Establishing Investigative Definitions, Lab Report Example

Health and Medicine:  Eastern Adult Training Center

Question 1. Case definition

My initial case definition would be patients between ages 20-60 at Eastern Adult Training Center experiencing bouts of loose motions. It cannot be determined diarrhea since laboratory reports have shown a causative organism. Precisely, to define the condition diarrhea there must be evidence that residents had three or more loose or watery bowel movements within 24 hours. supporting investigation link the loose motions to an etiology of the condition which was not done (Wilson, 2005).

Question 2- Description of at risk population

Nurminen (1999) and colleagues advance that risk assessment encompasses limitations in exposure to data. Usually, subjective assumptions involving reconsideration of choices made and applied in towards providing guidance for health policy or action can be irrelevant or simply inaccurate (Nurminen et.al, 1999).  As such, in the case of Eastern Adult Family Training Center from an epidemiological standpoint and data provided the risk population at this stage is limited to residents of this facility.

Question 3- Recommendation to Outbreak Investigative Team

The risk populations are residents of Eastern Adult Family Training Center. Hence, recommendations based on foregoing data collection process encompass further investigation of the facility’s operations with a view of offering an ultimatum to correct obvious violations. The factors are:-

• Overcrowding – Each of the 20 cottages, clustered in five groups of four, have 2-person bedrooms, a kitchen, den, two bathrooms and a dining area.
• There was a previous report of this condition occurring at the facility.
• Public health visits cited violations.

Question 4 – Method of Disease Surveillance and Action

So far the condition from an epidemiological perspective is a non-infectious disease which requires evaluation and intervention as an acute communicable disease. This could be active or passive. Passive surveillance is less costly.  Since it is only one death the two methods could be combined.  For the first week an active surveillance could be enacted then a passive approach after (Birkhead & Maylahn, 2000).

As such, notifiable disease reporting system would be established within the facility’ s population as well as with physicians, hospitals, or laboratory-based surveillance whereby all residents will be tested for evidence of an identifiable causative  organism (Birkhead  & Maylahn, 2000).

Question 5- Sample Surveillance Report Form

(Goggle Images, 2012)

Question 6- Line List Template

Birkhead, S., & Maylahn, M. (2000). State and local public health surveillance. In: Teutsch SM, Churchill RE, eds. Principles and practice of public health surveillance. New York: Oxford University PressQuestion 7- Projection of possible agent causing this suspected GI infection

The California health department reported that acute viral gastroenteritis has been common among skilled nursing; congregate living and residential facilities within that geographic location (California Department of Health Services, 2003). Hence, based on this report my conclusion is that the causative organism could be viral in origin. The specific organism identified was norovirus. However, other predisposing agents for gastrointestinal diseases are celiac disease; irritable bowel, malabsorption and carcinoid syndrome. None of these  other agents are infectious and can be merely provisional assumptions except for a specific investigation of the one death (California Department of Health Services, 2003).

References

California Department of Health (2003). Investigation of Acute Viral Gastroenteritis (Norovirus) Outbreaks in Residential Facilities. California Department of Health services.

Goggle Images (2012). Sample Surveillance Report Form. Retrieved 21^st December, 2012 from http://www.google.com/imgres?imgurl=http://img.docstoccdn.com/thumb/orig/49040043

Nurminen, M. Nurminen, T., & Corvalan, C (1999). Methodologic Issues in Epidemiologic Risk Assessment.  Epidemiology Resources. World Health Organization.

Wilson, E. (2005). Diarrhea in non-travelers: risk and etiology. Clin. Infect. Dis.. 41 41 (Suppl 8): S541–6