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Masters - CDC > Outbreaks > Flashcards

Outbreaks Flashcards

1
Q

Define an outbreak (3 possible definitions)

A

2 or more cases of an infection linked by time, place or person
An increase in cases of a disease over and above the normal background rate
Any case of an infection that doesn’t normally occur in a setting and carries a high public health risk

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2
Q

Name the key stages of managing an outbreak

A
  1. Confirm the diagnosis
  2. Define a case definition and conduct case finding
  3. Collect case information
  4. Analyse data
  5. Interpret data and manage risk
  6. Test hypothesis
  7. Draw conclusions
  8. Prepare written report
  9. Execute control and prevention measures
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3
Q

How can cases be confirmed?

A

Samples from the cases/food/environment

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4
Q

How can cases be defined?

A

By clinical features, by lab results, by epidemiology

Must be appropriate for the area you’re working in, precise and accurate

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5
Q

How are cases found?

A

GPs
Hospital data
Schools etc

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6
Q

What is the difference between a case control and a cohort study?

A

Case control - analyse the difference between case group and control group - must therefore know all cases
Cohort - take data from those affected by the disease - cannot compare

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7
Q

What might you ask in a case studies?

A 
Demographics - age/sex/ethnicity
Details of their illness
Exposure details 
Details of any other known cases
Burden of disease
Recent activities
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8
Q

How should the data be analysed?

A

Epidemiologically -

TIME, PLACE, PERSON, EXPOSURE

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9
Q

What does interpreting the data involve?

A

Establishing whether the outbreak is point source, continuing or propagated

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10
Q

What does the risk assessment identify?

A

Who is at risk?

What is the severity of the disease?

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11
Q

Who might be part of an outbreak control team?

A 
Health protection specialist
Public health officer
Doctors - usually GPs
Microbiologist
Communication leads
School teachers/nurse
Education representative
Local council
Environmental specialist if relevant
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12
Q

What is a point source outbreak - give an example of a disease that could cause a point source outbreak

A

Source infects cases at one particular location over a short period of time
Eg: Hepatitis A,

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13
Q

What is a continuing source outbreak and give an example

A

When all/most cases are infected by the same source but over a long period of time
Eg: GE

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14
Q

What is a propagated/case-to-case outbreak and give an example

A

Communicable through human transmitted - the causative agent is propagated within the population
Eg: TB, HIV, STIs,

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15
Q

What are the aims of outbreak investigation/management?

A

Minimise the number of primary cases
Minimise the number of secondary cases
Identify and eliminate sources of infection
Introduce measures to prevent future outbreaks

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16
Q

What features of outbreak data and information are essential?

A 
Accuracy
Consistency
Freedom from bias
Confidentiality
Security
Accessibility
17
Q

What is the odds ratio?

A

Calculate the approximate relative risk of developing a disease

18
Q

How is odds calculated?

A

Odds= risk of event A occuring / risk of event B occuring

19
Q

How is odds ratio calculated?

A

Odds 1 / Odds 2

Odds 1= cases with exposure / cases without exposure
Odds 2 = controls with exposure / controls without exposure

20
Q

In an outbreak of a disease transmitted faeco-orally (eg: food poisoning) name some features of the outbreak management

A 
Identify causative microbiological agent
Obtain stool samples
Collect clinical details
Exclude cases from work/school
Provide hygiene advice 
Check food hygiene and safety standards
Check infection control practices
21
Q

In an airborne disease outbreak such as TB/influenza - name some features of the outbreak management

A

Test to confirm strain type/microbiological agent
Mass Immunisations
Chemoprophylaxis
Reinforce hygiene measures

22
Q

In a blood-borne disease outbreak - name some features of outbreak management

A

Testing for viral cause
Look for a potential common source
Education advice
Enhanced surveillance??

23
Q

How would you manage a blood exposure incident?

A

Wash the wound with soap and water
Test the source (eg: if came from a patients blood sample)
Give PEP if HIV risk
Accelerated Hep B vaccination schedule

24
Q

In a vector-borne outbreak what should you consider in outbreak management?

A

Reviewing travel advice
Testing to confirm diagnosis
Treat patient
Minimise vector transmission - insecticides, molliscides etc.
If not endemic - notify authorities (eg: malaria in the UK)

25
Q

In a direct contact outbreak for an STI for example - what should you consider in outbreak management?

A

Active surveillance
Contact tracing
Mapping sexual networks

26
Q

In a HCAI outbreak - what should you consider in the outbreak management?

A

Confirm that cases are linked by the same microorganism/virus
Screen staff
Environmental investigation - identify a source?
Review clinical infection control practices
Restrict hospital admissions
Limit number of visitors

27
Q

In an emerging infection such as Ebola - what should you consider in the outbreak management?

A

Prompt/safe burial of the deceased
Monitor contacts of infected persons
Isolate infected cases
Maintain good hygiene and clean environment

28
Q

Give 4 prevention strategies for a pandemic of influenza

A

International surveillance
Virus research
Stockpiling drugs

29
Q

Alongside the main stages of outbreak investigation - what should be done concurrently?

A

Take samples
Instigate control measures
Convene an outbreak control group
COMMUNICATION

30
Q

Who should be contacted if an outbreak occurs?

A

Local authorities
Relevant local institution
GOARN (Global Outbreak Alert and Response Network)

31
Q

What are the benefits of partner notification in STI/HIV control?

A

Prevents further transmission
Prevents re-infection of the index patient
Prevents complications of an untreated infection

Masters - CDC (6 decks)

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