D028 POWERPOINT AJM3

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School

Western Governors University *

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Course

D028

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Health Science

Date

Dec 6, 2023

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pdf

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20

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AJM3 T ASK 1: COMMUNICABLE OUTBREAK ASSESSMENT Summer Whiteside Leavitt School of Health, Western Governors University D028:Advanced Health Assessment for Patients and Populations Ilene Gottesfeld 11/13/2023
TOPIC OUTLINE Case Definition Outbreak Investigation Steps Surveillance Methods Suspect Cases vs Probable Cases Mode Of Transmission Cumulative Incidence Research Project Purpose Statement Histogram Incubation Period Difference Between Outbreak Types Case Fatality Rate Attack Rates Outbreak Control Measures Disseminating Information Plan
Case definition Clinical features Lymph node swelling, shortness of breath, productive cough Flu like symptoms Person Residents local to Crab Apple Valley and those affected in the hospital after having a close encounter Place Crab Apple Valley and Golden Valley Hospital Time From the times symptoms were reported 8/1/21-8/7/21 KEY COMPONENTS OF A CASE DEFINITION OF AN OUTBREAK
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STEPS OF THE OUTBREAK INVESTIGATION 1. Identify Surveillance Team 2. Establish Existence of outbreak 3. Verify Diagnosis 4. Construct Case Definition 5. Find Cases 6. Conduct Research Study 7. Evaluate Hypothesis 8. Implement Control Measures 9. Communicate Findings 10. Maintain Surveillance
SURVEILLANCE METHODS Active surveillance More time consuming More expensive Requires more personnel Performs contact tracing Passive surveillance Requires a form to be submitted Provides limited information
SUSPECT CASES Meets the case definition Has signs & symptoms Presents during the time frame 73 people at the farmers market 31 employees from Golden Valley Hospital 104 total suspect cases
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PROBABLE CASES Meet case definition Have signs & symptoms Present during given time frame AND they have laboratory confirmation Diagnosis Bacteriological culture Sputum for Yersinia Pestis F1 antigen Chest x-ray 62 from the farmers market 31 from Golden Valley Hospital 93 total Probable Cases
MODE OF TRANSMISSION Direct From person-to-person It was spread via direct contact at farmers market and the hospital Droplets and contact Indirect Airborne transmission Affected those not in direct contact but in close proximity Farmers market & hospital workers Vector-to-Person Jack was bit by fleas on his farm
UTILIZATION & CALCULATION OF CUMULATIVE INCIDENCE Formula Total # of new cases Population at risk per 1,000 Used to predict risk of disease (WGU, n.d., Figure Residential Areas by Zip Code)
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DISEASE OUTBREAK INVESTIGATION PURPOSE STATEMENT Aim: to prevent further infection Proposed study: Quantitative via Case Control Hypothesis: "Individuals will be considered as a suspect case if positive contact with known exposure on or after August 1at the Crab Apple Valley farmer markets or Community Hospital exhibiting fever with or without painful, swollen lymph nodes, chills, cough, and weakness" (Western Governors University, n.d.)
STUDY DESIGN & JUSTIFICATION Quantitative Case Control Is the exposure associated with a certain outcome? 2 groups One with disease One without disease Both were exposed Justification: identifies at-risk population and can help prevent spread of plague
OUTBREAK HISTOGRAM SCREEN CAPTURE (WGU, n.d., Figure Histogram Primary and Secondary Attack)
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INCUBATION PERIOD Primary attack rate • Incubation period • One day Secondary attack rate • Incubation period • Three days
DIFFERENCES BETWEEN OUTBREAK TYPES • Example: Malaria • A disease regularly found among a certain population Endemic • Infectious disease with widespread occurrence in a community during a certain period of time • Example: The plague of Crab Apple Valley Epidemic • A disease that spread across several countries and affects many people • Example: COVID Pandemic
CASE FATALITY RATE Number of deaths/number of cases x 1000 93 cases 27 deaths Mortality rate = 29.03% (WGU, n.d., Figure Mortality Rates)
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PRIMARY AND SECONDARY ATTACK RATES Primary attack rate = 310 Site: Farmers Market Direct contact & Droplet spread + Indirect via airborne Secondary attack rate = 64.58 Site: Hospital Direct contact & Droplet spread + Indirect via airborne (WGU, n.d., Figure Primary and Secondary Attack Rates)
OUTBREAK CONTROL MEASURES Wash hands Face mask Spread via droplet & airborne PPE Gloves Gown Goggles Reduce rodents around home Spreads via fleas
DISSEMINATING INFORMATION PLAN Local news channel Social media Website Serving those with disabilities Interpreters Providing daily updates Receiving responses via a call center Handles questions and case reporting's
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REFLECTION What do you know now? What might you do differently? How can you apply these concepts to current clinical practice?
REFERENCES References AHRQ. (2014). Quick-start guide to dissemination for practice-based research networks [PDF]. https://www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/resources/dissemination-quick-start-guide.pdf Centers for Disease Control and Prevention. (2014). Outbreak case definitions [PDF]. CDC.gov. Retrieved November 16, 2023, from https://www.cdc.gov/urdo/downloads/casedefinitions.pdf Centers for Disease Control and Prevention. (2021, August 9). Plague home . Retrieved November 17, 2023, from https://www.cdc.gov/plague/index.html Centers for Disease Control and Prevention. (2023, August 17). Conducting a field investigation . Retrieved November 13, 2023, from https://www.cdc.gov/eis/field-epi-manual/chapters/Field-Investigation.html Kim, D.-H., Choe, Y., & Jeong, J.-Y. (2020). Understanding and interpretation of case fatality rate of coronavirus disease 2019. Journal of Korean Medical Science , 35 (12). https://doi.org/10.3346/jkms.2020.35.e137 Moore, Z., MD, MPH. (2011). Module_1_1.6_ppt_outbreakinvestigation [PDF]. NC Department of Health and Human Services. Retrieved November 16, 2023, from https://epi.dph.ncdhhs.gov/cd/lhds/manuals/cd/training/module_1_1.6_ppt_outbreakinvestigation.pdf Western Governor University. (n.d.). Crab Apple Valley Communicable Outbreak Scenario . Retrieved November 13, 2023, from https://wgu.yourlearningportal.com/wgu/resources/courses/wgu_courses/live/hp/D028v5/story.html World Health Organization. (2022, July 7). Plague . Retrieved November 17, 2023, from https://www.who.int/news-room/fact- sheets/detail/plague#:~:text=Plague%20is%20an%20infectious%20disease,bite%20of%20infected%20vector%20fleas