investigation of an outbreak.pptx
TRANSCRIPT
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Investigation of an outbreak
The ten steps
28.11.2012
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*As on October 26, 2012
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Objectives of the investigation
Define magnitude (time, place, person) Determine factors responsible Control the epidemic Prevent
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2.Confirm that these is an outbreak
clearly in excess of
expectations? Even a single case! Compare with previous
years records, otherareas
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3.Define the population at risk
Rough line-listing
People living in X slum,Inmates of a hostel...
Detailed, current map Counting the
population
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4.Develop a valid case definition &
suspect
Fever Joint pain
probable
Fever Joint pain Head ache Eye pain
confirmed
Fever Joint pain Head ache Eye pain Lab. Test
positive
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.&Quick-search for cases
Medical survey Epidemiological case
sheet
Search for more cases
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Refined Line-listing
S.No. Name Age Sex Address-R Address-O Dateof onset
Mainsymptoms/signs
Doctor/Hospital
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5.Analyze the initial data
Time
Epidemic curve Place
Spot map Person
Age, Sex, Occupation,Exposed/non-exposed
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Epidemic curve
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6.Study the ecological factors
Sanitary status of eating/drinking water/milksupply
Movements of humanpopulation
Dynamics of insects/animals
Atmosphere/Pollution
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7.Formulate (tentative) hypothesis
Possible source(s) Causative agent Mode of transmission Environmental factors Control measures to be
initiated
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8.More detailed investigations Among population at risk Examination of
unaffected people,samples of food, blood,faeces
Even clinicallyunapparent cases may be
found Better understanding &Future prevention
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9.Conclude final possible explanation
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10.Report!
Background Historical data Methodology Analysis Control measures
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The ten steps
Confirm the diagnosis Confirm that it is an outbreak Define the population at risk Search for cases & their characteristics Analysis of initial data Study of ecological factors Formation of hypothesis / control measures More detailed investigations Conclude final possible explanation Prepare the report
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References
Epidemiology made easy, Tiwari Poornima, Tiwari Shashank ,Jaypee publications
Parks Textbook of Preventive &Social medicine, 19 th edition
Textbook of Public Health &Community Medicine, Editedby RajVir Bhalwar
Notes of National Institute of Epidemiology for FETP
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Thank you!