Activity – Outbreak Investigation Suppose that you are part of a team of communicable disease epidemiologists at the Any Town Health Department (ATHD) in Any Town, Ohio. According to state law, physicians who diagnose or treat cases of specified reportable diseases are required to report those cases to the local health department with jurisdiction over the resident of the patient. In addition, physicians who diagnose or treat multiple cases of disease, that may or may not be specified as reportable, are also required to report those cases to the local health department as a suspected outbreak. In the state of Ohio, cases of infectious disease are reported to the local health department with the “Ohio Confidential Reportable Disease” form. Suppose that your team at ATHD receives three case reports of a suspected community outbreak of gastroenteritis originating from the Any Town Campground in the Any Town National Park. Work with your team to collect the information that you need to provide analyses and identify the source of the outbreak in order to recommend potential public health actions to your health commissioner. It may help to consider the following questions

1) Who will you contact to find out more information about the disease under investigation, the patients that were treated in the hospital, and any laboratory tests that were performed?

2) Who will you contact to find out more about the Any Town Campground and the potential exposure sources? How will you identify all of the campers that may have been exposed?

3) Once you identify all of the campers, how will you find out what each was exposed to and who became ill? How will you record the information?

4) Once you have collected all of the data regarding the disease and potential exposures, what type of analysis will you perform? What measures will you calculate to help identify potential sources of the outbreak? How will you interpret the results?

5) Once you have identified potential exposure sources, what will you do with the information? Will you try to confirm the exact exposure source? Will you involve other health department staff? Will you investigate to see if future campers are at risk?

6) Once you have identified the most likely exposure source, what recommendations will you make to your health commissioner for public health action?

In a real situation of this type, you would have to play the role of an investigator and track down people, conduct interviews, hold meetings, request assistance, gather resources, etc. However, for ease, you have been provided with all of the information you will need to identify the source of this outbreak and prevent future cases. The following documents will help you in this process: