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Infectious Disease Epi > Class 2- Outbreak Response > Flashcards

Class 2- Outbreak Response Flashcards

1
Q

Elements of the Course of Infection

A
  1. The incubation period
  2. The latent period
  3. The infectious period
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2
Q

The incubation period

A

The time between infection with a disease and the development of symptoms. Dictates when cases will be detected relative to individuals’ time of infection.

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3
Q

The latent period

A

the time between when an individual is infected and when he or she becomes infectious. May be the same about of time as the incubation period.

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4
Q

The infectious period

A

How long is a disease infectious to others?

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5
Q

Force of infection

A

the rate at which susceptible individuals acquire infection at a particular time, regardless of the source.

Force of infection= βI

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6
Q

Key components of analytic studies

A
  • Exposure Assessment
    • Determining the link between exposure (i.e. exposed and unexposed) and outcome of interest.
    • Exposures can be fixed in an individual (genetics) or vary over time (seasonal flu)
  • Outcome Assessment
    • At the end of the period of risk, individuals will be in one of two groups
      • infected or not infected
    • Epidemiology is interested in the rate people move from exposure to outcome.
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7
Q

Steps of Outbreak investigation

A

Step 1. Detect a possible outbreak

Step 2. Find and define cases

Step 3. Investigate cause

Step 4. Conduct analytic study

Step 5. Control measures

Step 6. Conclusions

Step 7. Plans for continued surveillance

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8
Q

Outbreak Investigation Step 1: Detecting a possible outbreak

A

Health surveillance systems are in place to monitor for abnormal trends in disease transmission Informal reports

  • Reports from the community of spreading illness Formal reports
  • Provided by doctors/microbiologist who observe an increase in cases for pathogen x.
    • Tip of the iceberg – what about cases not showing up at health centers?
    • Often, the first illnesses that are recognized are only a small part of the total outbreak.
    • Identify cases, population at risk, and controls
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9
Q

Outbreak Investigation Step 2: Find and define cases

A

Conduct interviews with questions pertaining to:

  • Signs and symptoms
  • Onset of symptoms
  • When did symptoms stop?
  • Sample collection?
  • Respond to Rx (if applicable)
  • Prior behaviors
  • Demographics
  • Potential exposures
    • There might be several case definitions for an outbreak investigation, each with a different purpose.
      • For example, one case definition might be for confirmed illnesses and another for probable illnesses. Understanding transmission mechanisms will assist in confirming the causative agent of interest and source of exposure.
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10
Q

Case count

A

The number of illnesses that meet the case definition Are there secondary cases?

  • Causative agent may be transmissible from person to person
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11
Q

Outbreak Investigation Step 3: Cause investigation

A

Identify common sources of exposure based on interviews, health reports, time lines

Cases can be both suspected or confirmed

Generate hypothesis about exposure

Determine probable route of exposure

  • Routes of exposure?

Component of pathogen discovery

  • Do you now have enough information to determine the pathogen?
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12
Q

Outbreak Investigation Step 4: Conduct analytic study

A

Choosing the correct study design

Determining the correct lab methods

  • By now you should hopefully have an idea of what pathogen you are dealing with:
    • Water/food/air/vector borne
    • bacteria/virus/parasite/prion

What additional tests (measurements) are needed to test sources of exposure

What type of outbreak are you looking at?

  • Point source
  • Continuous
  • Cluster
  • Propagated

Frequencies of exposure to certain sources

Dose response relationships

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13
Q

What is the dose response relationship?

A

Magnitude, duration, and frequency of exposure

  • i.e. 1 slice of contaminated cake vs a whole cake
  • Eaten immediately vs. eaten slowly over the course of a week
  • 1 slice vs 1 slice a day
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14
Q

Types of outbreaks

A
  1. Point source
  2. Continuous
  3. Cluster
  4. Propagated
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15
Q

Outbreak Response Step 5: Control measures

A

Initiating public health interventions

Monitoring and isolating infectious cases

Closing of area of source exposure

Communicating to the public ways to prevent infection

Examples of control measures:

  • Spraying for mosquitoes
  • decontaminating water supplies
  • offering screening
  • providing early treatment
  • rodent control
  • removal of vegetation
  • animal culling
  • vaccination programs
  • mass drug administrations
  • food recalls
    • Methods used vary by outbreak
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16
Q

Outbreak Response Step 6: Dissemination of information to the public and stakeholders

A

How do you know an outbreak is over?

Are there any social/economic ramifications to this outbreak?

  • Communicating with tact
  • Avoiding hysteria
    • Know your audience
  • Speaking with clarity and it terms the community would understand vs. scientific reporting to agency stake holders

What lessons were learned from your outbreak scenario?

Do surveillance and response protocols need to be re-evaluated?

17
Q

Outbreak Response Step 7: Plan for continued surveillance

A

If this is a new pathogen in the community, are plans being set in motion to monitor for the disease?

  • See ebola in Dallas

Do health care providers need additional education on this subject?

Are there more efficient ways to conduct surveillance?

18
Q

Chain of Infection

A
  1. Reservoirs maintain the agent
  2. Mode of transmission is how the agent moves from the reservoir to a host.
  3. Portal of entry=route of exposure
19
Q

What is individual prevention

A

What can “you” do to prevent outbreak

20
Q

What is community prevention

A

What groups/organizations can do to prevent outbreak

21
Q

Individual Prevention Measures

A
  1. Hand washing
  2. Food safety
  3. Male condoms
  4. Personal prevention measures against vector-borne diseases
    1. Avoidance and elimination
    2. Physical barriers
    3. Chemical barriers
    4. Other barriers
    5. Chemoprophylaxis
22
Q

Personal prevention measures against vector-borne diseases:

A
  1. Avoidance and elimination
  2. Physical barriers
  3. Chemical barriers
  4. Other barriers
  5. Chemoprophylaxis
23
Q

Community Prevention Measures

A
  1. Sanitation and water safety Isolation, quarantine, case finding, and contact tracing
  2. Screening of the blood supply
  3. Community prevention measures against vector-borne diseases
  • Environmental management
  • Larval control
  • Chemotherapy
  • Insecticide-treated bednets
  • Indoor residual spraying

Infectious Disease Epi (11 decks)

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