Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
2007
401-N07
Tags / Keywords
Outbreak investigation
Steps
Epidemic curve
Food-specific attack rates
Foodborne
Staphylococcus
Brief Description
S. aureus outbreak among church picnic attendees, 1940; the classic, straightforward outbreak investigation in a
defined population
Objectives
Define the terms cluster, outbreak, and epidemic;
List the steps in the investigation of an outbreak;
Draw, interpret, and describe the value of an epidemic curve;
Calculate and compare food-specific attack rates to identify possible vehicles;
List reasons for investigating an outbreak that has apparently ended.
Setting Country
Setting Year
United States
1940
CDC (EIS)
1940
Updaters, Editor(s)
xOswego.participant.401-N07.pdf
xOswego.instructor.401-N07.pdf
xOswego.Ref - Compendium.2006b.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 2
Version (Year)
2010
471-510
Tags / Keywords
Outbreak investigation
Descriptive epidemiology
Generate hypotheses
Unknown disease
Graphing
non-ID
Brief Description
Based on Goldberger's studies of pellagra in the Southeastern United States in the 1910s; uses descriptive epidemiology
and biologic categories of disease; presented as an unidentified illness (no clinical info) to focus thinking on
epidemiologic features. Good as either introductory (descriptive epi) or wrap-up (epidemiologic reasoning) exercise.
Objectives
Apply the principles of descriptive epidemiology (time, place, person) in the investigation of a disease outbreak;
Characterize the epidemiology of a disease with appropriate tables, graphs, and charts, and generate hypotheses
related to etiology.
Setting Country
Setting Year
United States
1910s
CDC (EIS)
1947
Updaters, Editor(s)
Alex Langmuir
Richard Dicker
xUnkDis_SC.participant.471-510.part1.pdf
xUnkDis_SC.instructor.471-510.pdf
xUnkDis_SC.participant.471-510.part2.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 3
2011
701-X11
Tags / Keywords
Outbreak investigation
Case definition
Epidemic curve
Attack rates
Time, place, person
Hepatitis A
Foodborne
Brief Description
Community outbreak of hepatitis A associated with glazed pastries, 1968; an outbreak investigation in a community.
Objectives
Setting Country
Setting Year
United States
1968
CDC (EIS)
1970
Updaters, Editor(s)
Richard Dicker
Submitted to TEPHINET by
Richard C. Dicker
Page 4
2005
711-505
Tags / Keywords
Outbreak investigation
Case definition
Vaccine efficacy
Attack rates
Measles
Brief Description
Measles outbreak in a community on the border of two states the Arkansas side with required school immunization
and high immunization rates, the Texas side without required immunization and low immunized rates, 1970.
Objectives
Discuss the advantages and disadvantages of using a sensitive and/or specific case definition in an epidemic
investigation;
Calculate vaccine efficacy and discuss its interpretation; and
Discuss the advantages and limitations of selecting a specific age as the recommended target date for administering
vaccinations.
Setting Country
Setting Year
United States
1970
CDC (EIS)
1971
Updaters, Editor(s)
Richard Dicker
xTexarkana.participant.711-505.pdf
xTexarkana.instructor.711-505.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 5
Version (Year)
2011
731-611
Tags / Keywords
study design
Case-control study
Prospective cohort study
Bias
Rate ratio
Odds ratio
Attributable risk percent
Causation
Analytic epidemiology
non-ID
Brief Description
Based on the classic studies (both case-control study and cohort study of physician mortality) of Doll and Hill, 1950's;
addresses study design, interpretation of measures of association, measures of impact, criteria of causation
Objectives
Define case-control and cohort studies and the advantages and disadvantages of each;
List some of the biases that might have affected these studies;
Describe person-time;
Calculate and interpret an odds ratio and a rate ratio;
Review the criteria for causation.
Setting Country
Setting Year
United Kingdom
1950s
CDC (EIS)
1973
Updaters, Editor(s)
xSmoking.Student.731-611.pdf
xSmoking.Instructor.731-611.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 6
2011
801-611
Tags / Keywords
Outbreak investigation
Case definition
Epidemic curve
Food-specific attack rates
Foodborne
C. perfringens
Brief Description
C. perfringens outbreak among members of the Kuwaiti medical mission during the pilgrimage to Mecca, 1979; a very straightforward
outbreak investigation in a defined population with only 3 foods.
Objectives
Setting Country
Setting Year
Saudi Arabia
1979
CDC (EIS)
1980
Updaters, Editor(s)
Richard Dicker
xMecca.Participant.801-611.pdf
xMecca.Instructor.801-611.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 7
2011
773-X11
Tags / Keywords
Cluster
Occupational
proportionate mortality ratio (PMR)
standardized mortality ratio (SMR)
retrospective cohort study
person-years
Brief Description
Four cases of hepatic angiosarcoma among polyvinyl chloride workers, 1974; addresses proportionate mortality ratio,
standardized mortality ratio, person-time denominators
Objectives
Define and calculate a proportionate mortality ratio (PMR) and standardized mortality ratio (SMR)
Discuss the strengths and weaknesses of the retrospective cohort study design,
Describe and calculate person-years at risk,
Discuss the key issues involved in selecting an appropriate study population.
Setting Country
Setting Year
United States
1974
CDC (EIS)
1977
Updaters, Editor(s)
Richard Dicker
xVinyl chloride.Participant.773-X11.pdf
xVinyl chloride.Instructor.773-X11.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 8
2011
811-X11
Tags / Keywords
data analysis
bias
case-control study
Mantel-Haenszel adjusted odds ratios
confidence interval
effect modification
confounding
non-ID
Brief Description
One of the first studies to address the association between oral contraceptive use and ovarian cancer; conducted by
CDC using a multicenter case-control study design, 1980-1982
Objectives
Setting Year
United States
19801981
CDC (EIS)
1981
Updaters, Editor(s)
xOCs OvCa.participant.811-X11.pdf
xOCs OvCa.Instructor.811-X11.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 9
2010
812-N10
Tags / Keywords
Outbreak investigation
Unknown cause; steps
Case definition
Time, place, person
Attack rates
Modes of transmission
Epidemic curve
Stratified analysis
Incubation period
Brief Description
Investigation of the first recognized outbreak of Ebola hemorrhagic fever, in Zaire (now DRC), 1976; a practical
outbreak investigation
Objectives
List the criteria for deciding whether a field investigation is warranted;
Describe the key tasks involved in investigating an epidemic of unknown cause, and, given a real outbreak, perform
each step;
Describe the components of a case definition, and develop a case definition for a new disease; and
Given the appropriate data, perform descriptive epidemiology and explain the importance of this step.
Setting Country
Setting Year
1976
CDC (EIS)
1981
Updaters, Editor(s)
Richard Dicker
xEbola.participant.812-N10.pdf
xEbola.instructor. 812-N10.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 10
2011
813-D11
Tags / Keywords
Environmental exposure
Sample size
Sampling
Survey
Agency roles
Registry
Descriptive epidemiology
Graphing
non-ID
Brief Description
Based on the exposure of farm animals to feed contaminated with polybrominated biphenyl in 1973, and the
subsequent concerns about human health.
Objectives
Describe the role of each government agency involved in a contaminated food situation;
Discuss different options for studying the human health effects following an environmental exposure;
Calculate sample size requirements for a community survey;
Discuss the reasons for and limitations of a registry following an environmental exposure.
Setting Country
Setting Year
United States
1973
CDC (EIS)
1981
Updaters, Editor(s)
Clark Heath
xPBBs.participant.813-D11.pdf
xPBBs.instructor.813-D11.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 11
Version (Year)
2004
831-704
Tags / Keywords
Matching
Case-control study
Data analysis
Control selection
Odds ratio
Bias
Confounding
Brief Description
The initial outbreak investigations of toxic shock syndrome in 1980 using a series of matched case-control studies.
Case study focuses on matching, secondarily on surveillance.
Objectives
Describe the concepts, applications, and limitations of matching in case-control studies;
Analyze matched case-control data; and
Discuss the issues involved in appropriate selection of controls in case-control studies.
Setting Country
Setting Year
United States
1980
CDC (EIS)
1983
Updaters, Editor(s)
Richard Dicker
xTSS.participant.831-704.pdf
xTSS.instructor.831-704.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 12
2011
871-111
Tags / Keywords
Screening
Sensitivity
Specificity
Predictive value positive
Predictive-value negative;
Brief Description
Hypothetical health department anticipating the release of the first HIV antibody test in 1985. Case study focuses on
screening issues.
Objectives
Define and perform calculations of sensitivity, specificity, predictive-value of a positive test, and predictive-value of
a negative test;
Describe the relationship between prevalence and predictive value;
Discuss the trade-offs between sensitivity and specificity;
List the principles of a good screening program.
Setting Country
Setting Year
United States
1985
CDC (EIS)
1987
Updaters, Editor(s)
xScreeningHIV.student.871-111.pdf
xScreeningHIV.instructor.871-111.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 13
Version (Year)
2003
873-703
Tags / Keywords
Outbreak investigation
Unknown cause
Agency roles
Case definition
Causation
Foodborne
non-ID
Brief Description
Outbreak with unknown etiology and mode of transmission, crossing state lines, 1985; a nice wrap-up study, but
domestic U.S. focus.
Objectives
Define and perform calculations of sensitivity, specificity, predictive-value of a positive test, and predictive-value of
a negative test;
Describe the relationship between prevalence and predictive value;
Discuss the trade-offs between sensitivity and specificity;
List the principles of a good screening program.
Setting Country
Setting Year
United States
1985
CDC (EIS)
1987
Updaters, Editor(s)
xThyrotox.participant.873-703.pdf
xThyrotox.instructor.873-703.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 14
2011
891-N11
Tags / Keywords
incidence, prevalence
Case-fatality rate
Surveillance
Case report form
Case definition
Sensitivity
Polio
Descriptive epidemiology
Generate hypotheses
Cross-sectional survey
Brief Description
Development of a surveillance system for polio and lameness in a fictitious African country in 1991
Objectives
Setting Country
Setting Year
About 1991
CDC (EIS)
1989
Updaters, Editor(s)
Nancy Binkin
Richard Dicker
xAbabo.participant.891-N11.pdf
xAbabo.instructor.891-N11.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 15
2011
901-N11
Tags / Keywords
Surveillance
Unknown disease
Case definition
Case-control study\
Cohort study
Bias
Risk ratio, odds ratio
Attributable risk percent
Causation
non-ID
Brief Description
National epidemic of a new syndrome in 1989 quickly traced to a commercial product. Case study addresses
surveillance, bias, criteria for causation.
Objectives
Discuss issues related to rapid establishment of national surveillance for a newly recognized and little understood
disorder;
Discuss development of case definitions;
Describe the elements of design and the advantages and disadvantages of case-control versus cohort studies;
Discuss some of the biases that might have affected these studies;
Calculate and interpret a relative risk, odds ratio, and attributable risk percent;
List and evaluate the criteria for causation..
Setting Country
Setting Year
United States
1989
CDC (EIS)
1990
Updaters, Editor(s)
xEMS.participant.901-N11.pdf
xEMS.instructor. 901-N11.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 16
2011
911-111
Tags / Keywords
Vaccination coverage
Sampling
WHO EPI
Survey
Vaccine efficacy
Case definition
Measles
Brief Description
An outbreak of measles occurred in health sector Muyinga (Burundi), several years into an apparently successful
vaccination program. This case study addresses estimation of vaccine coverage and vaccine efficacy in the field .
Objectives
Discuss methods for estimating vaccination coverage;
Describe the difference between a convenience sample and a probability sample;
Describe the sampling method used in WHO-EPI surveys; and
Calculate and interpret vaccine efficacy.
Setting Country
Setting Year
Burundi
1988
CDC (EIS)
1991
Updaters, Editor(s)
Richard Dicker
xBurundi.student.911-111.pdf
xBurundi.instructor.911-111.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 17
Version (Year)
2011
921-211
Tags / Keywords
Refugees
Surveillance
Sampling
Survey
Brief Description
Development of surveillance system to identify health problems among Kampuchean (Cambodian) refugees in 1979
and target interventions accordingly.
Objectives
List health problems common among refugee populations;
Identify sources of health information on persons living in refugee camps;
Calculate crude and age-specific mortality and morbidity rates;
Discuss the strengths and weaknesses of different survey methods for assessing the health needs of a displaced
population; and
Use anthropometric data to determine nutritional status of the population.
Setting Country
Setting Year
Thailand
1979
CDC (EIS)
1992
Updaters, Editor(s)
Jeanette Stehr-Green
Richard Dicker
xKampucheanRefugee.participant.921-211.pdf
xKampucheanRefugee.instructor.921-211.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 18
Version (Year)
2007
941-707
Tags / Keywords
Surveillance
Notifiable disease
Case report form
Descriptive epidemiology
Decision-making
One Health
Brief Description
Focuses on whether E. coli O157:H7 should be added to Oregons reportable disease list, and the difficulties in dealing
with an outbreak apparently linked to raw milk, 1993
Objectives
Discuss the process and criteria for placing a disease or condition on a state or national notifiable disease list;
List the categories of information that should be included in a surveillance instrument;
Summarize and interpret surveillance data;
Recognize difficulties in balancing public health concerns with consumer and industry considerations in emerging
issues.
Setting Country
Setting Year
United States
1993
CDC (EIS)
1994
Updaters, Editor(s)
xSurveillance E coli.Participant.941-707.pdf
xSurveillance E coli.Instructor.941-707.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 19
Version (Year)
2011
942-211
Tags / Keywords
Outbreak investigation
Outbreak steps
Case definition
Questionnaire
Epidemic curve
Brief Description
Investigation of an outbreak of Streptococcal pharyngitis traced to foodborne transmission at a school banquet. Case
study requires use of Epi Info and two small data files.
Objectives
Setting Country
Setting Year
United States
1991
CDC (EIS)
1994
Updaters, Editor(s)
Richard Dicker
xPharyngitis.participant.941-211.pdf
xPharyngitis.instructor.942-211.pdf
xPharyngitis.mdb
Submitted to TEPHINET by
Richard C. Dicker
Page 20
Version (Year)
2011
971-111
Tags / Keywords
Outbreak investigation
Outbreak steps
Case definition
Decision-making
Diethylene glycol
Non-ID
Brief Description
An outbreak of acute renal failure deaths among children in Haiti, eventually traced to paracetamol contaminated with
diethylene glycol.
Objectives
Describe the questions and decisions to be addressed before departing on a field investigation;
List the steps of an outbreak investigation;
List the components of a case definition;
Discuss the role of epidemiologic evidence in public health decision-making.
Setting Country
Setting Year
Haiti
1996
CDC (EIS)
1997
Updaters, Editor(s)
Richard Dicker
xARF Haiti.participant.971-111.pdf
xARF Haiti.instructor.971-111.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 21
Version (Year)
2005
000-805
Tags / Keywords
Outbreak investigation
Reasons to investigate
Outbreak steps
Case definition
Epidemic curve
E. coli
Waterborne
Generate hypotheses
Choosing controls
Brief Description
Large outbreak of both E. coli and Campylobacter traced to unregulated fairground water supply, 1999; another
straightforward outbreak investigation.
Objectives
Setting Country
Setting Year
United States
1999
CDC (EIS)
2000
Updaters, Editor(s)
Richard Dicker
Richard Dicker
xWashCo Fair.participant.000-805.pdf
xWashCo Fair.instructor.000-805.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 22
Version (Year)
2010
021-310
Tags / Keywords
Surveillance
Case report form
Notifiable disease
Syndromic
Brief Description
Addresses basic elements of the traditional reportable disease list, as well as syndromic surveillance established after
the World Trade Center attacks on September 11, 2001.
Objectives
List the types of information that should be collected on a surveillance case report form;
Describe the differences between notifiable disease surveillance and syndromic surveillance.
Setting Country
Setting Year
United States
2001
CDC (EIS)
2002
Updaters, Editor(s)
Richard Dicker
Richard Dicker
xSurv NYC.participant.021-310.pdf
xSurv NYC.instructor.021-310.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 23
Page 24
Version (Year)
2002
N/A
Tags / Keywords
Outbreak investigation
PFGE
Hypothesis-generating interview
Control selection
Traceback
E. coli
Alfalfa sprouts
Foodborne
Brief Description
Based on two outbreak investigations undertaken in Michigan and Virginia in 1997, eventually linked to consumption
of alfalfa sprouts.
Objectives
Describe the unique role the laboratory can play in the detection and investigation of a foodborne disease outbreak;
Perform in-depth interviews of selected case-patients to generate hypotheses about the source of an outbreak and
mode of transmission;
Determine the most efficient epidemiologic study design to test a hypothesis (including the case definition and
appropriate comparison group);
List three ways to select a comparison group for a study and the advantages and disadvantages of each method;
List detailed product information that will facilitate a traceback procedure;
Discuss the relative merits of an intervention based on changes in product processing (or design) versus changes in
consumer or producer behaviors.
Setting Country
Setting Year
United States
1997
2002
Updaters, Editor(s)
Jeanette Stehr-Green
File Name of Student / Participants Guide
xEcoli Multistate.2002.student.pdf
xEcoli Multistate.2002.instructor.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 25
Version (Year)
2002
N/A
Tags / Keywords
Outbreak investigation
Press release
Questionnaire
Brief Description
Based on an investigation of an outbreak of botulism among bus drivers in Buenos Aires in 1998.
Objectives
Setting Country
Setting Year
Argentina
1998
2002
Updaters, Editor(s)
Jeanette Stehr-Green
File Name of Student / Participants Guide
xBotulismArgentina.2002.student.pdf
BotulismArgentina.2002.instructor.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 26
Version (Year)
2002
N/A
Tags / Keywords
Outbreak investigation
Interview; specimens
Laboratory
Case definition
Questionnaire
Generating hypotheses
Norovirus
Foodhandler
Foodborne
Brief Description
Based on an investigation of an outbreak of norovirus gastroenteritis among students at the University of Texas in
1998, eventually traced to a foodhandler who worked in one of the campus cafeterias.
Objectives
List categories and examples of questions that should be asked of key informants who have reported a suspected
outbreak of foodborne disease;
List four criteria for establishing investigation priorities when food poisoning is suspected;
List three common pitfalls in the collection of clinical specimens for the investigation of suspected foodborne
diseases;
Determine the most efficient epidemiologic study design to test a hypothesis (including the case definition and the
appropriate comparison group;
Describe the advantages and disadvantages of different ways of administering questionnaires (e.g.: selfadministered, by telephone, in person);
List key areas of focus in interviewing foodhandlers and observing kitchen practices in a foodborne disease
outbreak.
Setting Country
Setting Year
United States
1998
2002
Updaters, Editor(s)
Jeanette Stehr-Green
File Name of Student / Participants Guide
xGastroenteritisUTexas.student.2002.pdf
xGastroenteritisUTexas.instruct.2002.pdf
Submitted to TEPHINET by
Page 27
Richard C. Dicker
Page 28
Version (Year)
2004
N/A
Tags / Keywords
Outbreak investigation
Modes of transmission
Incubation period
Epidemiologic study
Causation
Control measures
Bias
Cyclospora
Foodborne
Brief Description
Local outbreak of cyclosporiasis was harbinger of multistate outbreak in 1996-1997; initially thought linked to
strawberries, ultimately traced to raspberries from Guatemala.
Objectives
Use the modes of transmission and incubation period for a disease to focus the search for the source of an outbreak;
Describe the two most common types of epidemiologic studies routinely used to investigate outbreaks;
Interpret the results of an epidemiologic study;
Consider potential sources of error in designing or carrying out an epidemiologic study;
Apply the criteria for causation to the results of an outbreak investigation;
List considerations in implementing control measures before confirmation of the source of an outbreak;
Describe the occurrence, signs and symptoms, and control of cyclosporiasis.
Setting Country
Setting Year
1996
2004
Updaters, Editor(s)
Jeanette Stehr-Green
File Name of Student / Participants Guide
xCyclosporiasis.student.2004-08.pdf
xCyclosporiasis.instructor.2004-08.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 29
Version (Year)
2004
N/A
Tags / Keywords
Serotyping
Surveillance
Laboratory
Incidence
Brief Description
Focus on laboratory-based surveillance of Salmonella in Trinidad and Tobago in 19981999, leading to a case-control
study of risk factors for salmonellosis, and to control measures.
Objectives
Describe the signs and symptoms, means of diagnosis, and control of salmonellosis ;
Describe how Salmonella serotyping can be used in public health practice;
Given a disease, describe the desired characteristics of a surveillance system for that disease;
Discuss how the inclusion of the laboratory in the surveillance of a disease impacts the characteristics of the
surveillance system and the usefulness of the data;
Calculate the incidence of a disease if given the number of cases and population size;
Characterize a health problem by time, place, and person (e.g., perform the descriptive epidemiology);
Create and interpret a graph;
Interpret the measure of association for a case-control study.
Setting Country
Setting Year
19981999
2004
Updaters, Editor(s)
Jeanette Stehr-Green
File Name of Student / Participants Guide
xSalmonella Carib.2004.student.pdf
xSalmonella Carib.2004.instructor.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 30
Version (Year)
2005
972-705
Tags / Keywords
Displaced persons
Refugees
Mortality rates
Morbidity
Nutrition data
Survey
Sampling
Anthropometric data
Priority setting
Brief Description
Conduct of a rapid health assessment / cluster survey (including anthropometric measures) of an internally displaced
population in a fictional African country.
Objectives
Setting Country
Setting Year
Mid-1990s
1997
Updaters, Editor(s)
Michael Toole
File Name of Student / Participants Guide
X.Eng.Riverina.972-705.student.pdf
X.Eng.Riverina.972-705.instructor.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 31
Version (Year)
2011
053-D11
Tags / Keywords
Brucellosis
One Health
Brief Description
Examination of the brucellosis public health surveillance system and analysis of data from that system.
Objectives
Setting Country
Setting Year
Kyrgyzstan
2003
2005
Updaters, Editor(s)
Julia Ershova
Richard Dicker
xBrucellosis_Kyrgyz.participant.053-D11.pdf
xBrucellosis_Kyrgyz.instructor.053-D11.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 32
Version (Year)
2011
054-D11
Tags / Keywords
Outbreak investigation
Bioterrorism agents
Outbreak steps
Case definition
Line listing
Food-specific attack rates
Brief Description
Investigation of a cluster of botulism cases among guests who attended a social gathering at a home in Uzbekistan on
December 31, 2003. Straightforward outbreak investigation case study with only 24 attendees and 8 foods, but
addresses botulism as a possible bioterrorism agent.
Objectives
Setting Country
Setting Year
Uzbekistan
2004
2005
Updaters, Editor(s)
Richard Dicker
Richard Dicker
XBot in UZ.student.054-D11.pdf
XBot in UZ.instructor.054-D11.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 33
Version (Year)
2010
055-710
Tags / Keywords
Outbreak investigation
Case definition
Questionnaire
Risk ratio
Stratified analysis
Foodborne
Brief Description
Investigation of an outbreak of gastroenteritis among workers who ate catered food while taking inventory of a
warehouse. Straightforward outbreak investigation case study.
Objectives
Setting Country
Setting Year
United States
2003
2005
Updaters, Editor(s)
Richard Dicker
Richard Dicker
xWarehouseWorkers.participant.055-710.pdf
xWarehouseWorkers.instructor.055-710.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 34
Version (Year)
2008
071-908
Tags / Keywords
Brief Description
Analysis by time, place, and person of botulism surveillance data from Republic of Georgia, 1980 2002.
Objectives
After completing this case study, the participant should be able to:
Describe the key principles of public health surveillance,
Analyze surveillance data by time, place, and person,
Interpret surveillance data,
Discuss the uses of surveillance.
Setting Country
Setting Year
Georgia
2003
2007
Updaters, Editor(s)
xBotulism_in_Georgia.071-908.participant.pdf
xBotulism_in_Georgia.071-908.instructor.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 35
Version (Year)
2010
N/A
Tags / Keywords
Community survey
Sampling
Waterborne
Cryptosporidium
Brief Description
Investigation of a large, community-wide outbreak of cryptosporidiosis in Georgia in 1987 that resulted from
contamination of a public water supply that met all standards in effect at the time.
Objectives
After completing this case study, the student should be able to
1. discuss epidemiologic clues indicative of a waterborne disease outbreak as opposed to a foodborne disease outbreak;
2. describe a boil-water advisory and discuss problems that might be encountered in issuing such an advisory;
3. help plan a community survey to determine the prevalence and distribution of a health problem;
4. interpret a dose-response analysis for an exposure and development of a disease;
5. list activities that should be included in the evaluation of a public water system associated with an outbreak;
6. define turbidity and total coliform count and discuss how each are used to indicate drinking water quality;
7. discuss the typical steps used in the treatment of surface water at a community water treatment plant; and
8. describe the clinical features, epidemiology, and control of cryptosporidiosis.
Setting Country
Setting Year
1987
CDC (Waterborne)
2010
Updaters, Editor(s)
Jeanette Stehr-Green
File Name of Student / Participants Guide
xCryptospordiosis GA.student.2010-09.pdf
xCryptospordiosis GA.instructor.2010-09.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 36
Version (Year)
2010
N/A
Tags / Keywords
Swimming pool
Norovirus
Brief Description
Investigation of cluster of cases of vomiting and diarrhea among children who had attended a birthday party at an
indoor swim club in Vermont in 2004.
Objectives
After completing this case study, the student should be able to
1. list categories and examples of questions that should be asked of key informants who report a suspected infectious
disease outbreak;
2. discuss considerations in working with businesses that might be identified as a possible source of an outbreak;
3. outline components of swimming pool design and operation that help prevent the transmission of pathogenic agents;
4. discuss the action of chlorine to disinfect water and factors that influence its effectiveness;
5. interpret test results for chlorine and pH with respect to swimming pool water quality;
6. identify activities that increase a persons risk for exposure to pathogens in recreational water;
7. interpret results from a cohort study, including attack rates, relative risks, and P values; and
8. describe the steps for management of fecal incidents in treated recreational water venues.
Setting Country
Setting Year
2004
CDC (Waterborne)
2010
Updaters, Editor(s)
Jeanette Stehr-Green
File Name of Student / Participants Guide
xNorovirus Vermont.student.2010-11.pdf
xNorovirus Vermont.instructor.2010-11.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 37
Version (Year)
2010
N/A
Tags / Keywords
Case definition
Hypothesis generation
Water supply
Control measures
Typhoid fever
Brief Description
Investigation of an outbreak of several thousand cases of Typhoid fever in Dushanbe, Tajikistan in 1997 that resulted
from inadequately maintained public water supply.
Objectives
After completing this case study, the student should be able to
1. list health problems common in countries with economic hardships, deteriorating infrastructure, and displaced
populations;
2. discuss the steps typically used to develop hypotheses on the source of an infectious disease outbreak;
3. interpret the results of a matched case-control study;
4. list activities that should be included in the evaluation of a public water system associated with an outbreak;
5. define surface water and groundwater;
6. list the steps in collecting water samples from a point-of-use water tap;
7. describe point-of-use water disinfection and give examples of proven approaches; and
8. describe the clinical features, epidemiology, and control of typhoid fever.
Setting Country
Setting Year
Tajikistan
1997
CDC (Waterborne)
2010
Updaters, Editor(s)
Jeanette Stehr-Green
File Name of Student / Participants Guide
xTyphoid Tajik.student.2010-11.pdf
xTyphoid Tajik.instructor.2010-11.pdf
Submitted to TEPHINET by
Richard C. Dicker
Page 38
Version (Year)
Tags / Keywords
Outbreak investigation
Brief Description
Objectives
Setting Country
Setting Year
India
Case Study Source Institution
India MAE-FETP
2005?
Updaters, Editor(s)
Yvan Hutin
File Name of Student / Participants Guide
Submitted to TEPHINET by
Richard C. Dicker
Page 39
Version (Year)
Tags / Keywords
Outbreak investigation
Brief Description
Objectives
Setting Country
Setting Year
India
Case Study Source Institution
India MAE-FETP
2005?
Updaters, Editor(s)
Yvan Hutin
File Name of Student / Participants Guide
Submitted to TEPHINET by
Richard C. Dicker
Page 40
Version (Year)
Tags / Keywords
Brief Description
Objectives
Setting Country
Setting Year
India
Case Study Source Institution
India MAE-FETP
2005?
Updaters, Editor(s)
Yvan Hutin
File Name of Student / Participants Guide
Submitted to TEPHINET by
Richard C. Dicker
Page 41
Version (Year)
Tags / Keywords
Brief Description
Objectives
Setting Country
Setting Year
India
Case Study Source Institution
India MAE-FETP
2006?
Updaters, Editor(s)
Yvan Hutin
File Name of Student / Participants Guide
Submitted to TEPHINET by
Richard C. Dicker
Page 42
Version (Year)
Tags / Keywords
Brief Description
Objectives
Setting Country
Setting Year
India
Case Study Source Institution
India MAE-FETP
2005?
Updaters, Editor(s)
Yvan Hutin
File Name of Student / Participants Guide
Submitted to TEPHINET by
Richard C. Dicker
Page 43
Version (Year)
Tags / Keywords
Brief Description
Objectives
Setting Country
Setting Year
India
Case Study Source Institution
India MAE-FETP
2006?
Updaters, Editor(s)
Yvan Hutin
File Name of Student / Participants Guide
Submitted to TEPHINET by
Richard C. Dicker
Page 44
Version (Year)
Tags / Keywords
Brief Description
Objectives
Setting Country
Setting Year
India
Case Study Source Institution
India MAE-FETP
2008
Updaters, Editor(s)
Yvan Hutin
File Name of Student / Participants Guide
Submitted to TEPHINET by
Richard C. Dicker
Page 45
Page 46