Investigation of Epidemic
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SarahInvestigation of Epidemic
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INVESTIGATION OF EPIDEMIC
Dr Sara T
EPIDEMIC
The unusual occurrence in a community or region of disease , specific health related behaviour or other health related events clearly in excess of expected occurrence.
OBJECTIVES OF EPIDEMIC INVESTIGATION
Magnitude of epidemic outbreak Conditions and factors responsible Identify cause , source and modes of transmission Recommendations to prevent recurrence.
SIMPLE OUTLINE
EPIDEMIC INVESTIGATION- 10 STEPS
1.
2.
3. 4.
5. 6. 7.
8.
9. 10.
Verification of epidemic Confirmation of existance of epidemic Defining the population at risk Rapid search for all cases and their characteristics Data Analysis Formulation of Hypothesis Testing of Hypothesis Evaluation of ecological factors Further investigation of population at risk Writing the report
TEAM Epidemiologist Clinician Pathologist Entomologist Environmental Specialist Local authorities , people for digging etc.
EQUIPMENT Sample collection bottles/camera Personal protective measures LIASON WITH LOCAL AUTHORITIES
VERIFICATION OF DIAGNOSIS
Clinical examination of cases Laboratory Investigation
CONFIRMATION OF EXISTANCE OF EPIDEMIC
Comparing the disease frequencies during the same period of previous years.
DEFINING THE POPULATION AT RISK
Map of the area Counting the population at risk denominator for caculating rates.
RAPID SEARCH OF ALL CASES AND THEIR CHARACTERISTICS
Medical Surveys To identify all cases and those who have not sought medical care and those possibly exposed to risk. Searching for more cases - May reveal person to person spread
Epidemiological case sheet
DATA ANALYSIS
FORMULATION OF HYPOTHESIS
Formulate hypothesis to explain epidemic in terms of Possible source Causative agent Modes of spread Environmental factors
TESTING OF HYPOTHESIS
Compare attack rate in exposed vs attack rate in non exposed.
EVALUATION OF ECOLOGICAL FACTORS
Ecological factors which have made the epidemic possible should be investigated Water and milk supply Breakdown in water supply system Atmospheric changes
FURTHER INVESTIGATION OF POPULATION AT RISK
Medical examination Screening tests Examination of suspected food,faeces or blood sample Biochemical studies Assesment of Immunity status
WRITING THE REPORT
1.
2. 3. 4. 5.
Contents of report Background Historical Data Methodology of Investigation Analysis of Data Control of measures
At commencement of epidemic , on basis of known facts of disease temporary control measures should be implemented which may be modified or replaced in light of new knowledge acquired by epidemic investigation.
SUMMARY: STEPS IN THE MANAGEMENT OF A COMMUNICABLE DISEASE OUTBREAK BY WHO
1. PREPARATION - Health coordination meetings , Surveillance
system , Outbreak response plan for each disease: resources, skills and activities required , Stockpiles: sampling kits, appropriate antimicrobial, intravenous fluids, vaccines , plans for isolation wards in hospitals , Laboratory support
2. DETECTION - By surveillance system 3. RESPONSE -Confirmation ,Investigation , Control 4. EVALUATION- effectiveness of containment measures , timeliness of outbreak detection and response, change public health policy if indicated (e.g. preparedness) , write and disseminate outbreak report.
THANKYOU
