Outbreak Lecture with CDC Representative
Outbreak Lecture with CDC Representative 620
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This 3 page Class Notes was uploaded by Victoria Snow on Sunday September 4, 2016. The Class Notes belongs to 620 at University of North Carolina - Chapel Hill taught by Karin Yeatts in Fall 2016. Since its upload, it has received 27 views. For similar materials see Exploring Public Health in School of Public Health at University of North Carolina - Chapel Hill.
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Date Created: 09/04/16
SPHG 620 9/1/2016 Centers forDiseaseControl& NC Departmentof Health and HumanServices, Divisionof Public Health OutbreakInvestigations-Who,What, Where,and How Thoughts from a Career Epidemiology Field Officer Aaron Fleischauer,PhD Centers for DiseaseControl (CDC)&NC DHHS 2003-SARSoutbreak .Dr.Fleishcauerwas the 1 person inthe world to write about it. Demonstrated that we livein a global economy. This virus was insouthern China,(probs from animal to human). Then the superspreader,traveledto Hong Kong, infected a lot ofpeople, they all infectedother people. Then in days,100s are infected. In Toronto, someone shows up infected. Healthcare workers getinfected, and it just kept spreading. Impacted the economy in China by millions. Deforestation, poverty, more expansion ofpopulous inunpopulated areas are a concern for public health becauseitincreases the risks for zoonotics(diseasethatjumps from animals to humans) Ebola - zoonotic- reservoir probs a bat. CDC has been studying itfor approx 35 years (since1979) It was contained insmall villages inWestAfrica for years. Blood borne pathogen. Ebola blew up there surprisinglybecauseit was in a new part of the region, sopeople did not know a lot about it. Ebola was named after a river. Exploded becauseof: cultural practices,poverty (reallydue to fear of the diseaseand fear of speaking up about having it becausegov would come inand evacuate that “infected” person) in 1/3 of the cases,thereare hemorrhages, after infected has died the family cleans up the bodies but they areinfecting themselves by doing so. CDC did not try and change this practice, but gavethem gloves,inform them on how to be safersothey canbe less susceptibletoinfection. Zika virus -firstseenon islandofYap. Vector-borne from certain type of mosquito. Thosetypes of mosquitos livehere inNC. Causes birth defects when pregnant women are infected. 1 time seeing a mosquito-borne illness causebirthdefect. 10 steps to outbreak but here is anoutline: OutbreakProcedures : 1. What isan outbreak? a. More cases thanwhat is normally seenin a given period of time and in a particular location. Different from “baseline”. b. Look atthe infected people. Do they know eachother? Are they all inthe same town? c. CDC gotreport from orange county and had all cases fromCarborro. 2. Case finding- Interview infected individuals to determine where the outbreak is stemming from. a. What did you eat, did you goto the zoo, did you do any of xyz. b. Looking at patterns and ifgroups of people are similaror different. 3. Diagnosis/labtesting-toseeifthey are the samestrain. a. If they are all the samestrain of salmonella,probably related. b. If different strains,then we are pretty certain it is not related. Salmonella outbreak in CH -bacterial infection that causes diarrhea. About 116cases,all hadsamestrain inthe sameweek. Salmonella typhurmurium. Then he went out and askedthe infected ppl the samequestions from a standardized survey to try and find patterns of behavior. Askabout- food, cheese(bc doctor mentioned a fewpatients had cheese). After the first20 interviews, 15 people saidthey had particular cheese-Chapel Hill creamery cheese. Sent people to the cheesefarm, tested the cheese,and two days later itcame back positive for salmonella. Finishinterviews and lots of people saidthe CH cheese. Then we tested and it was the same strainof salmonella found at the creamery. Then instructed the agriculture director to put out a recall for those cheeses. Pulled all of the cheeseproducts they could find. Shut down cheeseproduction at the creamery. Discussion notes/thoughts: -150ishoutbreaks happen every year inNC. Only investigateda handful. -Noravirus is pretty normal for everyone. But ifit happens in a nursing home, then there a biggerrisk. -Recall bias-peopledon’t remember what they ate/when they ateit. -Every state health dept. mandates a listofabout 75 infectious diseases thatevery physician sends to CDC.There is a massivedatabasefor this.Gonnorrhea is the most reported. -Public health is exempt from HIPPA. That’s why they canlook into it and interview patients. -Pertussis/Whooping cough- vaccine is onlyabout 75% effective