician records, doctor survey to determine expected # for the area in a given time
******numbers may exceed normal due to factors such as better reporting, seasonal fluctuations,
population changes
DETERMINE EXPECTED NUMBER of cases for the area in a given time using health department, hospital,
death, and physician RECORDS AND SURVEYS. Determine FACTORS that may affect the expected number,
which may include better reporting, seasonal fluctuations, and population changes.
, Step 3: Verify the Diagnosis - Answer CHECK DIAGNOSIS PROCEDURES used to diagnose the problem
and the IDENTIFICATION METHODS used to identify infectious and toxic chemical agents. Check for
EXPERIMENTAL LAB ERROR that could have made the number of cases abnormally high. Look for
COMMONALITIES by INTERVIEWING several persons to gain insight concerning possible cause, source,
and spread of disease or problem.
Step 4: Define and Identify Cases - Answer CREATE A CASE DEFINITION by establishing standard criteria
for determining who has the disease/condition: CLINICAL INFORMATION, CHARACTERISTICS of affected
people, LOCATION OR PLACE of infection/outbreak, TIME SEQUENCE during which the outbreak occurred
Step 5 perform descriptive epidemiology - Describe in terms of time, place and period triad - Answer
MAKE A HISTOGRAM showing the course of the disease/outbreak to identify the source of exposure
(Epidemic Curve). PLOT A SPOT MAP and geographic extent to groups specific to a location or
environmental factors. IDENTIFY THE AFFECTED POPULATION in terms of age, sex, behavior, or high risk
exposure.
STEP 6: Develop Hypothesis (Agent/Host/Environment Triad) - Answer DETERMINE AGENT capable of
causing disease and its source, the HOSTS/persons susceptible to agent, and ENVIRONMENT allowing
agent-host contact. Must be TESTABLE and BASED ON CURRENT KNOWLEDGE or UPDATED as new
information is uncovered.
STEP 7: Evaluate Hypothesis - Answer COMPARE HYPOTHESIS to established fact. CONDUCT
OBSERVATIONAL STUDIES using COHORT (exposure to outcome stage) and CASE CONTROL (outcome to
exposure). NEEDS LAB VERIFICATION. Calculate ATTACK RATE AND RISK using cohort. Calculate ODDS
RATIO using case-control.
Step 8 : Compare and reconcile with laboratory and/or environmental studies - Answer Verify the
results of hypothesis against laboratory and/or environmental studies
Step 9: Surveillance: Implement Control and Preventive measures - Answer INFORM people of AGENT
AND SOURCE OF AGENT, SUSCEPTIBILITY OF HOST, and CHAIN OF TRANSMISSION. BREAK the agent-
source-host chain. INTERRUPT CHAIN OF TRANSMISSION OR EXPOSURE with isolation for example.
REDUCE SUSCEPTIBILITY with immunization, education, legal issues.
Step 10: Communicate Findings - Answer INFORM LOCAL HEALTH OFFICIALS in an ORAL BRIEFING.
Create a WRITTEN REPORT in scientific format for future reference, legal issues, and education.
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