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CPH LEC MIDTERMS > Outbreak investigation > Flashcards

Outbreak investigation Flashcards

1
Q

occurrence of more cases of disease than expected in a given area or among a specific group of people over a
particular period of time

A

Outbreak

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2
Q

occurrence of more cases of disease than expected over a larger area than that experienced in an outbreak

A

Epidemic

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3
Q

aggregation of cases in a given are over a period without regard to whether the number of cases is more than expected

A

Disease Cluster

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4
Q

usually, the size of the population at risk is unknown

harder to prevent and control

A

Disease Cluster

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5
Q

First COVID-19 Infections in the Philippines

A

December 2019
January 2020, DOH informed the countr

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6
Q

main objectives of Outbreak Investigation

A

to help guide disease prevention and control strategies

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7
Q

Agents responsible for Outbreak Investigation

A

Local : mesu, cesu
Higher: resu, doh-eb

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8
Q

what are the steps of outbreak investigation

A
  1. Prepare for field work
  2. Establish the existence of the disease
  3. Verify the diagnosis of a case
  4. Construct a working case of definition and search for additional cases
  5. Conduct a descriptive epidemiologic study
  6. Develop hypotheses
  7. Evaluate hypotheses
  8. Refine/ reconsider hypotheses, conduct additional studies if necessary
  9. Implement control and prevention measures
  10. Communicate findings
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9
Q

who made the Steps in Outbreak Investigation

A

US CDC prescribed investigatory steps(1992)

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10
Q

when will the prepare for field work begin

A

begins when the decision from higher health agencies has been made

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11
Q

assembling a multidisciplinary outbreak investigation team and gathering the necessary equipment and supplies to collect the clinical environmental sample

A

Prepare for field work

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12
Q
  • working knowledge or background on the public health concern
  • e.g. different literature articles and studies
A

Scientific Aspect

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13
Q
  • travel arrangements
  • supplies and equipment
  • administrative and scientific
    contacts
  • communication line from the internal and external stakeholders
  • e.g. extra equipment especially disposable equipments
A

Administrative Aspect

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14
Q
  • clear understanding of the role in the field
  • familiarity of the chain of authority involved in the process
  • expertise in clinical medicine, epidemiology, environmental health, microbiology, and et
A

Personal Aspect

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15
Q

review the existing surveillance baseline data

A

Establish the existence of an outbreak

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16
Q

allows the confirmation that reported cases actually have the disease being reported

A

standard diagnostic criteria

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17
Q

How is comparison carried out?

A

▪ compare the currently observed number of cases in previous weeks or months
▪ compare the currently observed number of cases with the number of cases in a comparable period from previous years

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18
Q

▪ needs certain individuals such as Medical Technologists and Doctors
▪ to ensure that disease in question has been
properly identified

A

Verify the diagnosis of cases

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19
Q

the multidisciplinary clinical team should create a case definition and begin to identify cases that may be associated with the outbreak

A

Construct a working case of definition and search for additional cases

20
Q

▪ to rule out laboratory error as the cause of the reported increase in the number of cases

A

Verify the diagnosis of cases

21
Q

in constructing a case definition, we should consider what?

A

consider the time period, incubation period, and location

22
Q

standard set of criteria for deciding whether an individual should be classifies as having the health condition of interest

A

Case Definition

23
Q

Case Definition includes

A
  • clinical criteria – signs and symptoms
  • restrictions by time, place, and person – descriptive epidemiology
24
Q

How do we stratify case?

A

▪ Confirmed
o underwent RT-PCR or there is a
laboratory confirmation
▪ Probable
o meets clinical criteria
o contact of a probable or confirmed
case
▪ Possible (Suspected)
o signs and symptoms only, no
confirmation yet

25
Q

▪ summarizing the person, place, and time variables
▪ uses different bars, charts and epidemic curve

A

Conduct a descriptive epidemiologic study

26
Q

give one objective of Conduct a descriptive epidemiologic study

A

to determine range and extent of the outbreak

to assess the possible source of exposure, mode of transmission, incubation period, environmental, host, or agent factors

to generate hypotheses about the outbreak

27
Q

▪ a visual display of the magnitude and time trend of the outbreak
▪ a histogram or a bar chart that shows the distribution of cases over time

A

Epidemic Curve

28
Q

essential tool in an outbreak investigation and a key feature of descriptive epidemiology

A

Epidemic Curve

29
Q

represents the number of cases (%)

A

y axis

30
Q

represents a timeline (should
begin before the epidemic period, and extend to the period after the epidemic is over)

A

x-axis

31
Q

persons are exposed to the same
source over a relative short period o the curve

has a steep upslope but a
more gradual downslope

only peaks one time

A

Point Source Epidemic (Common Point Source Outbreak)

32
Q

disease agent spread from person to
person with increasing number of
cases in each generation

A

Propagated Epidemic

33
Q

lasts longer than the common source
epidemic

A

Propagated Epidemic

34
Q

o exposure to the agent is sporadic over time
o the curve is irregularly jagged

A

Intermittent Common Source Epidemic

35
Q

exposure duration is prolonged

the curve has a plateau instead of a
peak

exposure persists

A

Continuous Common Source Epidemic

35
Q

serve to document geographic extent
of the problem, and can provide
evidence of clustering

A

Dot Maps

36
Q

suitable when comparing areas with
populations of unequal sizes

A

Maps of Area-specific rates

37
Q

frequency of disease should be
described by ________ (at minimum)

A

age and sex

38
Q

in an outbreak investigation, hypotheses should address:

A
  • source of the exposure to the etiologic agent
  • modes of transmission
  • next steps in the investigation
  • future control measures
38
Q

how is search for specific exposures that have
the strongest association with the disease

A

one by computing for the Relative Risk/OR/Risk Difference

39
Q

describe Retrospective Cohort Study

A

o determining present to future
o small, well-circumcised outbreaks
o incidence is high due to the exposure time and true disease

40
Q

hypotheses are re-examined, refined, and tested throughout the investigation

A

Evaluate hypotheses

41
Q

describe Case-Control Study

A

o determining from past to present
o large, poorly-circumcised outbreaks
o incidence is low due to information or knowledge of the infected individual through surveys and questionnaires

42
Q

how to Implement control and prevention measures

A

epidemiological triad
levels of susceptibility
levels of prevention

43
Q

give to the necessary agencies such as local health agencies, local municipalities, or higher registries (DOH)

A

Communicate findings

43
Q

investigation is not complete until the results are _____

A

disseminated to the public and the profession

44
Q

Forms of the outbreak investigation

A

o oral briefing
o written report
o media

CPH LEC MIDTERMS (4 decks)

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