Unit 8-9

Question 1

“ongoing/continuous systematic collection, analysis and interpretation of data” and “the application of that data to plan, implement and evaluate public health process/practice.”

Are used to describe/define…

Answer 1

surveillance

Question 2

What is the surveillance cycle?

Answer 2

• data collection
• analysis
• interpretation of data
• dissemination
• action to reduce disease
• improve productivity/health

Question 3

Surveillance allows for ____, _____, ____ the disease in epidemiology.

Answer 3

• recognize
• describe
• control

Question 4

What are 2 surveillance data collection methods?

Answer 4

passive data collection

active data collection

Question 5

What is passive data collection?

Answer 5

data is acquired from other primary sources derived for other purposes
i.e. reports by doctors, hospital information, absentees in school

Question 6

What is active data collection?

Answer 6

data actively searched for and collected for goal of surveillance (targeted surveillance)
i.e. sampling retail meats for pathogens, testing hospital volunteers for TB

Question 7

What are the pros of passive surveillance?

Answer 7

• inexpensive

- useful for diseases that are required to be reported to public health agencies

Question 8

What are the pros of active data collection?

Answer 8

• timely

- accurate

Question 9

What are the cons of passive surveillance?

Answer 9

• time issues, data may not be correct
• may be underreported
• willingness of individuals to ensure information flowing to necessary offices
• data collection between diseases may be inconsistent

Question 10

What are the cons of active surveillance?

Answer 10

• costly
• may require new infrastructure
• time requirements greater
• may be difficult logistically

Question 11

What are 4 types of surveillance?

Answer 11

• lab based surveillance
• sentinel surveillance
• syndromic surveillance
• social media surveillance

Question 12

Indicators are used before confirmed diagnoses or laboratory confirmations to identify outbreaks outlines what type of surveillance?

Answer 12

Syndromic

• useful to identify disease clusters in an outbreak
  i. e. monitoring sale of over the counter drugs

Question 13

Collection of in depth data with hopes that it will represent that broader population outlines what type of surveillance?

Answer 13

Sentinel surveillance

i.e. FoodNet at 3 main locations that monitor reportable illnesses

Question 14

To rely on data produced in clinical/public health labs outlines what type of surveillance?

Answer 14

Lab-based surveillance
- important for detecting changes in presence of behaviour of pathogens and evaluating the impact of prevention and control measures

Question 15

What are 4 issues to surveillance that public health officials encounter?

Answer 15

• underreporting
• lack of denominator (number that are at risk)
• false alarms
• other issues (lack of covariate data or up to date information in passive surveillance)

Question 16

An increase, often sudden, in cases of disease above expected in population is…

Answer 16

an outbreak

Question 17

What is the difference between an outbreak and an epidemic?

Answer 17

outbreak is more localized

epidemic is more widespread (and prolonged)

Question 18

What are the objectives of an outbreak investigation?

Answer 18

• halt progress/spread of disease
• determine reasons for outbreak
• institute corrective measures
• make recommendation to reduce further risk

Question 19

What are the 10 important steps for conducting outbreak investigations?

Answer 19

1. determine existence of outbreak
2. confirm diagnosis
3. prepare for field and assemble team
4. implement immediate control measures
5. define a case and case-finding
6. describe data by time, place, person
7. Develop a hypothesis
8. Test hypothesis - implement studies
9. Implement prevention and control measures
10. disseminate findings, conduct evaluation

Question 20

What are 2 ways an outbreak is detected?

Answer 20

• Community-identified

- Lab-identified

Question 21

If an outbreak is community identified, the next step is to…

Answer 21

lab-confirm diagnosis

Question 22

If an outbreak is lab-identified, the next step is to…

Answer 22

clinically confirm with standardized techniques

Question 23

After preparation and a team is assembled, what is the next step?

Answer 23

implement immediate control measures

Question 24

To attempt to contain the outbreak rapidly, what should be done?

Answer 24

control measures implemented

these should be evidence-based and balance public health with risk of causing unnecessary stress

Question 25

What is a case definition?

Answer 25

a standard set of criteria for deciding whether an individual should be classified as having a condition of interest

Question 26

What are 5 main things a case definition should include?

Answer 26

• agent
• clinical criteria
• person
• place
• time

Question 27

What are 3 types of cases?

Answer 27

• confirmed cases (lab verification)
• probably cases (clinical features but no lab confirmation)
• possible cases (fewer of typical clinical features)

Question 28

Bloody diarrhea (but no culture) in school-aged children residing in Wellington County who had GI symptoms beginning June 4th, 2015, to July 6th, 2015.
This is an example of what type of case?

Answer 28

probable case

Question 29

Residents of, or visitors to, the Capital Health region (metro Edmonton, AB) with Salmonella Heidelberg of a PFGE patterns indistinguishable from pattern SheXAI 0.0001 (national designation) isolated in a clinical specimen collected on or between 1 June and 15 July, 2004.
This is an example of what type of case?

Answer 29

confirmed case

Question 30

Abdominal cramps and diarrhea in school-aged children residing in Wellington County who had GI symptoms beginning June 4th, 2015, to July 6th, 2015.
This is an example of what type of case?

Answer 30

Possible case

Question 31

When individuals are exposed to a common noxious agent, this is called a ____ outbreak

Answer 31

common source outbreak

Question 32

What are 3 types of common source outbreaks?

Answer 32

• point source
• intermittent source
• continuous source

Question 33

Contaminated food product with long shelf life. What type of common source outbreak is this?

Answer 33

• continuous

- epidemic curve has wider peaks, less gaps

Question 34

Contaminated food eaten at a wedding. What type of common source outbreak is this?

Answer 34

Point source

- ill at the end of one incubation period

Question 35

Contaminated cheese sold every weekend at a market. What type of common source outbreak is this?

Answer 35

Intermittent source

Question 36

A disease that spreads slowly from person to person, occurring over more than one incubation period is what type of outbreak?

Answer 36

Propagated outbreak

Question 37

What are 3 options t o develop and test a hypothesis?

Answer 37

• conduct epidemiology study
• conduct trace-back, trace-forward exercise
• perform an environmental investigation

Question 38

What are the options to conducting an epidemiological study?

Answer 38

• retrospective cohort (look back in time to identify exposed and outcome)
• case-control study (group that experienced outcome and group that did not)

Question 39

When implementing measures, what could these measures target?

Answer 39

• agent
• source
• mode of transmission
• portal entry
• host

Question 40

A written report that discusses actions leading to the outbreak, a record of performance, details on medical and/or legal issues, and a record of the events for future situations of similar nature.
These are examples of…

Answer 40

dissemination of findings