Outbreak investigation assignment Submit Assignment · Due6th Octby23:59 · Points60 ...

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Outbreak investigation assignment

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· Due6^th Octby23:59

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PEH60001 COMMUNICABLE DISEASE CONTROL

Assignment 1: Outbreak Investigation

Due Date:11:59 p.m. AEDT Tuesday 6^thOctober

Weighting: 20% of overall unit grade

Word Count:No word limit but please be succinct.

Submission:Turnitin

This assignment is divided into 4 parts.

Part A (20 marks)

Read the article by Smith et al XXXXXXXXXXand answer the questions below.

Article

Smith, AJ, McCarthy, N, Saldana, L, Ihekweazu, C, McPhedran, K, Adak, GK, Iturriza-Gomara, M, Bickler, G and O’Moore, E 2012, A large foodborne outbreak of norovirus in diners at a restaurant in England between January and February 2009,Epidemiology and Infection, vol. 140, pp XXXXXXXXXX
http://ezproxy.lib.swin.edu.au/login?url=https://search.proquest.com/docview/ XXXXXXXXXX?accountid=14205(Links to an external site.)(Links to an external site.)

Questions

1. The authors state that norovirus is the most common known cause of infectious intestinal disease in Western Europe and North America.
a. What are some of the features of norovirus that makes it so common?(1 mark)
b. Is norovirus a notifiable disease in Victoria?(1 mark)
c. Do you think notification data could be used to accurately estimate the true prevalence of norovirus?(1 mark)
d. What other data might be used to estimate the prevalence of norovirus?(1 mark)

2. What are the three key components of an outbreak investigation? Briefly describe how this study addressed these three components.(3 marks)

3. The authors stated that the delay in reporting the outbreak to the health authority impeded the investigation.
a. What are some possible reasons why customers reported their illness to the restaurant rather than to the health authority?(1 mark)
b. How did the delay impact on the interviews with affected diners? How did the investigators work around this?(1 mark)
c. How did the delay impact on the food and environmental investigations?(1 mark)

4. An analytical study was undertaken to identify risk factors in order to make recommendations to assist in the prevention and control of future outbreaks.
a. What type of analytical study was undertaken?(1 mark)
b. What were the case and control definitions?(1 mark)
c. Why is it important to establish a case definition when investigating an outbreak?(1 mark)
d. Why were staff members also interviewed as part of the investigation?(1 mark)

5. The authors stated that the investigation of staff food handling and hygiene practices was undertaken by interview rather than observation. What are some limitations associated with this method of data collection?(1 mark)

6. Describe the shape of the epidemic curve. What did the epidemic curve reveal about the incubation period and type and magnitude of the outbreak?(1 mark)

7. The univariate analysis found that the oyster, passion fruit jelly, lavender dish had an odds ratio of 18.0. Explain how this was calculated and what it means.(1 mark)

8. Explain why molluscs are susceptible to norovirus contamination and why they are often implicated in foodborne disease.(1 mark)

9. Explain why food handlers likely contributed to this outbreak.(1 mark)

10. What were some of the measures that were suggested to prevent or control outbreaks of this nature in the future?(1 mark)

Part B (15 marks)

Read the article by de Gooyer et al XXXXXXXXXXand answer the questions below.

Article

de Gooyer, TE, Gregory, J, Easton, M, Stephens, N, Fearnley, E and Kirk, M 2017, Waterparks are high risk for cryptosporidiosis: a case-control study in Victoria, 2015,Communicable Diseases Intelligence, vol. 41, no. 2, pp. E143-E149
https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi4102c.htm(Links to an external site.)(Links to an external site.)

Questions

1. The authors state that cryptosporidiosis is the third most commonly notified gastrointestinal disease in Australia.
a. What was the prevalence of the disease in 2014 according to the article?(1 mark)
b. Which notifiable disease group does cryptosporidiosis belong to according to thePublic Health and Wellbeing Regulations2009?(1 mark)

2. Cryptosporidiosis is a type of gastrointestinal illness.
a. Describe the aetiological agent that causes cryptosporidiosis.(1 mark)
b. What is the incubation period for the disease?(1 mark)
c. What are the symptoms of cryptosporidiosis?(1 mark)

3. Explain why swimming pools are commonly implicated in outbreaks of cryptosporidiosis.(1 mark)

4. The authors state that the DHHS detected an increase in cryptosporidiosis in March and April 2015 in one particular region which prompted an epidemiological investigation.
a. What was the aim of the case-control study?(1 mark)
b. What were the case and control definitions?(1 mark)
c. What risk factors were investigated using the telephone questionnaires and which risk factors were found to be significantly associated with illness?(1 mark)
d. The epidemic curve revealed several peaks of onset. What did the authors suggest this meant?(1 mark)

5. An environmental investigation was undertaken as part of the study.
a. What did the environmental investigation by local government environmental health staff reveal as a potential contributing factor to the outbreak?(1 mark)
b. What actions were undertaken by the authorities and water park operators to control the outbreak?(1 mark)

6. What design factors associated with waterparks and toddler pools were identified as increasing the cryptosporidiosis risk of these pools?(1 mark)

7. Explain what the authors mean by “bi-modal age distribution of notification rates of cryptosporidiosis” and “notification bias”.(1 mark)

8. What are some reasons why a microbiological investigation of water from the implicated waterparks was not undertaken?(1 mark)

Part C (8 Marks)

Read through theGuidelines for the Investigation of Gastroenteritisand answer all of the questions below.Each question is worth 1 mark.

Guidelines

https://www2.health.vic.gov.au/about/publications/researchandreports/guidelines-for-investigation-gastroenteritis-for-environmental-health-officers(Links to an external site.)

Questions

1. Identify the legislation which gives powers to EHOs to investigate infectious diseases in Victoria and briefly describe what is meant by the term ‘notifiable diseases’.

2. Describe the privacy legislation which EHOs must be aware of when interviewing cases.

3. Differentiate between a sporadic case, a cluster and an outbreak of gastroenteritis.

4. Describe the key risk factors which must be examined when investigating a single incident case of gastroenteritis.

5. Identify some of the common settings for gastroenteritis outbreaks. Suggest some reasons why gastroenteritis is easily spread in these settings.

6. Describe the different routes by which outbreaks of gastroenteritis may be transmitted.

7. Briefly explain what is involved in Environmental Cleaning following an outbreak of gastroenteritis and differentiate between cleaning and disinfection.

8. Explain what Chain of Custody means and what it involves in relation to investigating outbreaks of gastroenteritis.

Part D (12 marks)

Watch the movieContagion(2011) and answer the questions below.

Questions (adapted from Fuller 2016)

1. How did MEV-1 arise as a new viral pathogen?(1 mark)

2. What is R₀? What is it for MEV-1 and why does it change in the movie?(1 mark)

3. What are the clinical features of the MEV-1 disease? Write a case description as would be released to medical facilities from the CDC as an alert about this virus (e.g. symptoms, incubation period, disease outcomes, etc.)(2 marks)

4. What are the modes of transmission of this pathogen? Give as many as you can using specific examples of characters from the movie.(1 mark)

5. How did MEV-1 become a pandemic?(1 mark)

6. What are some of the economical and societal impacts illustrated in the movie of the virus infection on normal life processes, community life and city life? Do you think these are realistic? Why or why not? You may choose to reflect on the current COVID pandemic to answer this question.(6 marks)

Presentation, spelling and grammar (2 marks)

Please use size 12 font and 1.5 line spacing. Use subheadings for each Assignment Part and number each answer accordingly. Marks will be deducted for spelling, grammar or typographical errors. Marks will also be deducted for overly long answers or answers lacking sufficient detail.

Referencing (3 marks)

Please use Swinburne Harvard Style to cite the articles/movie and any other sources used to support your answers.

Rubric

PG Outbreak Investigation

PG Outbreak Investigation
Criteria	Ratings	Pts
This criterion is linked to a learning outcomePart A		20.0pts
This criterion is linked to a learning outcomePart B		15.0pts
This criterion is linked to a learning outcomePart C		8.0pts
This criterion is linked to a learning outcomePart D		12.0pts
This criterion is linked to a learning outcomePresentation, spelling, grammar		2.0pts
This criterion is linked to a learning outcomeReferencing		3.0pts
Total points:60.0

Sunabh · Accepted Answer

PEH60001 COMMUNICABLE DISEASE CONTROL
ASSIGNMENT 1: OUTBREAK INVESTIGATION
Table of Contents
Part A	4
1.	4
a.	4
b.	4
c.	4
d.	4
2.	4
3.	4
a.	4
b.	4
c.	4
4.	5
a.	5
b.	5
c.	5
d.	5
5.	5
6.	5
7.	5
8.	5
9.	5
10.	5
Part B	6
1.	6
a.	6
b.	6
2.	6
a.	6
b.	6
c.	6
3.	6
4.	6
a.	6
b.	6
c.	6
d.	6
5.	7
a.	7
b.	7
6.	7
7.	7
8.	7
Part C	8
1.	8
2.	8
3.	8
4.	8
5.	8
6.	8
7.	9
8.	9
Part D	10
1.	10
2.	10
3.	10
4.	10
5.	10
6.	10
References	11
Part A
1.
a. 
Norovirus can spread very easily through stool particles, accidental contact with tiny particles from vomit or stool of the infected individual or having direct contact with the infected individual. 
b. 
No, it is not a notifiable disease in Victoria.
c. 
Yes, notification data could be helpful in estimation of prevalence of norovirus because it would facilitate the analysis of real time prevalence of disease along with real time comparison. 
d.
Incidence can also be used to reflect upon the prevalence of disease because it includes both new and existing cases. 
2. 
The three key components of an outbreak investigation are determining the existence of outbreak, confirming or verifying the diagnosis and using descriptive findings to test hypothesis in order to draw conclusions
No, the provided study only presented confirmation of the outbreak and confirmed the diagnosis; however, the study did not present hypothesis testing.
3. 
a.
Lack of awareness, fear of isolation, considering the illness temporary and accompanied with food could be some possible reasons.
b. 
The delay in reporting led to an ongoing risk of exposure to infection for the diners, which did not allow the investigators to implicate appropriate interventions sooner.
c. 
This led to increase in the size of outbreak because there were two transmitters that is, oysters or contaminated food along with infected food handlers at the restaurant.
4. 
a. 
Case-control study was performed
b. 
Cases were anyone with gastrointestinal illness who attended the restaurant from Christmas break re-opening on 6 January 2009 and its voluntary closure on 22 February 2009. Controls were individuals that also belonged to the same group but did not show any symptoms of infection. 
c. 
It helps in the identification of the magnitude of specific disease in a population.
d. 
Staff members were the part of disease transmission.
5. 
Staff members could have lied about their health condition or the information provided.
6. 
Shape of epidemic curve reflected that there was a point source involved that is, a common source of infection and all exposure occurred in a relatively brief period (Smith et al. 2012). 
7. 
Higher odd ratio reflected that the infected foods were consumed and ordered by the case group leading to increased infection. 
8. 
Molluscs can accumulate norovirus through filter feeding and they are often consumed raw or uncooked, which increases the risk of disease spread and infection. 
9.
Food handlers did not report the occurrence of disease during initial stages instead; they further transmitted the disease through the food. 
10.
Early reporting and check-up of the individuals and cooking the food properly
Part B
1. 
a.
In 2014, 2,405 cases were reported that is, 10.2 cases of Cryptosporidium per 100,000 population.
b.
According to Public Health and Wellbeing Regulations 2009,

Outbreak investigation assignment Submit Assignment · Due 6 th Octby23:59 · Points 60 · Submitting a file upload PEH60001 COMMUNICABLE DISEASE CONTROL Assignment 1: Outbreak Investigation Due...

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