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Questions and Answers
What is the first step in investigating cases of hospital-acquired infections or a suspected outbreak?
What is the first step in investigating cases of hospital-acquired infections or a suspected outbreak?
Detection
What is the purpose of healthcare-associated infection surveillance?
What is the purpose of healthcare-associated infection surveillance?
To prevent and control infection
What is the benefit of monitoring hospital-acquired infections?
What is the benefit of monitoring hospital-acquired infections?
Early detection of abnormal hospital infection increases
What is the result of a successful outbreak investigation?
What is the result of a successful outbreak investigation?
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What is the final step in investigating cases of hospital-acquired infections or a suspected outbreak?
What is the final step in investigating cases of hospital-acquired infections or a suspected outbreak?
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What is the purpose of case definition in outbreak investigation?
What is the purpose of case definition in outbreak investigation?
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What is an outbreak?
What is an outbreak?
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What are the objectives of a field investigation during an outbreak?
What are the objectives of a field investigation during an outbreak?
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How are potential outbreaks typically identified? (Select all that apply)
How are potential outbreaks typically identified? (Select all that apply)
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A hypothesis in the context of an outbreak is an educated guess that cannot be tested.
A hypothesis in the context of an outbreak is an educated guess that cannot be tested.
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Outbreak case definitions are commonly constructed using clinical and _____________ criteria.
Outbreak case definitions are commonly constructed using clinical and _____________ criteria.
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Study Notes
Outbreak Investigation
- An outbreak is the occurrence of more cases of a disease than expected for a particular place and time.
Identifying Potential Outbreaks
- Review of surveillance data
- Clinician or laboratory reports of unusual diagnoses
- Reports from the public
- Reports from the media
Objectives of a Field Investigation
- Identify the agent, source, and/or mode of transmission
- Characterize the extent of the outbreak (who has been affected, who is at risk)
- Identify exposures or risk factors that increase risk of disease
- Develop and implement control and prevention measures
General Phases of an Outbreak Investigation
Descriptive Phase
- Prepare for fieldwork
- Confirm existence of an outbreak
- Verify the diagnosis
- Construct a case definition
- Find cases systematically and record information
- Perform descriptive epidemiology
Explanatory Phase
- Develop hypotheses
- Evaluate hypotheses epidemiologically
- Reconcile epidemiology with laboratory and environmental findings
- Conduct additional studies as necessary
Response Phase
- Implement and evaluate prevention and control measures
- Initiate or maintain surveillance
- Communicate findings
Components of an Outbreak Field Investigation
- Epidemiology
- Laboratory
- Environmental
Outbreak Case Definitions
- Clinical criteria based on symptoms and signs, laboratory tests
- Epidemiological criteria specifying time, place, person
- Criteria should be objective, simple, accurate, practical, and measurable
Hypothesis Development
- Educated guess about an association between an exposure and outcome, and/or about mode of spread
- Hypothesis should be in a form that allows it to be tested
- Knowledge of the disease, its reservoir, mode of transmission, and other features is probably the most common way of developing hypotheses
Evaluating Hypotheses
- Conduct analytic study
- Comparing hypotheses with collected evidence (laboratory, clinical, environmental, epidemiologic)
- Conduct cohort study or case-control study
Implementing Control Measures
- Prevent further exposure and future outbreaks by eliminating or treating the source
- Initiate as soon as possible
Control Strategies
- Control the reservoir
- Interrupt transmission
- Protect the host
Long-term Response
- Identify why the outbreak occurred
- Determine if conditions still exist that could lead to another outbreak
- Develop strategies to change conditions and reduce the possibility of future outbreaks
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Description
Learn about the principles and objectives of outbreak investigation, including identifying potential outbreaks, reviewing surveillance data, and characterizing the extent of the outbreak.
