HCA 415 Week 3 Assign 1

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The 11 Blue Men Assignment University of Arizona Global Campus HCA 415 Community & Public Health Cardra Burns July 10, 2023

1. Draw a timeline marking the time each of the 11 blue men presented symptoms. Explain the point of mapping out the incident timeframe (i.e. why would epidemiologists need this information and how would it be used) The 11 Blue Men incident is very important and critical to map out because of the data that can be collected from the distinct pattern that can include specific characteristics or symptoms between the men. With the creation of a timeline, epidemiologist can track down when the disease possibly started and how it is initially spreading to people. It is important to map out incidents that occur within a timeframe to understand the complexity of the disease that epidemiologists are dealing with. From understanding the symptoms that continue to show to even changing of symptoms. This also includes the relationship between how the disease manifested and how it is spreading. Epidemiology assists with controlling such diseases and coming up with ways to prevent it. “It is the scientific method of investigation problem-solving used by disease detectives— epidemiologists, laboratory scientists, statisticians, physicians and 8:00AM A man collapsed on the floor due to abdominal cramps. When discovered, his lips, ears, nose, and fingers were blue. 8:30AM He was rushed to the hospital where the blueness had spread to a big portion of his body and he was unconsious. He was also in a state of shock. 10:25AM-12:00PM 9 other men were rushed to the hospital between this time frame. They were elderly men that were experiencing pain, were cyanotic and in the state of shock. 6:45PM Another elderly aged man was rushed to the hospital with the same conditions as the others. He was blue and was not able to ask for help.

other health care providers, and public health professionals—to get to the root of health problems and outbreaks in a community” (CDC, 2011). 2. Describe the key symptoms and incubation period for the illness affecting the eleven blue men. The main symptoms of what the 11 blue men were going through were cyanotic which is the decreased oxygen in the bloodstream. All 11 men reported to have their lips, nose, fingers, and ears turn blue and within thirty minutes to an hour, the blueness had begun to spread. The other major symptoms that the men were going through were being in a state of shock and were experiencing excruciating pain. The incubation period for the illness started at least 30mins after the 11 men ate food from the restaurant. 3. Describe each step of an outbreak investigation as it pertains to this particular event, indicating all of the key points in the investigation (include how it started, why epidemiologists got involved, where did the investigation take the epidemiologists, who was interviewed, what/who were the potential culprits identified during the investigation) After receiving a man who collapsed on a sidewalk in excruciating pain and half his body was deprived of oxygen, several more men were rushed to the hospital in the same condition with similar symptoms. All men had their body turn blue, were in a state of shock and diagnosed with carbon-monoxide. As required, the hospital reported this incident as an epidemic nature to the department of health in which two epidemiologists were sent to

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investigate. After speaking with the doctor and concluding that there were limited chances the patients suffered from gas poisoning, the two epidemiologists went on to interrogate the recovering patients where they had gathered more information. The information they required was that not only did all the men had eaten oatmeal that the restaurant, but they also got sick within thirty minutes of the meal. With that information, one of the epidemiologists went to investigate the restaurant while the other gained blood samples from the patients for further analysis. Having previously determined that all the men had taken oatmeal, the epidemiologists took samples of the ingredients that were used to prepare the oatmeal for further analysis. The results revealed that there was a presence of sodium nitrite in the saltshakers. “Sixteen contained either pure sodium chloride or just a few inconsequential traces of sodium nitrite mixed in with the real salt, but the other was point thirty-seven per cent nitrite.” ( ArtBea. 2014). 4. Identify three questions that Dr. Greenberg and Dr. Pellitteri asked the patients. Explain why these three questions were relevant. To understand the problem and the similarity of the symptoms, the investigators were more than likely to ask the patients where they were located when the pain started occurring. This initial question assisted with determining the geographic location of the source of the problem. Another question the investigators asked was what the patients ate within the last twenty-four hours to try to establish a commonality between the places that they all had visited and possibly eaten at. This helped with identifying that all the patients ate at the same place and had relatively eaten the same meal that day.

5. Identify three questions that the epidemiologists asked the Eclipse Cafeteria employees. Explain why these three questions were relevant. The first question that the investigators asked the crew at the restaurant was if there was any food leftover from the morning of were still there. Although the investigator knew it was a long shot for the food to still be there, this still assisted him with pinpointing what ingredients to look for. Another question he asked was how the cook prepared the food for the morning and was there any change to any ingredients recently. This question helped understand how the cook prepared the oatmeal and what specific ingredients were put in the food. Lastly, the investigator asked to leave with the specific ingredients. This allowed for the further analysis on the food that was cooked for that day to determine what could possibly lead to this outbreak. 6. Identify the final culprit and how it was discovered. After receiving the analysis of the salt taken from the restaurant, the lab results indicated that the presence of sodium nitrate was in the salt. The investigator also received the results from one of the doctors which included traces of sodium nitrite in the patients’ blood furthering the conclusion that sodium nitrite in the salt was what poisoned the victims. 7. Explain why were these specific men more affected than other people who ate in the cafeteria?

The salt that contained the sodium nitrite was used in the making of the oatmeal. Therefore, these specific men also added more salt to their oatmeal which increased the amount of nitrite in their bodies.

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References: CDC. (n.d.). The Importance of Epidemiology - Centers for Disease Control and Prevention. https://www.cdc.gov/eis/downloads/epidemiology-factsheet.pdf ArtBeat. (2014, October 12). Eleven blue men (Berton roueché) Links to an external site. [Blog post]. Retrieved from https://utmedhumanities.wordpress.com/2014/10/12/eleven-blue-men- berton-roueche/