ANSWER THE QUESTIONS BELOW IN DETAILS
Case Study #6
On October 14, 2005, Acute Communicable Disease Control (ACDC) received information from a confirmed giardiasis case stating that her fellow gym members were symptomatic with a similar gastrointestinal illness. ACDC contacted Public Health Nursing in the Foothill Health District (FHD) for further information about giardiasis cases in the area around the gym. A review of giardiasis cases reported since the beginning of August 2005 to October 18, 2005 in the FHD identified 10 laboratory-confirmed cases.
Preliminary findings indicated that all cases resided in the same zip code and all were females between 35 and 77 years of age. Nearly all of the confirmed cases (9 of 10) reported attending a particular gym before onset of symptoms and no other common risk factors could be identified from their epidemiological case history forms.
Onset of illness for these women ranged from August 30 to September 26, 2005. In comparison, no cases with the same characteristics were reported in the FHD in September of the previous year (2004). Due to the increased number of people reported with giardiasis, the temporal clustering of cases, and the association of the cases with the gym, ACDC initiated an outbreak investigation.
ACDC made a site visit to the gym on October 17, 2005. The site supervisor was interviewed about possible drinking water sources, food sources, plumbing problems, and cleaning procedures. A list of self-reported symptomatic members was obtained.
Q.How would you determine the number of cases and contact them for investigation? For controls?
Q.What information would you provide to members and why?
Q.How would you define a confirmed case and how would you define a probable case?
Q.What is the specific time period you would identify for outbreak-associated cases at the gym?
Q.What symptoms would you likely include in a frequency table for your cases?
Q.What study design would you use here?
Q.List all questions you would ask interviewees.
Q.Would you inspect the gym? Why or why not? What would you inspect and why?
Q.What other risk factor (non-gym-related) data would you gather and why?
Q.What specimens would you send to a lab for analysis and what lab tests would you run?
Q.What specific interventions would you perform as a public health professional (e.g. close the gym..etc) and why?