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Getting Ready
for the Investigation
• OUTBREAK INVESTIGATION 10 STEPS
1. Prepare to investigate
a. Identify outbreak investigation team
b. Review scientific literature
c. Notify appropriate state and local entities
d. Determine if immediate control measures are needed
2. Verify the diagnosis and confirm outbreak
a. Get laboratory confirmation
b. Collect specimens from affected animals
c. Perform bacteriologic, virologic or parasitic testing at the Laboratory.
d. Link sick animals and environmental specimens by DNA
fingerprinting/Pulse Field Gel Electrophoresis (PFGE)
3. Case definition
a. Establish a set of standard criteria for deciding which are sick animals related to the outbreak (“case-patients”)
b. Narrow or broad (confirm, probable, suspect)
c. DYNAMIC: may change during investigation
4. Case finding
a. Conduct systematic search based on case definition
b. Create line list of possible cases (animal exposed)
5. Perform descriptive epidemiology
a. Tabulate and orient data: PERSON, PLACE, TIME
b. Frequencies
c. Mapping
d. Epidemic Curve
6. Hypothesis generation—the how and the why
a. Compare with known sources or similar outbreaks
b. Design questionnaire
7. Evaluate hypothesis thorough statistics
a. Perform epidemiologic study: cohort, case-control
b. Compare risk factors among ill (cases) vs not ill (controls)
8. Additional environmental studies
a. Collect food, water, and/ or environmental samples
b. Determine what happened with the implicated source or food
9. Implement control/prevention measure
a. Coordinate with all stakeholders including regulatory partners
b. Develop strategies to prevent further or future illness
10. Communicate findings
a. Disseminate outbreak investigation report—internal and external audience
د/منتصر محمد عبدالله
السودان / نهر النيل / شندي
ساحة النقاش