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FCPH > outbreak investigation > Flashcards

outbreak investigation Flashcards

1
Q

what is an endemic ?

A

defined as the habitual presence of a disease within a given geaographical area

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2
Q

what is an epidemic ?

A

occurence in a community or region of a group of illnesses

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3
Q

what is a pandemic ?

A

refers to a worldwide epidemic

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4
Q

what is an outbreak ?

A

occurence of more cases of disease than expected in a specific place and time in a specific group of people

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5
Q

what is a cluster ?

A

an aggregation of cases

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6
Q

what factors may change a cluster to become an outbreak ?

A

person
place
time

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7
Q

how can an outbreak be detected ?

A

health personnel
laboratories
newspaper and media
concerned citizens

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8
Q

what are the steps of outbreak investigations ?

A
  1. confirm the existence of an outbreak
  2. verify diagnosis and etiology of the disease
  3. case definition and case finding
  4. describe person, place and time, formulate hypothesis
  5. test hypothesis
  6. carry out additional studies to support epidemiological study
  7. draw conclusions
  8. provide preventative protocol and report
  9. communicate the findings to educate people
  10. follow up the recommendations
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9
Q

when can outbreak be declared ?

A

detection of a single case in a non endemic area
or
after the number of reported cases reaches the threshold incidence rate

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10
Q

what are factors that may affect the reporting of the number of cases ?

A

diagnostic bias
diagnostic errors
seasonal variations
notification artefacts

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11
Q

what are the factors that affect the decision to launch a field investigation ?

A 
severity of the illness 
the transmissibility 
ongoing illness 
availability of control measures 
political considerations
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12
Q

what is the best next step in action once an outbreak has been confirmed ?

A

further investigations

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13
Q

what is case definition ?

A

a standard set of criteria for deciding whether a person should be classified as having the illness or not

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14
Q

what are the different degrees in certainty when it comes to case definiton ?

A

suspect
probable
confirmed

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15
Q

what is the gold standard to diagnose a specific disease ?

A

the case definition

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16
Q

what is the general rule for case finding and case definition ?

A

cast the net wide and get all the fish

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17
Q

what are the different types of surveillance ?

A

active
passive
sentinel
syndromic

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18
Q

what is a line listing ?

A

a list of possible cases based on information collected

19
Q

what points are to be addressed in the descriptive epidemiology part ?

A

time
person
place

20
Q

how is the scourse of an epidemic presented ?

A

through an epidemic curve

21
Q

what does the epidemic curve provide information on ?

A

the course of the epidemic

if the incubation period is known

22
Q

what are the different types of epidemic curves ?

A

point source outbreaks
continuous common source epidemic
propagated epidemic curve ( person to person)

23
Q

what are the features of common source outbreak ?

A

lasts more than one incubation period

cases dont all Happen in one incubation period

24
Q

what is a propagated epidemic curve ?

A

infectious agent is propagated in a community by passage from person to person

25
Q

what are the main features of a propagated curve ?

A

rises and falls gradually

cases occur over a longer period of time (more than one incubation period )

26
Q

what is an example of a common source epidemic ?

A

cholera

27
Q

what is an example of a propagated source ?

A

secondary and tertiary cases ( hepatitis A)

28
Q

when describing the place of which an outbreak happened which rate should be used ?

A

attack rate

29
Q

what are the two ways of evaluating a hypothesis ?

A

analytical epidemiology

comparison of the hypothesis with established facts

30
Q

what is the purpose of analytical epidemiology ?

A

use a comparison group top quantify relationships

31
Q

what is the purpose of comparing the hypothesis with established facts ?

A

evidence is so strong that the hypothesis does not need to be tested

32
Q

what kind of studies can we use to test a hypothesis ?

A

case control

cohort

33
Q

what is the formula for the attack rate ?

A

number of people who got sick
_____________
no of people who are at risk

34
Q

how would the overall attack rate be calculated ?

A

number of new cases
______________
total population

35
Q

what is the excess risk ?

A

the attributable risk

36
Q

how is the attributable risk calculated ?

A

incidence in exposed - incidence in unexposed
___________________
incidence in exposed

37
Q

what is the difference in population between cohort and case control studies ?

A

in cohort - it is a well defined population

case control - not in a well defined population

38
Q

what is the comparitive measure in cohort and in case control ?

A

cohort - compares rate of illness among those with risk factors and those without
case-control - compares exposure among people with illness and those without illness

39
Q

what are the measurement of association a cohort study ?

A

incidence
relative risk
attributable risk

40
Q

what are the measurements of association in a case control study ?

A

odds ratio

proportion of exposure

41
Q

what is the primary goal in outbreak investigations ?

A

control of the outbreak and prevent occurence of additional cases

42
Q

when should control measures be done ?

A

at any time during the outbreak investigation

43
Q

when can we say that an outbreak has ended ?

A

when the number of new illness drops back to the normally expected

FCPH (39 decks)

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