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Describe the steps you would take if you were leading this outbreak investigation.

For this assignment, you will use your knowledge of the field of epidemiology to outline how you would respond to a real disease outbreak. This case study is based on an investigation conducted by the New York State Department of Public Health Division and is used to train the CDC’s Epidemic Intelligence Service Officers (CDC “disease hunters”). Refer to Chapter 4, page 80 in your textbook for more information on this case.

On April 19, 1940, the local health officer in the village of Lycoming, Oswego County, New York, reported the occurrence of an outbreak of acute gastrointestinal illness to the District Health Officer in Syracuse. Dr. A. M. Rubin, epidemiologist-in-training, was assigned to conduct an investigation. When Dr. Rubin arrived in the field, he learned from the health officer that all persons known to be ill had attended a church supper held on the previous evening, April 18. Family members who did not attend the church supper did not become ill. Accordingly, Dr. Rubin focused the investigation on the supper. He completed interviews with 75 of the 80 persons known to have attended, collecting information about the occurrence and time of onset of symptoms, and foods consumed. Of the 75 persons interviewed, 46 persons reported gastrointestinal illness.

The supper was held in the basement of the village church. Foods were contributed by numerous members of the congregation. The supper began at 6:00 p.m. and continued until 11:00 p.m. Food was spread out on a table and consumed over a period of several hours. Data regarding onset of illness and food eaten or water drunk by each of the 75 persons interviewed are provided in the attached line listing. The approximate time of eating supper was collected for only about half the persons who had gastrointestinal illness.

Reference: Centers for Disease Control and Prevention Epidemiology Program Office Case Studies in Applied Epidemiology No. 401–303 Oswego—An Outbreak of Gastrointestinal Illness Following a Church Supper

Instructions

For this assignment, use the information in the case to answer the following questions. Click on each number for details about the assignment question.

Question 1: Would you call this an epidemic? Would you call it an outbreak?

Question 2: Describe the steps you would take if you were leading this outbreak investigation.

Question 3: The investigators suspected that this was a vehicle-borne outbreak, with food as the vehicle. What is a vehicle? What is a vector?

Question 4: What is the value of an epidemic curve?

Question 5: Using the data in the line listing below, download and complete the attack ratio table (Attached).

You will complete this only for the 40 patients listed in the line listing below instead of the 75 that were interviewed. (Be sure to paste the table into your submission document.)

Which food is the most likely vehicle of infection? Explain your reasoning.