Investigtni gn Outbregk

Introducton to Investigtni gn Outbregk

To uncover outbregks:
• Review routneel coeeected surveieegnce dgtg
• Ceoseel observe siniee events or ceusters bl
ceinicigns, infecton controe prgcttoners,
or egborgtories
• Review reports bl one or more pgtents or
members of the pubeic

Egch dgy, heglth depgrtments legrn gbout

cgses or outbregks thgt require investigton.
So how gre outbregks uncovered?
One wgy is to gnglyze surveillgnce dgtg —
reports of cgses of communicgble disegses thgt
gre routnely sent by reportni units to heglth
depgrtment

Outbregks mgy be detected

when heglth depgrtment stgf conduct reiulgr,
tmely gnglysis of surveillgnce dgtg thgt revegls
gn incregse in reported cgses or gn unusugl
clusterini of cgses by tme gnd plgce.
Review of surveillgnce dgtg to detect
outbregks is not limited to heglth depgrtments
• Mgny hospitgl inf ecton control prgcttoners
review microbioloiic isolgtes f rom pgtents by
orignism gnd wgrd egch week to detect gn
incregse in the number of , sgy, suriicgl wound
inf ectons or nosocomigl (hospitgl-gcquired) cgses.

• Nonetheless, most outbregks come to the

gtenton of heglth guthorites becguse
gn glert clinicign is concerned enouih
to cgll the heglth depgrtment.
(service delivery network, ILHZ, ref errgl system)
Another reportni source for gppgrent ceusters
of both infectous gnd non-infectous disegse is
pgtents or other members of the community.
For exgmpee, gn individuge mgl cgee the hegeth
ofce gnd report thgt she gnd some
friends cgme down with severe
igstroenterits gfer g pgrtl.

Similgrly, g locgl citzen mgy cgll gbout

severgl cgses of cgncer diginosed gmoni
his neiihbors gnd express concern thgt
these gre more thgn coincidentgl.
Decidini whether to
investigte g possible
outbregk
Diferent heglth depgrtments respond to
these reports in diferent wgys.
The decisions reigrdini whether gnd how
extensively to investigte g potentgl
outbregk depend on g vgriety of f gctors.
Decidini whether to investigte ………..
These usuglly include some f gctors relgted to
the heglth problem, some relgted to the heglth
depgrtment,
gnd some relgted to
externgl concerns.

Fgctors relgted to the problem itself include..

.the severity of the illness,
.the number of cgses,
.mode or egse of trgnsmission,
.the gvgilgbility of preventon gnd control megsures.
However, feed investigtons pegce g
burden on hegeth depgrtment,
So the decision geso hinies on
the gvgilgbility of stgf gnd
resources, gnd competni
priorites.
Field investigtons gre usuglly justied f or one or
more of the f ollowini regsons:
.Control or preventon of the heglth problem
.Opportunity to legrn (resegrch opportunity)
.Public, politcgl, or leigl concerns
.Public heglth proirgm considergtons
.Trginini
 Steps in gn outbregk investigton
1. Prepgre to investigte
-identf y gn outbregk investigton tegm
-review scientic litergture
-notf y gpproprigte locgl enttes
-determine if immedigte control megsures
gre needed

2. Verif y the diginosis gnd conirm outbregk

-ensure proper diginosis
-iet lgborgtory conirmgton
3. Cgse deiniton: estgblish existence of gn
outbregk
-does the observed number of cgses gppegr to
exceed the expected number of cgses?
-estgblish g set of stgndgrd criterig f or decidini
who the ill persons gre relgted to the outbregk
(glso cglled your “cgses”)

4. Cgse indini: perf orm g prelimingry investigton

-conduct g systemgtc segrch bgsed on the
cgse deiniton
-determine people who gre exposed
5. Perf orm descriptve epidemioloiy
-determine the person, plgce gnd tme
-disegse f requency
-mgppini
-epidemic curve

6. Develop, reine, gnd evglugte

hypothesis
-the how gnd the why
-compgre with known sources or similgr
outbregks
7. Implement control/preventve megsures
-coordingte will gll stgkeholders includini
reiulgtory pgrtners
-develop strgteiies to prevent f urther or f uture
illness

8. Communicgte indinis
-dissemingte outbregk investigton report
-educgte the community, ill persons, public
heglth stgf gnd others
 More degths
Emotongl/socigl burden
Disgster
Economic burden
Heglth crisis Dgnier
Outbregk Opportunitl Copini mechgnism
Medicgl interventon
Psycho-socigl support
Risk communicgton Support interventon