Nov.

9, 2020
Laboratory Activity 3.1 (Outbreak Investigation)

Based on the videos you have watched, write a short essay by answering the following
questions.

Video 1: Medical Detectives (Forensic Files)

1. What is the video all about?

2. What is the source of the outbreak?
3. How is it transmitted?
4. Who are affected by the outbreak? Why were they affected?
5. Where did the outbreak happen?
6. What are the factors that played roles in the outbreak?

The Video Entitled “Medical Detectives (Forensic Files) – Season 1, Ep 7:

Legionnaires’ Disease”. From the title itself we can say that the video is about the
Legionnaires’ Disease, which becomes famous due to the its irritating missteps and
frustrations. It is believed by Dr. David W. Fraser that the bacteria came from the air
condition water-cooling towers at the Bellevue Startford Hotel. Inside the cooling
towers are warm water that is cooled down as it cascades over wooden louvers. The
excess water falls into a collection pan at the bottom, where it stagnates if it fails to
drain properly. Investigators believe that the bacteria most likely came from inside
these water cooling units, where the deadly legionella bacteria grew and multiplied.
They believe that the mist containing the bacteria was drawn up into the air by the
unit’s powerful fans. Now, airborne the deadly mist of bacteria and warm water flew
up into the atmosphere and floated down the side of the building, making its way to
the street below. It landed on pedestrians walking by the hotel, which explained the
contraction of some people who are not legionnaire’s. Then the mist was also drawn
into the lobby of the hotel by intake fans on the south side of the building infecting
legionnaires. Inhaling or breathing the contaminated mist resulted to the contraction
of the disease. However, this data was not really confirmed since after they found
out about the nature of this bacteria. The air condition water-cooling towers was
cleaned and the bacteria was gone. The people who are affected by the outbreaks
was the Legionnaires who attended the event in Philadelphia City. The first
Legionnaires who died were James Dolan and John Ralph, which the official cause
of death was Pneumonia. It was identified that most of the people who contracted
the virus was old, Current or former smokers, and people with underlying illnesses.
Since, Employees probably developed an immunity to the bacteria, or weren’t
susceptible to the disease since they are younger and healthier than those who
contracted the disease. The outbreak may happened before, however this outbreak
discovered and started at the summer of 1976 at Philadelphia City, USA. Where the
Legionnaires gather, celebrate and attended the Philadelphia convention of the
American Legion. The factors that played roles in the outbreak was that most of the
people who contracted the outbreak were over aged of 50 years old, current or
former smokers, and has other underlying illnesses.

Video 2: Responding to Outbreaks

1. What is the video all about?

2. What is the disease outbreak that was shown in the video?
3. Where did the outbreak happen? Who were affected?
4. How did the outbreak happen, according to the video?
5. What are the steps/actions taken by the investigation team  (CDC) in
responding to the outbreak? Relate these to the steps of outbreak
investigation?

The video is about the CDC responding to the outbreaks and they also introduce
the Special Pathogen Branch of CDC that responds to the disease outbreak. Hospitals
send specimens to the Special Pathogen Branch, for them to study and identify what
kind of disease outbreak it is. In this case, the video focuses on the disease outbreak
that happened in Western Uganda which is the Ebola Hemorrhagic fever (EHF)
outbreak caused by Bundibugyo Ebola Virus that occurred in Bundibugyo District,
Uganda in 2007. According to Dr. Emmanuel Otaala, the Deputy Minister of Health in
Uganda, they recorded 101 Ebola virus cases. Wherein out of 101, 22 infected patients
already have died. The outbreak is identified to be transmitted to people by bodily fluids.
In addition to that one of the places that people can contract the virus other than the
hospitals are the burials. Since in the Africa they perform a ritual wherein they cleanse
the body resulting to possible transmission of the disease. The Ebola Virus
predominantly affect populations in secluded villages in West and Central Africa,
particularly those close to tropical rainforests. As a response to the Ebola Virus
Outbreak in the Uganda the CDC and the Special Pathogen Branch of CDC will meet
up with the Ministry of Health and with other non-governmental organizations. They
Communicate with them to figure out where they fit in responding to the outbreaks.
Then they send the a team from the Special Pathogen Branch of CDC, wherein they
packed materials, equipment and tests paraphernalia. Once they arrive to the place of
the outbreak they will set-up a laboratory diagnostics. Wherein on a daily bases, the
laboratory receives specimens then the laboratorian tests it to see if its positive or
negative. In addition to that the team also do a community surveillance in-order to
identify the total number of confirmed cases. They will also educate the people on what
are the symptoms you can see if a person has contracted the Ebola virus so that the
community can report any suspected cases of Ebola virus. Once they identify active
cases, they send them to a health care facilities, where health care workers are wearing
PPE. Unfortunately the beginning of an outbreak, health care workers usually don’t
have the proper personal protective equipment. Therefore the CDC also gave out
equipment and personal protective equipment and trains them how to use it properly for
them not to contract the virus. Furthermore to fully understand the virus, the Special
Pathogen Branch has a small ecology unit that investigates the circumstances the
surrounding the spillover of zoonotic disease pathogens into human populations. They
are in-charge in finding the natural reservoir host for the Ebola/Marburg viruses and
where do these viruses circulate in nature?. For them to answer these questions, the
small ecology unit start with doing sampling of the immediate environment. They
gathered information from previous investigations that the species of bat, Rousettus
aegyptiacus. is likely to be the reservoir host. Just like the steps listed for an Outbreak
Investigation. The CDC follow the steps, they prepare the laboratory and equipment
used to respond to the outbreak. They also established the existence of the disease,
where in they communicate with the Ministry of Health in announcing cases of the virus.
They have laboratorian tests specimens to verify the diagnosis. They do a community-
surveillance to identify the total number of confirmed cases. They informed the
community about the disease to describe the epidemiology. The small ecology unit of
the Special Pathogen Branch of CDC develops and evaluates hypothesis, tests possible
reservoir hosts until they determine that the possible reservoir host of the virus is the
Rousettus aegyptiacus. In implementing control measures, they gave out equipment to
health care workers and they also educated people about the virus and to communicate
the findings.