Dicker.tephinet Case Study Information Form.2011!12!2

Page 5

TEPHINET CASE STUDY INFORMATION FORM

Long Title

An Outbreak of Gastroenteritis Following a Church Supper

Short Title, if any

Oswego

Version (Year)Version CDC Code (YYX-MYY), if any

2007401-N07

Tags / Keywords

Outbreak investigation Steps Epidemic curve Food-specific attack rates Foodborne Staphylococcus

Brief Description

S. aureus outbreak among church picnic attendees, 1940; the classic, straightforward outbreak investigation in a defined population

Objectives

Define the terms cluster, outbreak, and epidemic; List the steps in the investigation of an outbreak; Draw, interpret, and describe the value of an epidemic curve; Calculate and compare food-specific attack rates to identify possible vehicles; List reasons for investigating an outbreak that has apparently ended.

Setting CountrySetting Year

United States1940

Case Study Source InstitutionCase Study Year Written

CDC (EIS)1940

Authors of Original VersionUpdaters, Editor(s)

Wendell Ames, Stafford WheelerAlex Langmuir, Richard Dicker

File Name of Student / Participants GuideFile Name of Instructors Guide

xOswego.participant.401-N07.pdfxOswego.instructor.401-N07.pdf

File Names of Other Required Files for StudentsFile Names of Optional Files for Instructors, Students

xOswego.Ref - Compendium.2006b.pdfxOswego.Ref - Gross.Oswqgo Revisited.PHR 1976.pdfxOswego.Ref - MMWR Supp 2006.pdf

Submitted to TEPHINET bySubmission to TEPHINET on (Date)

Richard C. DickerDec. 23, 2011


Long Title

An Epidemic Disease in South Carolina

Short Title, if any


2010471-510

Tags / Keywords

Outbreak investigation Descriptive epidemiology Generate hypotheses Unknown disease Graphing non-ID

Brief Description

Based on Goldberger's studies of pellagra in the Southeastern United States in the 1910s; uses descriptive epidemiology and biologic categories of disease; presented as an unidentified illness (no clinical info) to focus thinking on epidemiologic features. Good as either introductory (descriptive epi) or wrap-up (epidemiologic reasoning) exercise.

Objectives

Apply the principles of descriptive epidemiology (time, place, person) in the investigation of a disease outbreak;

Characterize the epidemiology of a disease with appropriate tables, graphs, and charts, and generate hypotheses related to etiology.


United States1910s


CDC (EIS)1947


Alex LangmuirRichard Dicker


xUnkDis_SC.participant.471-510.part1.pdfxUnkDis_SC.instructor.471-510.pdf


xUnkDis_SC.participant.471-510.part2.pdfxUnkDis_SC.Ref - Fact Sheet.doc xUnkDis_SC.Ref - Harkness.PHR 1996.pdfxUnkDis_SC.Ref - Marks.2003.pdfxUnkDis_SC.Ref - Rajakumar.2000.pdfxUnkDis_SC.Ref - Schultz.AJE1977.pdfxUnkDis_SC.Ref - WHO 2000.pdf




Long Title

An Outbreak of Jaundice in a Rural County

Short Title, if any

West Branch Hepatitis, Ogemaw County


2011701-X11

Tags / Keywords

Outbreak investigation Case definition Epidemic curve Attack rates Time, place, person Hepatitis A Foodborne

Brief Description

Community outbreak of hepatitis A associated with glazed pastries, 1968; an outbreak investigation in a community.

Objectives

Define the term epidemic,

Create a case definition and explain its importance in an outbreak investigation,

Draw and interpret an epidemic curve,

Calculate an attack rate,

Characterize an outbreak by time, place, and person.


United States1968


CDC (EIS)1970


Virgil Peavy, Fred HoeslyRichard Dicker


xWest Branch Hep.participant.701-X11.pdfxWest Branch Hep.instructor.701-X11.pdf


xWest Branch.ref Schoenbaum.AJE 1976.pdf




Long Title

Epidemic Measles in a Divided City

Short Title, if any

Texarkana


2005711-505

Tags / Keywords

Outbreak investigation Case definition Vaccine efficacy

Attack rates Measles

Brief Description

Measles outbreak in a community on the border of two states the Arkansas side with required school immunization and high immunization rates, the Texas side without required immunization and low immunized rates, 1970.

Objectives

Discuss the advantages and disadvantages of using a sensitive and/or specific case definition in an epidemic investigation;

Calculate vaccine efficacy and discuss its interpretation; and

Discuss the advantages and limitations of selecting a specific age as the recommended target date for administering vaccinations.


United States1970


CDC (EIS)1971


Philip Landrigan, Lyle Conrad, John WitteRichard Dicker


xTexarkana.participant.711-505.pdfxTexarkana.instructor.711-505.pdf


xTexarkana.Ref - Landrigan.JAMA 1972.pdf




Long Title

Cigarette Smoking and Lung Cancer

Short Title, if any


2011731-611

Tags / Keywords

study design Case-control study Prospective cohort study Bias Rate ratio Odds ratio Attributable risk percent Causation Analytic epidemiology non-ID

Brief Description

Based on the classic studies (both case-control study and cohort study of physician mortality) of Doll and Hill, 1950's; addresses study design, interpretation of measures of association, measures of impact, criteria of causation

Objectives

Define case-control and cohort studies and the advantages and disadvantages of each;

List some of the biases that might have affected these studies;

Describe person-time;

Calculate and interpret an odds ratio and a rate ratio; Review the criteria for causation.


United Kingdom1950s


CDC (EIS)1973


Clark Heath, Godfrey Oakley, David Erickson, Howard OryNancy Binkin, Julie Magri, Richard Dicker


xSmoking.Student.731-611.pdfxSmoking.Instructor.731-611.pdf


xSmoke.Ref - RichardDollInterview.pdfxSmoke.Ref - Doll and Hill original pub.pdfxSmoke.Ref - BMJ Doll and Hill followup.pdfxSmoke.Ref - BMJ Stampfer editorial on Doll and Hill followup.pdf




Long Title

An Outbreak of Enteritis During a Pilgrimage to Mecca

Short Title, if any

Mecca


2011801-611

Tags / Keywords

Outbreak investigation Case definition Epidemic curve Food-specific attack rates Foodborne C. perfringens

Brief Description

C. perfringens outbreak among members of the Kuwaiti medical mission during the pilgrimage to Mecca, 1979; a very straightforward outbreak investigation in a defined population with only 3 foods.

Objectives

Define the term epidemic;

Create and understand the uses of a case definition;

Draw an epidemic curve;

Calculate food-specific attack rates;

List the steps in investigating an acute outbreak.


Saudi Arabia1979


CDC (EIS)1980


Fred Hoesly, Virgil PeavyRichard Dicker


xMecca.Participant.801-611.pdfxMecca.Instructor.801-611.pdf





Long Title

Vinyl Chloride Exposure and Angiosarcoma of the Liver

Short Title, if any

Vinyl Chloride, Vinyl Chloride and Cancer


2011773-X11

Tags / Keywords

Cluster Occupational

proportionate mortality ratio (PMR) standardized mortality ratio (SMR) retrospective cohort study person-years

Brief Description

Four cases of hepatic angiosarcoma among polyvinyl chloride workers, 1974; addresses proportionate mortality ratio, standardized mortality ratio, persontime denominators

Objectives

Define and calculate a proportionate mortality ratio (PMR) and standardized mortality ratio (SMR) Discuss the strengths and weaknesses of the retrospective cohort study design, Describe and calculate person-years at risk, Discuss the key issues involved in selecting an appropriate study population.


United States1974


CDC (EIS)1977


Henry Falk, Richard WaxweilerRichard Dicker


xVinyl chloride.Participant.773-X11.pdfxVinyl chloride.Instructor.773-X11.pdf


xVinyl chloride.Ref - Waxweiler.NYAcadSci 1976.pdf




Long Title

Oral Contraceptive Use and Ovarian Cancer

Short Title, if any

OCs and Ovarian Cancer


2011811-X11

Tags / Keywords

data analysis bias case-control study Mantel-Haenszel adjusted odds ratios confidence interval effect modification confounding non-ID

Brief Description

One of the first studies to address the association between oral contraceptive use and ovarian cancer; conducted by CDC using a multicenter case-control study design, 19801982

Objectives

List the elements needed for Informed Consent in an epidemiologic study Outline the sequence of an epidemiologic analysis Discuss the biases of particular concern in case-control studies and ways to minimize their influence Describe why and when to use crude and adjusted odds ratios and 95% confidence intervals, and how to interpret them Define and recognize effect modification and confounding


United States19801981


CDC (EIS)1981


Richard Dicker, Peter LaydeRichard Dicker, Julie Magri


xOCs OvCa.participant.811-X11.pdfxOCs OvCa.Instructor.811-X11.pdf


xOCs OvCa.Ref - JAMA 1983 orig article.pdfxOCs OvCa.Ref - Lancet 2008 analysis.pdfxOCs OvCa.Ref - Lancet 2008 comment.pdfxOCs OvCa.Ref - Lancet 2008 editorial.pdf




Long Title

An Outbreak of Hemorrhagic Fever in Africa

Short Title, if any

Ebola


2010812-N10

Tags / Keywords

Outbreak investigation Unknown cause; steps Case definition Time, place, person Attack rates Modes of transmission Epidemic curve Stratified analysis

Incubation period

Brief Description

Investigation of the first recognized outbreak of Ebola hemorrhagic fever, in Zaire (now DRC), 1976; a practical outbreak investigation

Objectives

List the criteria for deciding whether a field investigation is warranted; Describe the key tasks involved in investigating an epidemic of unknown cause, and, given a real outbreak, perform each step; Describe the components of a case definition, and develop a case definition for a new disease; and Given the appropriate data, perform descriptive epidemiology and explain the importance of this step.


Zaire (now Democratic Republic of Congo)1976


CDC (EIS)1981


David Heymann, Wayne BrownRichard Dicker


xEbola.participant.812-N10.pdfxEbola.instructor. 812-N10.pdf


xEbola.Ref -Nat History.pdf




Long Title

A Mixed Bag in Michigan

Short Title, if any

PBBs in Michigan


2011813-D11

Tags / Keywords

Environmental exposure Sample size Sampling Survey Agency roles Registry Descriptive epidemiology Graphing non-ID

Brief Description

Based on the exposure of farm animals to feed contaminated with polybrominated biphenyl in 1973, and the subsequent concerns about human health.

Objectives

Describe the role of each government agency involved in a contaminated food situation;

Discuss different options for studying the human health effects following an environmental exposure;

Calculate sample size requirements for a community survey;

Discuss the reasons for and limitations of a registry following an environmental exposure.


United States1973


CDC (EIS)1981


Clark HeathTom Gomez, Dori Reissman, Richard Dicker


xPBBs.participant.813-D11.pdfxPBBs.instructor.813-D11.pdf





Long Title

Tampons and Toxic Shock Syndrome

Short Title, if any


2004831-704

Tags / Keywords

Matching Case-control study Data analysis Control selection Odds ratio Bias Confounding

Brief Description

The initial outbreak investigations of toxic shock syndrome in 1980 using a series of matched case-control studies. Case study focuses on matching, secondarily on surveillance.

Objectives

Describe the concepts, applications, and limitations of matching in case-control studies; Analyze matched case-control data; and Discuss the issues involved in appropriate selection of controls in case-control studies.


United States1980


CDC (EIS)1983


Richard Dicker, Ruth BerkelmanRichard Dicker


xTSS.participant.831-704.pdfxTSS.instructor.831-704.pdf


xTSS.Ref - Shands.NEJM 1980.pdfxTSS.Ref - Schlech.JAMA 1982.pdf




Long Title

Screening for Antibodies to the Human Immunodeficiency Virus

Short Title, if any

Screening for HIV


2011871-111

Tags / Keywords

Screening Sensitivity Specificity Predictive value positive Predictive-value negative;

Brief Description

Hypothetical health department anticipating the release of the first HIV antibody test in 1985. Case study focuses on screening issues.

Objectives

Define and perform calculations of sensitivity, specificity, predictive-value of a positive test, and predictive-value of a negative test; Describe the relationship between prevalence and predictive value; Discuss the trade-offs between sensitivity and specificity; List the principles of a good screening program.


United States1985


CDC (EIS)1987


Lyle Peterson, Guthrie Birkhead, Richard DickerRichard Dicker, Julie Magri


xScreeningHIV.student.871-111.pdfxScreeningHIV.instructor.871-111.pdf


xScreeningHIV.Ref - UNC.ERIC.Dx, Screen Tests.pdf




Long Title

An Epidemic of Thyrotoxicosis

Short Title, if any


2003873-703

Tags / Keywords

Outbreak investigation Unknown cause Agency roles Case definition Causation Foodborne non-ID

Brief Description

Outbreak with unknown etiology and mode of transmission, crossing state lines, 1985; a nice wrap-up study, but domestic U.S. focus.

Objectives

Define and perform calculations of sensitivity, specificity, predictive-value of a positive test, and predictive-value of a negative test; Describe the relationship between prevalence and predictive value; Discuss the trade-offs between sensitivity and specificity; List the principles of a good screening program.


United States1985


CDC (EIS)1987


Frederic Shaw, Richard DickerRichard Dicker, Julie Magri


xThyrotox.participant.873-703.pdfxThyrotox.instructor.873-703.pdf


xThyrotox.Ref - Hedberg.NEJM 1987.pdf




Long Title

Paralytic Illness in Ababo

Short Title, if any

Ababo


2011891-N11

Tags / Keywords

incidence, prevalence Case-fatality rate Surveillance Case report form Case definition Sensitivity

Polio Descriptive epidemiology Generate hypotheses Cross-sectional survey

Brief Description

Development of a surveillance system for polio and lameness in a fictitious African country in 1991

Objectives

Define incidence, prevalence, and case-fatality rate; Define surveillance and identify the key features of a surveillance system; List the types of information that should be collected on a surveillance case report form; List the factors that can account for a change in the reported incidence of a disease; Define sensitivity of a surveillance system, and the effect of different case definitions on sensitivity.


Ababo (fictional African country)About 1991


CDC (EIS)1989


Nancy BinkinRichard Dicker


xAbabo.participant.891-N11.pdfxAbabo.instructor.891-N11.pdf





Long Title

l-Tryptophan and Eosinophilia-Myalgia Syndrome

Short Title, if any

EMS


2011901-N11

Tags / Keywords

Surveillance Unknown disease Case definition Case-control study\ Cohort study Bias Risk ratio, odds ratio Attributable risk percent Causation non-ID

Brief Description

National epidemic of a new syndrome in 1989 quickly traced to a commercial product. Case study addresses surveillance, bias, criteria for causation.

Objectives

Discuss issues related to rapid establishment of national surveillance for a newly recognized and little understood disorder;

Discuss development of case definitions;

Describe the elements of design and the advantages and disadvantages of casecontrol versus cohort studies;

Discuss some of the biases that might have affected these studies;

Calculate and interpret a relative risk, odds ratio, and attributable risk percent;

List and evaluate the criteria for causation..


United States1989


CDC (EIS)1990


Leslie Swygert, Richard Dicker Richard Dicker, Philip Brachman


xEMS.participant.901-N11.pdfxEMS.instructor. 901-N11.pdf





Long Title

A Measles Outbreak in a Highly Vaccinated Population

Short Title, if any

Measles in Burundi


2011911-111

Tags / Keywords

Vaccination coverage Sampling WHO EPI Survey Vaccine efficacy Case definition Measles

Brief Description

An outbreak of measles occurred in health sector Muyinga (Burundi), several years into an apparently successful vaccination program. This case study addresses estimation of vaccine coverage and vaccine efficacy in the field.

Objectives

Discuss methods for estimating vaccination coverage; Describe the difference between a convenience sample and a probability sample; Describe the sampling method used in WHO-EPI surveys; and

Calculate and interpret vaccine efficacy.


Burundi1988


CDC (EIS)1991


Robert Chen, Bernard Morniere, Richard DickerRichard Dicker


xBurundi.student.911-111.pdfxBurundi.instructor.911-111.pdf


xBurundi.Ref - bullwho00089-0084.pdf




Long Title

Rapid Assessment of Health Status and Preventive Medicine Needs of Kampuchean Refugees in Thailand

Short Title, if any


2011921-211

Tags / Keywords

Refugees

Surveillance Sampling Survey Age-specific mortality morbidity rate

Anthropometric data Nutrition

Brief Description

Development of surveillance system to identify health problems among Kampuchean (Cambodian) refugees in 1979 and target interventions accordingly.

Objectives

List health problems common among refugee populations; Identify sources of health information on persons living in refugee camps; Calculate crude and age-specific mortality and morbidity rates; Discuss the strengths and weaknesses of different survey methods for assessing the health needs of a displaced population; and Use anthropometric data to determine nutritional status of the population.


Thailand1979


CDC (EIS)1992


Jeanette Stehr-GreenRichard Dicker


xKampucheanRefugee.participant.921-211.pdfxKampucheanRefugee.instructor.921-211.pdf


xRefugee.Ref - MSF.Rapid_Health_Assess.pdfxRefugee.Ref - MSF.Refugee Health 1997.pdf




Long Title

Surveillance for E. coli O157:H7 Information for Action

Short Title, if any


2007941-707

Tags / Keywords

Surveillance Notifiable disease Case report form Descriptive epidemiology Decision-making One Health

Brief Description

Focuses on whether E. coli O157:H7 should be added to Oregons reportable disease list, and the difficulties in dealing with an outbreak apparently linked to raw milk, 1993

Objectives

Discuss the process and criteria for placing a disease or condition on a state or national notifiable disease list;

List the categories of information that should be included in a surveillance instrument;

Summarize and interpret surveillance data;

Recognize difficulties in balancing public health concerns with consumer and industry considerations in emerging issues.


United States1993


CDC (EIS)1994


Julie Crom, Richard DickerRichard Dicker, Julie Magri


xSurveillance E coli.Participant.941-707.pdfxSurveillance E coli.Instructor.941-707.pdf


xSurveillance E coli.Ref - Keene JID 1997.pdf




Long Title

Outbreak of Group A Pharyngitis in Louisiana

Short Title, if any


2011942-211

Tags / Keywords

Outbreak investigation Outbreak steps Case definition Questionnaire

Epidemic curve Food-specific attack rates Epi Info Data analysis Transmission Decision-making

Brief Description

Investigation of an outbreak of Streptococcal pharyngitis traced to foodborne transmission at a school banquet. Case study requires use of Epi Info and two small data files.

Objectives

Define the terms cluster, outbreak, and epidemic;

List the steps of an outbreak investigation;

Create a case definition and explain its importance in an outbreak investigation;

List five types of information to include in an outbreak questionnaire; Draw, interpret, and describe the value of an epidemic curve;

Calculate food-specific attack rates and risk ratios;

Use EPI INFO to perform basic descriptive analysis and cross-tabulations of epidemiologic data.


United States1991


CDC (EIS)1994


Jeanette Stehr-Green, Richard DickerRichard Dicker


xPharyngitis.participant.941-211.pdfxPharyngitis.instructor.942-211.pdf


xPharyngitis.mdbxPharyngitis.Ref - Farley JID 1993.pdf




Long Title

Acute Renal Failure and a Long Night in Haiti

Short Title, if any


2011971-111

Tags / Keywords

Outbreak investigation Outbreak steps Case definition Decision-making

Diethylene glycol

Non-ID

Brief Description

An outbreak of acute renal failure deaths among children in Haiti, eventually traced to paracetamol contaminated with diethylene glycol.

Objectives

Describe the questions and decisions to be addressed before departing on a field investigation;

List the steps of an outbreak investigation;

List the components of a case definition;

Discuss the role of epidemiologic evidence in public health decision-making.


Haiti1996


CDC (EIS)1997


Richard Dicker, Linda DickerRichard Dicker


xARF Haiti.participant.971-111.pdfxARF Haiti.instructor.971-111.pdf


xARF Haiti.Ref - O'Brien Selanikio.JAMA.pdfxARF Haiti.Ref - Woolf.editorial.JAMA.pdf




Long Title

No Fair Warning: An Outbreak Following the 1999 Washington County Fair

Short Title, if any


2005000-805

Tags / Keywords

Outbreak investigation Reasons to investigate Outbreak steps Case definition Epidemic curve E. coli Waterborne Generate hypotheses Choosing controls

Brief Description

Large outbreak of both E. coli and Campylobacter traced to unregulated fairground water supply, 1999; another straightforward outbreak investigation.

Objectives

List the reasons to investigate an outbreak;

List and discuss each step in the investigation of an outbreak;

Describe the features of an appropriate case definition; and

Construct an epidemic curve.


United States1999


CDC (EIS)2000


Richard DickerRichard Dicker


xWashCo Fair.participant.000-805.pdfxWashCo Fair.instructor.000-805.pdf


xWashCo Fair.Ref - MMWR.pdf




Long Title

Public Health Surveillance in New York City Then and Now

Short Title, if any


2010021-310

Tags / Keywords

Surveillance

Case report form Notifiable disease Syndromic

Brief Description

Addresses basic elements of the traditional reportable disease list, as well as syndromic surveillance established after the World Trade Center attacks on September 11, 2001.

Objectives

Define surveillance and identify the key features of a surveillance system;

Apply criteria for deciding which diseases should be included in a notifiable disease surveillance system;

List the types of information that should be collected on a surveillance case report form;

Describe the differences between notifiable disease surveillance and syndromic surveillance.


United States2001


CDC (EIS)2002




xSurv NYC.participant.021-310.pdfxSurv NYC.instructor.021-310.pdf


xSurv NYC.Ref 1 - post-911 surveillance form.pdfxSurv NYC.Ref 2 - U.S. Nationallynotifiable.2011.docxSurv NYC.Ref 3 - Case Report Form examples.pdfxSurv NYC.Ref 4 - 3030G Case Report Form.pdfxSurv NYC.Ref 5 - Doyle.completeness.AJE.pdfxSurv NYC.Ref 6 - Global PH Surv Regs.pdfxSurv NYC.Ref 7 - Reingold.syndromic.pdfxSurv NYC.Ref 8 - DiabetesDiseaseSurv.pdf




Long Title

A Multistate Outbreak of E. coli O157:H7 Infection

Short Title, if any


2002N/A

Tags / Keywords

Outbreak investigation PFGE

Hypothesis-generating interview

Control selection Traceback

E. coli

Alfalfa sprouts

Foodborne

Brief Description

Based on two outbreak investigations undertaken in Michigan and Virginia in 1997, eventually linked to consumption of alfalfa sprouts.

Objectives

Describe the unique role the laboratory can play in the detection and investigation of a foodborne disease outbreak; Perform in-depth interviews of selected case-patients to generate hypotheses about the source of an outbreak and mode of transmission; Determine the most efficient epidemiologic study design to test a hypothesis (including the case definition and appropriate comparison group); List three ways to select a comparison group for a study and the advantages and disadvantages of each method; List detailed product information that will facilitate a traceback procedure; Discuss the relative merits of an intervention based on changes in product processing (or design) versus changes in consumer or producer behaviors.


United States1997


CDC (Food Safety Initiative)2002


Jeanette Stehr-Green


xEcoli Multistate.2002.student.pdfxEcoli Multistate.2002.instructor.pdf





Long Title

Botulism in Argentina

Short Title, if any


2002N/A

Tags / Keywords

Outbreak investigation

Press release Questionnaire Food-specific attack rates Control measures

Botulism Foodborne

Brief Description

Based on an investigation of an outbreak of botulism among bus drivers in Buenos Aires in 1998.

Objectives

Describe outbreak situations in which acute control measures should be undertaken; Communicate information on an outbreak or outbreak investigation and write a press release; Given the leading hypothesis(es) in an outbreak, develop a questionnaire; Given details on the origin, distribution, and preparation of an implicated food item, identify critical points for the control of contamination and microbial survival and growth; Discuss possible barriers to implementation of specific interventions following an outbreak investigation; Describe measures that can be used to monitor the success of an intervention; Describe the occurrence, signs and symptoms, and control of foodborne botulism.


Argentina1998






xBotulismArgentina.2002.student.pdfBotulismArgentina.2002.instructor.pdf


xBotulismArgentina.2002.Ref - Villar.JAMA 1999.pdf




Long Title

Gastroenteritis at a University in Texas

Short Title, if any


2002N/A

Tags / Keywords


Interview; specimens Laboratory Case definition Questionnaire

Generating hypotheses

Norovirus

Foodhandler

Foodborne

Brief Description

Based on an investigation of an outbreak of norovirus gastroenteritis among students at the University of Texas in 1998, eventually traced to a foodhandler who worked in one of the campus cafeterias.

Objectives

List categories and examples of questions that should be asked of key informants who have reported a suspected outbreak of foodborne disease;

List four criteria for establishing investigation priorities when food poisoning is suspected;

List three common pitfalls in the collection of clinical specimens for the investigation of suspected foodborne diseases;

Determine the most efficient epidemiologic study design to test a hypothesis (including the case definition and the appropriate comparison group;

Describe the advantages and disadvantages of different ways of administering questionnaires (e.g.: self-administered, by telephone, in person);

List key areas of focus in interviewing foodhandlers and observing kitchen practices in a foodborne disease outbreak.


United States1998






xGastroenteritisUTexas.student.2002.pdfxGastroenteritisUTexas.instruct.2002.pdf


xGastroenteritisUTexas.Ref - Daniels.JID 2000.pdf




Long Title

A Multistate Outbreak of Cyclosporiasis

Short Title, if any


2004N/A

Tags / Keywords

Outbreak investigation Modes of transmission Incubation period Epidemiologic study Causation Control measures Bias Cyclospora Foodborne

Brief Description

Local outbreak of cyclosporiasis was harbinger of multistate outbreak in 1996-1997; initially thought linked to strawberries, ultimately traced to raspberries from Guatemala.

Objectives

Use the modes of transmission and incubation period for a disease to focus the search for the source of an outbreak; Describe the two most common types of epidemiologic studies routinely used to investigate outbreaks; Interpret the results of an epidemiologic study; Consider potential sources of error in designing or carrying out an epidemiologic study; Apply the criteria for causation to the results of an outbreak investigation; List considerations in implementing control measures before confirmation of the source of an outbreak; Describe the occurrence, signs and symptoms, and control of cyclosporiasis.


United States, Canada (and Guatemala)1996






xCyclosporiasis.student.2004-08.pdfxCyclosporiasis.instructor.2004-08.pdf


xCyclosporiasis.Ref1 - Herwaldt.NEJM 1997.pdfxCyclosporiasis.Ref2 - Herwaldt.Ann IM 1999.pdf




Long Title

Salmonella in the Caribbean

Short Title, if any


2004N/A

Tags / Keywords

Serotyping

Surveillance Laboratory Incidence Time, place, and person (descriptive epidemiology)

Graphs Control measures Eggs

Foodborne

Brief Description

Focus on laboratory-based surveillance of Salmonella in Trinidad and Tobago in 19981999, leading to a case-control study of risk factors for salmonellosis, and to control measures.

Objectives

Describe the signs and symptoms, means of diagnosis, and control of salmonellosis ; Describe how Salmonella serotyping can be used in public health practice; Given a disease, describe the desired characteristics of a surveillance system for that disease; Discuss how the inclusion of the laboratory in the surveillance of a disease impacts the characteristics of the surveillance system and the usefulness of the data; Calculate the incidence of a disease if given the number of cases and population size; Characterize a health problem by time, place, and person (e.g., perform the descriptive epidemiology); Create and interpret a graph; Interpret the measure of association for a case-control study.


Trinidad and Tobago19981999






xSalmonella Carib.2004.student.pdfxSalmonella Carib.2004.instructor.pdf


xSalmonella Carib.Ref - Indar-Harrinauth CID 2001.pdf




Long Title

Riverina

Short Title, if any


2005972-705

Tags / Keywords

Displaced persons

Refugees Mortality rates Morbidity Nutrition data Survey Sampling Anthropometric data Priority setting

Brief Description

Conduct of a rapid health assessment / cluster survey (including anthropometric measures) of an internally displaced population in a fictional African country.

Objectives

List the health problems common among displaced populations.

Identify sources of health information on persons living in displaced-person camps.

Calculate crude and age-specific mortality rates.

Use morbidity, mortality, and nutrition data to identify and prioritize specific health problems in a displaced population and plan interventions.

Plan a community survey based on objectives, resources, and geographic distribution of the population.

Use anthropometric data to determine nutritional status of a population.

Analyze and interpret survey data on nutritional status in order to plan appropriate nutrition programs.


Riverina (fictional country in Africa)Mid-1990s


CDC (Global Health)1997


Michael Toole


X.Eng.Riverina.972-705.student.pdfX.Eng.Riverina.972-705.instructor.pdf





Long Title

Brucellosis in Kyrgyzstan

Short Title, if any


2011053-D11

Tags / Keywords

Public health surveillance

Reportable disease

Case definition Brucellosis

One Health

Brief Description

Examination of the brucellosis public health surveillance system and analysis of data from that system.

Objectives

Describe the key principles of public health surveillance,

Describe criteria for including a disease in a national surveillance system,

Describe the data flow of a surveillance system,

Discuss the advantages and disadvantages of diseases case definition,

Summarize and interpret surveillance data,

Define incidence and prevalence of a disease and calculate the incidence rate.


Kyrgyzstan2003




Julia ErshovaRichard Dicker


xBrucellosis_Kyrgyz.participant.053-D11.pdfxBrucellosis_Kyrgyz.instructor.053-D11.pdf





Long Title

A Cluster of Botulism Cases in Uzbekistan

Short Title, if any


2011054-D11

Tags / Keywords

Outbreak investigation Bioterrorism agents Outbreak steps Case definition

Line listing Food-specific attack rates

Brief Description

Investigation of a cluster of botulism cases among guests who attended a social gathering at a home in Uzbekistan on December 31, 2003. Straightforward outbreak investigation case study with only 24 attendees and 8 foods, but addresses botulism as a possible bioterrorism agent.

Objectives

Assess whether an increase in the number of apparent cases represents an outbreak,

Optional: Describe some of the features that are consistent with an intentional or an unintentional exposure that results in an outbreak,

Describe some of the decisions that must be made before going to the field to conduct a field investigation,

Develop and apply a case definition in a field investigation,

Calculate and compare exposure-specific attack rates to identify possible vehicles.


Uzbekistan2004






XBot in UZ.student.054-D11.pdfXBot in UZ.instructor.054-D11.pdf





Long Title

An Outbreak of Gastroenteritis Among Warehouse Workers

Short Title, if any


2010055-710

Tags / Keywords


Case definition Questionnaire Risk ratio Stratified analysis Foodborne

Brief Description

Investigation of an outbreak of gastroenteritis among workers who ate catered food while taking inventory of a warehouse. Straightforward outbreak investigation case study.

Objectives

Develop a case definition for an outbreak of gastroenteritis,

Discuss why an epidemiologic study with a comparison group is useful in the investigation of an outbreak,

Discuss the types of studies one might conduct in an outbreak setting,

Calculate appropriate measures of association for the type of study selected,

Conduct a stratified analysis to address possible confounding, and

Properly interpret a test of statistical significance and confidence interval.


United States2003






xWarehouseWorkers.participant.055-710.pdfxWarehouseWorkers.instructor.055-710.pdf





Long Title

Botulism in the Republic of Georgia

Short Title, if any


2008071-908

Tags / Keywords

Public health surveillance

Descriptive epidemiology

Sensitivity

Botulism

Brief Description

Analysis by time, place, and person of botulism surveillance data from Republic of Georgia, 1980 2002.

Objectives

After completing this case study, the participant should be able to:

Describe the key principles of public health surveillance,

Analyze surveillance data by time, place, and person,

Interpret surveillance data,

Discuss the uses of surveillance.


Georgia2003




Richard Dicker, Naile Malakmadze, Colleen Shane, and Eric Guenther


xBotulism_in_Georgia.071-908.participant.pdfxBotulism_in_Georgia.071-908.instructor.pdf


xBotGeorgia Ref 5.Varma EID 2004.pdfxBotGeorgia Ref 6.Varma CID 2004.pdfxBotGeorgia Ref 7.Sobel CID 2005.pdfxBotGeorgia Ref 10.Hennessy Rotz.CID 2004.pdf




Long Title

Cryptosporidiosis in Georgia

Short Title, if any


2010N/A

Tags / Keywords

Community survey Sampling Waterborne Cryptosporidium

Brief Description

Investigation of a large, community-wide outbreak of cryptosporidiosis in Georgia in 1987 that resulted from contamination of a public water supply that met all standards in effect at the time.

Objectives

After completing this case study, the student should be able to

1. discuss epidemiologic clues indicative of a waterborne disease outbreak as opposed to a foodborne disease outbreak;

2. describe a boil-water advisory and discuss problems that might be encountered in issuing such an advisory;

3. help plan a community survey to determine the prevalence and distribution of a health problem;

4. interpret a dose-response analysis for an exposure and development of a disease;

5. list activities that should be included in the evaluation of a public water system associated with an outbreak;

6. define turbidity and total coliform count and discuss how each are used to indicate drinking water quality;

7. discuss the typical steps used in the treatment of surface water at a community water treatment plant; and

8. describe the clinical features, epidemiology, and control of cryptosporidiosis.


United States (Georgia)1987


CDC (Waterborne)2010




xCryptospordiosis GA.student.2010-09.pdfxCryptospordiosis GA.instructor.2010-09.pdf


xCryptoGA.Ref - Hayes NEJM 1989.pdf




Long Title

Norovirus in Vermont

Short Title, if any


2010N/A

Tags / Keywords

Swimming pool

Norovirus

Brief Description

Investigation of cluster of cases of vomiting and diarrhea among children who had attended a birthday party at an indoor swim club in Vermont in 2004.

Objectives


1. list categories and examples of questions that should be asked of key informants who report a suspected infectious disease outbreak;

2. discuss considerations in working with businesses that might be identified as a possible source of an outbreak;

3. outline components of swimming pool design and operation that help prevent the transmission of pathogenic agents;

4. discuss the action of chlorine to disinfect water and factors that influence its effectiveness;

5. interpret test results for chlorine and pH with respect to swimming pool water quality;

6. identify activities that increase a persons risk for exposure to pathogens in recreational water;

7. interpret results from a cohort study, including attack rates, relative risks, and P values; and 8. describe the steps for management of fecal incidents in treated recreational water venues.


United States (Vermont)2004






xNorovirus Vermont.student.2010-11.pdfxNorovirus Vermont.instructor.2010-11.pdf


xNorovirusVT.Ref1 - MMWR 2004.pdfxNorovirusVT.Ref2 - Podewils Epi Infect 2007.pdff




Long Title

Typhoid in Tajikistan

Short Title, if any


2010N/A

Tags / Keywords

Case definition

Hypothesis generation

Water supply Control measures

Typhoid fever

Brief Description

Investigation of an outbreak of several thousand cases of Typhoid fever in Dushanbe, Tajikistan in 1997 that resulted from inadequately maintained public water supply.

Objectives


1. list health problems common in countries with economic hardships, deteriorating infrastructure, and displaced populations;

2. discuss the steps typically used to develop hypotheses on the source of an infectious disease outbreak;

3. interpret the results of a matched case-control study;

4. list activities that should be included in the evaluation of a public water system associated with an outbreak;

5. define surface water and groundwater;

6. list the steps in collecting water samples from a point-of-use water tap;

7. describe point-of-use water disinfection and give examples of proven approaches; and 8. describe the clinical features, epidemiology, and control of typhoid fever.


Tajikistan1997






xTyphoid Tajik.student.2010-11.pdfxTyphoid Tajik.instructor.2010-11.pdf


xTyphoid Tajik.Ref1 - MMWR 1998.pdfxTyphoid Tajik.Ref2 - Mermin JID 1999.pdf




Long Title

An Outbreak of Cholera in Parbatia, Orissa, India

Short Title, if any


N/A

Tags / Keywords


Brief Description

Objectives


India


India MAE-FETP2005?


Yvan Hutin


N/A





Long Title

An Outbreak of Acute Hepatitis in Baripada, Orissa

Short Title, if any


N/A

Tags / Keywords


Brief Description

Objectives


India


India MAE-FETP2005?


Yvan Hutin


N/A





Long Title

Causes of Hepatitis B in Kerala, India

Short Title, if any


N/A

Tags / Keywords

Brief Description

Objectives


India


India MAE-FETP2005?


Yvan Hutin


N/A





Long Title

Using Bed Nets Against Malaria in West Bengal

Short Title, if any


N/A

Tags / Keywords

Brief Description

Objectives


India


India MAE-FETP2006?


Yvan Hutin


N/A





Long Title

Analyzing Malaria Surveillance Data in Darjeeling

Short Title, if any


N/A

Tags / Keywords

Brief Description

Objectives


India


India MAE-FETP2005?


Yvan Hutin


N/A





Long Title

Evaluating Public Health Surveillance in the Context of a Chikungunya Outbreak

Short Title, if any


N/A

Tags / Keywords

Brief Description

Objectives


India


India MAE-FETP2006?


Yvan Hutin


N/A





Long Title

Oswego Masala: Constructing and Epidemic Curve

Short Title, if any


N/A

Tags / Keywords

Brief Description

Objectives


India


India MAE-FETP2008


Yvan Hutin


N/A




Dicker.tephinet Case Study Information Form.2011!12!2

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