Outbreak Management and High Consequence Infectious Disease

Question 1

List some examples of common outbreaks.

Answer 1

Gastroenteritis
C.difficile infection
MRSA (methicillan resistant straph aureus)
Multi-resistant gram negative bacilli
Influenza / other resp. illness

Question 2

What should a case definition include?

Answer 2

-People involved
-The pathogen
-The place
-Time period

Question 3

What are the three case catergories?

Answer 3

Confirmed
Probably
Possible

Question 4

What is meant by a confirmed case?

Answer 4

Patient has predetermined signs and symptoms or a positive lab test

Question 5

What is meant by a probable case?

Answer 5

Patient has predetermined signs and symptoms or close contact

Question 6

What is meant by a possible cause?

Answer 6

Patient has one or few predetermined signs and symptoms

Question 7

What is meant by a point source?

Answer 7

Source comes from a single person

Question 8

What is meant by a continuous common source?

Answer 8

Ongoing contamination e.g. water source

Question 9

What is meant by propagated source?

Answer 9

Person to person spread

Question 10

What are some of the control measures which should be put into place in an outbreak?

Answer 10

Patient placement
Hand hygiene
PPE
Safe management of care equipment and environment
Stagg
Closure of ward/unit
Waste and linen

Question 11

Give an example of an animal which can spread ebola to humans.

Answer 11

Fruit bat

Question 12

How is ebola transmitted from person to person?

Answer 12

Direct contact with infected bodily fluids

Can spread after death, common in open casket funerals seen in Africa

Question 13

Which regions is Ebola more likely to infect people in?

Answer 13

Central and West Africa

Question 14

Ebola starts with generic symptoms e.g. fever, headache, fatigue etc.
However, which symptoms follow which are characteristic of Ebola?

Answer 14

Internal or external bleeding

Question 15

How is diagnosis of Ebola made?

Answer 15

PCR of blood

Question 16

What is the treatment of Ebola?

Answer 16

Mainly supportive e.g. fluids, oxygen

Ongoing research for antivirals

Question 17

Lassa fever is another viral haemorrhagic fever.

What animal does it come from?

Answer 17

Rats or, Mastomys rodents to be specific ;)

Become infected by their faeces or urine

Question 18

How does transmission of Lassa virus occur?

Answer 18

Human to human transmission via contact with infected bodily fluids

Question 19

Sorry, forgot a question about Ebola, what is the mortality rate like?

Answer 19

Very high- approx. 50% cases result in death

Question 20

What is the incubation period for Ebola?

Answer 20

2-12 days

Question 21

Which areas are endemic of Lassa fever?

Answer 21

West Africa- Nigeria, Sierra Leone, Ghana, Liberia, Benin

Question 22

What is the mortality rate like for Lassa fever?

Answer 22

Quite low, approx !%

Most cases are asymptomatic or mild symptoms with only 1% resulting in severe illness resulting in death

Question 23

What is the incubation period of Lassa fever?

Answer 23

6-21 days

Question 24

Lassa fever also has generic symptoms like weakness, malaise, headache, sore throat, chest pain, diarrhoea, cough etc.
However, what can happen in approx. 25% of cases?

Answer 24

Deafness

->had a wee Google and as far as I can work out, it’s permanent…

Question 25

How is a diagnosis of Lassa fever made?

Answer 25

PCR of blood

Question 26

What's the treatment of Lassa fever?

Answer 26

Supportive Antivirals are experimental

Question 27

CCHF- Crimean-Congo Haemorrhagic Fever..Where is CCHF endemic?

Answer 27

Africa Balkans (Turkey, Bulgaria, Albania, Bosnia, Romania, Croatia, Slovenia, Serbia, etc.) Middle East Asia

Question 28

What are the host of CCHF?

Answer 28

Mammals like goats and cattle

Question 29

How is CCHF spread?

Answer 29

Tick bites or direct contact with infected blood

Question 30

What is the incubation period of CCHF?

Answer 30

Depends of type of transmission Ticks- 1-9 days Blood-1-13 days ->lecturer said for a lot of these conditions, they consider the incubation period to be three weeks after returning and after that, it is assumed any illness if not related to the travel. Obviously some exceptions as some conditions can have incubation periods of a few months

Question 31

What is the mortality rate of CCHF?

Answer 31

High at 30%

Question 32

Again, a lot of the symptoms of CCHF are generic. What are some more suggestive symptoms?

Answer 32

Severe abdominal pain Sore eyes Photophobia

Question 33

What is the management of CCHF?

Answer 33

Supportive Experimental antivirals- Ribavarin

Question 34

Mpox, previously known as Monkeypox, is endemic where?

Answer 34

Central/Western Africa

Question 35

What is the natural reservoir animal of Mpox?

Answer 35

More likely to be rodents but monkeys discovered initially hence the name

Question 36

What is the incubation period of Mpox?

Answer 36

5-21 days

Question 37

Which symptom is more characteristic of Mpox?

Answer 37

Lesions on face, extremities, sometimes genital Lesions evolve in 1-2 day increments Contagious until crust falls off with intact skin underneath

Question 38

MERS?

Answer 38

Middle East Respiratory Syndrome ->same family as Covid but a lot more severe w/ a 35% mortality rate

Question 39

Which animals are thought to be the host of MERS?

Answer 39

Camels

Question 40

How can MERS spread?

Answer 40

Between animals and humans e.g. contact w a camel or consumption of camel milk Droplet spread person to person

Question 41

Symptoms of MERS?

Answer 41

Fever Cough Difficulty breathing Diarrhoea and vomiting

Question 42

What is the treatment of MERS?

Answer 42

Supportive ->basically, a lot of these infectious conditions just require supportive care through fluids and oxygen with more research being done into anti-virals

Question 43

There are four types of influenza, ABCD, which can infect humans?

Answer 43

A- can cause influenza pandemic B- causes seasonal flu C- can infect but very rare

Question 44

If you see a patient in A&E which you suspect of having an infectious disease, what should be done?

Answer 44

Put them in a side room Get their number and take a history on the phone If suspicion still there, they need to be put in a negative pressure room