Case Study: Gastrointestinal Illness on a College Campus

Group Brainstorm

Choose one member of the team to record responses. As a group, discuss the following question.

 

Question 1: What questions do you ask Sheila during this phone call?

Question 2: What diseases would you suspect at this point?

Question 3: What, if any, clinical specimens should be collected from the ill students? Who is responsible for collecting the specimens? Where should the specimens be sent?

Question 4: Of the diseases listed above, norovirus is the only one which is not routinely tested by the State Laboratory of Public Health (SLPH) when stool samples are submitted. However, SLPH does have the capacity to test for norovirus. What steps should you take to ensure that the specimens are tested for norovirus?

Question 5: What specific actions will you take to determine whether there are other possible cases? Discuss which team members will be responsible for each case finding task.

 

Activity

As a team, decide upon an initial (working) case definition. Keep in mind that your case definition will change as you obtain more information. A case definition should always include clinical information, and elements related to person, place, and time.

Clinical Information (e.g. disease signs and symptoms, lab results)  
Person  
Place  
Time  

Question 6: What is the purpose of these initial interviews?

Question 7: Will you create a new questionnaire specifically for this outbreak, or will you use an existing questionnaire? If you choose to use an existing questionnaire, please discuss where this questionnaire is located, and how it will need to be modified for this outbreak.

Question 8: Should your health department activate its Incident Command System (ICS) at this time? If so, who is responsible for activating the ICS?

Question 9: What actions will your environmental health specialist take in response to this information?

Question 10: Is it time to conduct a case control or a cohort study? If so, which type of study design will you use? Explain your answer.

Question 11: Based on the laboratory results, what infection control measures would you recommend?

Question 12: What activities, if any, is your health educator conducting at this time?

Question 13: Should you attempt to contact Marcia again? Why or why not? Are there confidentiality issues that you should consider?

Question 14: How do you interpret these findings overall? After describing the findings generally, interpret the odds ratio for deli roast beef. Remember, an odds ratio is the odds of exposure among cases divided by the odds of exposure among controls.

Question 15: Is your outbreak investigation complete? Why or why not?

 

Group Brainstorm

Often, after an outbreak investigation, a team reviews the investigation in a “hot wash” or after-action review. The questions below are examples of questions that could be used in such a review. Choose one member of the team to record responses. As a group, discuss one or more of the following questions.

  • What aspects of the investigation were successful?
  • All outbreaks present unique challenges. What characteristics of this outbreak made it challenging?
  • What areas of the investigation could have been improved?
  • If a similar outbreak occurred in your county, do you think that your team would be prepared to handle it?
  • What are the challenges of investigating an outbreak on a college campus?