Montazar AlmashamaEnglish 102Kevin Leaverton8-3-14.docx

Montazar Almashama
English 102
Kevin Leaverton
8-3-14
PAGE
11
Almashama
NASA
The National Aeronautical and Space Administration is a state
agency of the United States, which is generally responsible for
exploration of science, and technology that is related to space
and air. It was formed in 1958 to oversee the US airspace
exploration and research in aeronautics.
Functions of NASA
This agency is generally tasked with researching and exploring
of scientific aspects beneficial to human beings. Astronauts are
sent to the orbit to conduct scientific research on different
aspects. The satellite assists scientists in learning more about
the earth. The space exploration enables the study of the solar
system among other aspects. The new studies help in improving
air travel among other flight aspects.
NASA is also involved in programs of sending human beings to
the Mars, Moon and also beyond. These are among the many
missions that NASA has that are beneficial to the human race.
All the research that NASA does is shared among the people,

with the aim of making life better for all around the world.
NASA also has an Education Office that works with teachers in
preparing students who will be future engineers, astronauts,
scientists and also other NASA staff. This aspect is very critical
as these students will be the explorers that will research on the
universe and the solar system in years to come. NASA has been
fully supporting students, communities and families in
discovering and exploring through inspiring and investing in
activities and programs. NASA has continued to provide
training thereby enabling teachers to learn advanced ways of
teaching science, engineering, technology and mathematics. In
view of this, NASA involves students in its missions to assist
them in getting excited about learning science and all its
aspects.
NASA has field centers and research and test facilities that
enable them to carry out their work. It has a combined
workforce representing a wide range of jobs. The staff includes
astronauts, engineers and scientists and other disciplines.
Achievements of NASA
NASA began with the human spaceflight program, which
assisted the agency in learning more in flying in the space, and
it culminated to the first human being to land on the moon.
NASA has also made robotic space probes that have visited all
planets in solar system and also some other celestial bodies.
The telescopes used by NASA have helped scientists in looking
beyond the space. The satellites have shown immense data about
the earth, which has resulted to adequate information on
learning, and understanding about the weather patterns.
NASA has also been involved in developing and testing various
aircrafts where some of them have set new advances in
technology. These tests and advances have assisted engineers in
improving air transportation. NASA has also been involved in
inventing equipments used everyday ranging from medical tests
to smoke detectors among other systems. Currently, NASA is
completing its International Space Station to improve on its
activities.

Importance of NASA
NASA has maintained its mandate in aeronautical and aerospace
industry enabling the US to have the most successful and
advanced space programs, have the strongest private
aeronautical and aerospace industry, and also have the most
intelligent and experienced scientists and engineers.
NASA is the backbone of science, technology, engineering and
mathematics (STEM) in the US education system and also helps
in developing commercial as well as defense technologies
working with engineering and science organizations across the
country.
Through its advanced scientific research and space exploration,
NASA is thus very important to the welfare and security of this
and US remains its national priority. It has employed a vast
workforce of brilliant scientists, technicians and engineers that
ensure the American population is safe through maintaining its
technology and exploration aspects.
NASAs achievements such as capabilities of orbiting human
beings around the planet, building a station in the space, placing
a human being on the moon among other things have very much
inspired people to aspire for such careers in the agency.
As science, mathematics are the core disciplines in NASA,
students usually involve themselves in STEM subjects. This in
turn increases demand for STEM programs thereby enhancing
more people involvement in the STEM disciplines. Students
learning the STEM subjects usually develop critical thinking
knowledge and skills that help them to develop solutions to
problems. This program is thus critical as a new breed of
brilliant workforce replaces the retiring workforce and so no
gap is created. This is only achievable with enough funding
from the government to enhance such programs.
NASA has also enabled the making of equipments such as
thermal video imaging, heart rate monitors, light emitting
diodes and other technologies. Enough funding from the

government has enabled this and one may ask him without the
funding where would we be technologically?
NASA has been critical in the defense industry, as it has been
involved in communications technologies. It has acted as a
customer to the defense industry through improving private and
public partnership in defense technologies. This has been
possible as NASA develops a project and contracts the
production and testing activities to private industry. This aspect
challenges scientists and engineers in improving their
technologies and designs which aspires manufacturing
developments resulting to NASA completing its missions in an
effective and efficient manner.
NASA has continued to occasionally challenge the private
industry, which has helped in keeping America competitive
beyond other countries. They make sure the technological and
space developments surpass other country’s capabilities that in
turn assist in preventing enemies from defeating their
technologies, keeping them safe.
NASA has developed unimaginable technologies that has
inspired more people to be more curious in learning what lies
beyond the universe and this aspect has helped to improve the
quality of life, technology advances and a solid defense
capability against threats..
Problems facing NASA
NASA has in the past few years experienced budget cuts in its
allocation forcing it to review on its programs. It has many
projects it wants to achieve each with a time frame but due to
cash constraints, it’s therefore looking for other ways to use in
order to meet its goals. There has been debate on whether
NASA should be phased out or downsized as it demands for
more budgetary allocation from the government. The
government has been grappling with budget deficits over the
last few years and this has pushed it to reducing budget
allocation to NASA.

Other foreign countries like China, European Space agency,
India, Russia among other countries are investing more of their
money and time in advancing their programs, plans and
educational efforts in order to surpass the capabilities of
America in the future. These countries are considering
innovating technologies instead of importing them.
Technological innovation is growing very rapidly in other
foreign countries. In view of this, America shouldn’t be asking
the necessity of NASA on budgetary allocation but should be
meeting the budget demands of NASA.
During the Cold War, NASA became very instrumental. When
the security threats brought about due to the capabilities of the
Soviet technology mixed with the technological challenges of
the Apollo program, NASA emerged as a source of innovation
that inspired space exploration, which provided a feeling and,
state of security to the American people who feared a
devastating war.
China has continued to prove its capabilities through destroying
one of their satellites, announcing its plans of developing space
program separate from the Americans influence and also plans
on landing on the moon by 2020.
Countries like Iran, India, Japan, Romania, and Pakistan among
others are currently working on programs of launches that will
make them become space powers themselves through developing
their own aerospace programs and industries. North Korea and
Iraq are also involved in launches.
NASA has continued to keep America competitive through
challenging the private industry constantly and thus make sure
its technological and space development are beyond other
countries capabilities. This has helped in preventing enemies
from defeating American technologies thus keeping America
safe.
During the current times, advanced scientific research and space
exploration programs have seemed to be inappropriate to public
funding due to economic difficulties as the financial aspects

demand precedence, NASA requires to be promoted.
The tax cut will therefore make it difficult for NASA to handle
ambitious space research and exploration projects including the
current ExoMars. This has resulted NASA to reset their
priorities and has intended to slash the budget allocation for
planetary science to cover for other programs such as the Webb
Space Telescope.
ExoMars without NASA
One of the current programs NASA has is the ExoMars, which
plans on launching the methane –sniffing Gas Trace Orbiter to
the red planet by 2016 and also a robotic rover after 2 years.
The rover would use a drill to allow it in sampling subterranean
soils to explore if life Mars can support life. NASA would
provide rockets as well as instrumentation for the rover and
orbiter. It would also provide a landing system for Rovers
descent on the Martian surface. In view of the cash cuts, this
program has been shelved. This would cause a major uproar
internationally on one dimension.
However, America needs to be cautious as according to media
reports, ESA is contemplating working with Russia on this
project. This will indeed be a major setback to the US
technological power as other countries strive to gain
prominence.
Salary trims
NASA funds almost all of the US planetary scientists from its
budgetary allocation. Individual missions enable established and
older researchers get money. Researchers rely on the analysis
and research budget, which are the funds, set-aside for scientists
in exploring data that streams back from the planetary missions.
According to a survey by Planetary Science institute, over half
of American planetary scientists usually depend on these
projects for over half of their salaries. The budget cuts have
created fear that many will be loosing their jobs. A planetary
scientist Britney Schmidt admitted this from Georgia Institute
of Technology, Atlanta. In particular, NASA announced that

funding proposals in Solar Systems observations was not likely
until after some few years. This caused outrage on many
researchers as they depend on such grants for livelihood.
Indeed, the budget cuts have resulted into social problems.
Solution
to NASAs budget deficits
NASA depends on the Federal government for funding in
creating and continuing programs already started. NASA studies
the solar system and the stars and creates advanced technologies
on these projects. NASA also researches on new products that
are beneficial to the society today.
An article on thespacereview.com by Jeff Brooks proves that
“For every $1 the federal government spends on NASA, it
spends $98 on social programs. In other words, if we were to
cut spending on social programs by a mere one percent, we
could very nearly double NASA’s budget.” In a scenario that
NASA was not around today, many technological advances
would not have been met including equipments that detect early
breast cancer along with other countless discoveries.
With less money on researching on advanced technologies,
NASAs solution lies with the private sector. NASA should
therefore work on modalities of allowing the private sector to
control part of the space community. NASA should come up

with structures to enable this as to ensure programs are
efficiently executed. It has since in the past collaborated with
the private sector and this relationship has proved to be worthy.
Private companies like Bigelow can work out space research
with NASA on a structured program. The private programs that
NASA has collaborated have bored great advances both
technologically and in education. It have in the past been able
to integrate effectively with this partnership and so with
enhanced structures, the private sector can be able to assist
NASA through laid down procedures
However, NASAs intended purpose for researching and
developing products and projects is not for profit but
information gained and the data available for use in creating
these products. Private entities look for information and data in
order to make new or advance their products. NASA can
therefore look for ways of selling all these information and data
to corporations and even small businesses at a minimal amount
in order to cover for its proposed budget. The selling of
information must however be very well structured to prevent
inefficiencies. With structures to govern this program, they will
be able to meet their goals within the set timeframe.
Setting up priorities could be another way NASA can cope up
with the deficits. Some programs are almost through while some
are starting. By prioritizing them and laying down structures to
manage this, NASA will be able to complete their programs

efficiently. Also some programs that have shown not to be
worthy should be abandoned to give more time and money on
most beneficial projects according to priorities.
Arguments against more funds to NASA
Some people are against funding more money to NASA as that
money can be used on some more important things such as
provision of proper home and other social amenities to the
people. They argue that more emphasis should be put on solving
problems of life on earth before going to the space.
As the US owes more money to China, some people argue why
more money is being budgeted for such programs when the
country is already in debt. Focus should not be put on space
projects when there is no enough money to fund it. Other
agencies such as ESA and CNSA can work effectively together
in space as they can afford it.
Conclusion
NASA has indeed helped shape life on earth and has proved to
be beneficial to people in various ways including:-
· It has promoted and inspired science education, which has
resulted, to astronauts, engineers and rocket scientists among
other disciplines.
· Has impacted on environmental research through studying
climate change, air quality, and energy among other
environmental issues.

· NASA technology has enabled detecting and treating of heart
diseases.
· NASA advances have also helped in developing wireless
technology.
· NASA developments have helped in understanding more on
hurricanes thereby saving lives.
The benefits of NASA are indeed immense and therefore budget
cuts are really detrimental to their activities. NASA should
therefore seek for ways of coping with this aspects and maintain
its mandate of changing the lives if people on earth to be much
better.
References
Guide to FY2014 Research Funding at the National Aeronautics
and Space Administration (NASA)
http://www.nasa.gov
http://www.nasa.gov/about/index.html
http://www.nasa.gov/about/highlights/what_does_nasa_do.html
http://www.nasa.gov/missions/highlights/index.html
http://www.nasa.gov/education →
http://www.nasa.gov/offices/education/programs/descriptions/St
udents-rd.html →

thespacereview.com
HCA 415: Community and Public Health
Online
Epidemiological Case #1: Norovirus in Vermont
PART I
On the morning of February 5
th
, the mother of a young child called the Vermont Department of
Health (VDH) to report a possible foodborne outbreak. The
woman’s child, age 5 years, and two
neighborhood children, ages 7 and 10 years, had become ill with
vomiting and diarrhea within 12
hours of each other. The child aged 5-years had become so sick

that her mother had taken her to the
emergency department at the local hospital.
Question 1: What questions (or types of questions) would you
ask the mother to help
determine the seriousness of this problem and the steps needed
to explore the problem further?
The mother reported that her child initially complained of
nausea around 10:00 a.m. on Monday,
February 2
nd
. The nausea was followed by vomiting and multiple episodes of
diarrhea. The child was
unable to eat or drink anything without vomiting. Toward
evening, the child became listless. The
woman took the child to the emergency department where she

was noted to be dehydrated and that
she had a fever. Stool and blood specimens were collected, and
the child was treated with
intravenous fluids and released.
The mother called the emergency department the following day
to receive the test results for
her child. A nurse told her that preliminary stool culture results
were “negative for the usual
bacteria.” The two neighborhood children had had similar
symptoms (i.e., nausea, vomiting,
diarrhea, and fever) but had not become as ill as the woman’s
child. Their symptoms started a few
hours earlier than her child’s. Both had returned to school the
day after becoming ill.
The three children usually did not play together but had
attended a birthday party on the

morning of Sunday, February 1
st
. The mother was concerned about homemade ice cream that was
served at the party because she had heard it had been prepared
using raw eggs.
Question 2: What etiologic agents are consistent with the illness
among the children?
After confirming the mother’s information with the emergency
department physician, VDH staff
called the mother who had organized the February 1
st
birthday party. The woman reported that her
own child was well (except for a cold). Other parents had called
her, however, saying that their

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children had become ill with vomiting and diarrhea. The woman
reported that her son’s birthday
party had occurred at a private indoor swim club in Essex,
Vermont, close to Burlington.
Approximately 30 children and adults were in attendance. The
children ranged in age from 5 to 10
years. Not all of the children attended the same school.
Cake, ice cream, and canned drinks had been served at the
party. All refreshments had been
commercially prepared. The ice cream had not contained raw
eggs. The majority of children had
played in the pool at the swim club before presents were opened
and cake and ice cream were
served. Two children who later became ill had left the party

before cake and ice cream were served
to attend another birthday party. The mother provided a list of
party attendees, indicating which ones
she knew had been ill, and their telephone numbers. She also
provided the name and telephone
number for the swim club manager.
Question 3: On the basis of the information provided so far,
what actions would you take?
Whom would you contact? What additional information would
you be interested in collecting?
VDH investigators notified the district health department of the
problem and then contacted the
manager of the private swim club. The manager stated that he
was dealing with a “problem” and
refused to talk with health department investigators. He

suggested that they leave their telephone
number and he would call them back if he had time.
Question 4: How would you approach the swim club manager to
gain his cooperation?
After VDH investigators stated the reason for their call and
reassured the swim club manager that the
health department needed to investigate the reported illnesses so
that the source could be found and
actions could be taken to prevent others from becoming ill, the
manager spoke with investigators.
The manager had not heard about the illnesses associated with
the February 1
st
birthday party, but
had received reports of illness among other persons who had
used the pool during the weekend.

Rumors were circulating that participants in the infant-mother
swim class (that last met on Saturday,
January 31
st
) were sick with “stomach flu.”
The manager provided VDH investigators with the names and
contact information for persons
who had complained to him about being ill and for members of
the infant-mother swim class.
VDH investigators, with the assistance of district health
department staff, contacted households of
persons who had visited the swim club and reported illness
since January 27
th
to VDH, the mother
organizing the February 1
st
birthday party, or the swim club manager. Investigators asked

about
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specific symptoms, the date of illness onset, and the most recent
date the ill person had visited the
swim club.
On the basis of these calls, 21 individuals were identified as
having attended the swim club and
having reported being ill (Table 1). Signs and symptoms
included vomiting (90%), nausea (81%),
abdominal cramps (67%), diarrhea (48%), fever (48%), and
headache (43%). Symptoms began a
median of 30 hours (range: 8−62 hours) after visiting the swim
club.

Table 1. Line list of persons becoming ill after a visit to the
private swim club, Essex, Vermont,
January 27
th
− February 1
st
.
Patient No.
Age
Sex

Signs and
Symptoms*
Examined
by a doctor
Date of
symptom
onset
Date of exposure
to the pool
1 5 yrs F V, D, N, C, F, H Yes 2/2 2/1 (morning)
2 7 yrs M V, D, N, C, H 2/1 2/1 (morning)
3 10 yrs M V, D, N, C, H 2/2 2/1 (morning)
4 5 mos F V, F 2/1 1/31 (morning)
5 1 yrs M V, D Yes 1/31 1/31 (morning)
6 (mother of #5) 31 yrs F D, N, C, F 2/1 1/31 (morning)

7 7 yrs M V, N, C, H 2/1 2/1 (morning)
8 11 yrs F V, N, C, H 2/2 2/1 (afternoon)
9 65 yrs M D, N, C, H 2/2 2/1 (morning)
10 18 mos F V, D, N, F 2/1 1/31 (morning)
11 11 mos F V, D 2/2 1/31 (morning)
12 7 yrs M V, D, N, C, F 2/3 2/1 (morning)
13 61 yrs F V, D, N, C, F Yes 2/2 2/1 (morning)
14 2 yrs M V, N, F 2/2 1/31 (afternoon)
15 5 yrs M V, N, H 2/2 2/1 (morning)
16 8 yrs F V, N, C, H 2/3 2/1 (morning)
17 12 yrs F V, N, C, H 2/1 1/31 (afternoon)
18 10 yrs F V, N, C, F 2/2 2/1 (morning)

19 8 mos M V, F Yes 2/1 1/31 (morning)
20 (mother of
#19)
22 yrs F V, N, C 2/3 1/31 (morning)
21 12 yrs F V, N, C, F 2/2 1/31 (afternoon)
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*V = vomiting; D = diarrhea (defined as 3 or more loose stools
in a 24-hour period); F = fever; N = nausea; C =
abdominal cramps; and H = headache.
Question 5: Summarize the descriptive epidemiology of cases.

Do signs and symptoms among
patients support your earlier suspicions about the causative
agent? Were cases clustered by
selected demographic characteristics? What was the time course
of the outbreak?
During the calls, multiple parents, who had been at the pool on
January 31 noted that the water in the
pool had been cloudy. One parent had reported the pool’s
condition to the lifeguard and was told that
the cloudiness resulted from chemicals added to the water. The
parent later saw another swim club
staff member collecting water from the pool for testing. No one
reported having seen a fecal incident
or vomiting while they were at the pool.
On the basis of the initial findings, VDH investigators believed
that the gastrointestinal illness

was consistent with Norovirus infection. They hypothesized that
the virus was spread by exposure to
the pool at the private swim club on Saturday, January 31, or
Sunday, February 1. The district health
department arranged collection of stool specimens from 10
patients for norovirus testing at the
Centers for Disease Control and Prevention (CDC), using
reverse transcription-polymerase chain
reaction (RT-PCR).
Question 6: What studies or investigations would you undertake
to explore the hypothesis that
exposure to the pool at the private swim club was the source of
the outbreak?
PART II

Based on this week’s readings and your knowledge of
epidemiological concepts address the
following questions:
Which offices need to respond? How would you coordinate a
response?
Does the case require an immediate public health response?
Determine what type of emergency is described in the case
below. Is this an epidemic,
endemic, pandemic or an isolated incidence?
List categories and examples of questions that should be asked
of key informants who report
a suspected outbreak of foodborne disease
Describe the steps for management of fecal incidents in treated
recreational water venues.
discuss considerations in working with businesses that might be
identified as a possible

source of an outbreak;
Online
Discuss considerations in working with businesses that might
be identified as a possible
source of an outbreak;
Identify activities that increase a person’s risk for exposure to
pathogens in recreational
water;

Online
Epidemiological Case #1: Gastroenteritis at a University in
Texas
PART I
On the morning of March 11, the Texas Department of Health
(TDH) in Austin received a telephone
call from a student at a university in south-central Texas. The
student reported that he and his
roommate, a fraternity brother, were suffering from nausea,
vomiting, and diarrhea. Both had become
ill during the night. The roommate had taken an over-the-
counter medication with some relief of his
symptoms. Neither the student nor his roommate had seen a
physician or gone to the emergency

room.
The students believed their illness was due to food they had
eaten at a local pizzeria the previous
night. They asked if they should attend classes and take a
biology mid-term exam that was scheduled
that afternoon.
Question 1: What questions (or types of questions) would you
ask the student?
Question 2: Do you think this complaint should be investigated
further?
TDH staff were skeptical of the student’s report but felt that a
minimal amount of exploration was
necessary. They began by making a few telephone calls to
establish the facts and determine if other

persons were similarly affected. The pizzeria, where the
student and his roommate had eaten, was
closed until 11:00 A.M. There was no answer at the University
Student Health Center, so a message
was left on its answering machine.
A call to the emergency room at a local hospital (Hospital A)
revealed that 23 university students
had been seen for acute gastroenteritis in the last 24 hours. In
contrast, only three patients had been
seen at the emergency room for similar symptoms from March
5-9, none of whom were associated
with the university.
At 10:30 A.M., the physician from the University Student
Health Center returned the call from
TDH and reported that 20 students with vomiting and diarrhea
had been seen the previous day. He

believed only 1-2 students typically would have been seen for
these symptoms in a week. The Health
Center had not collected stool specimens from any of the ill
students.
Question 3: Do you think these cases of gastroenteritis
represent an outbreak at the university?
Why or why not?
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TDH staff asked health care providers from the University
Student Health Center, the Hospital A
emergency room, and the emergency departments at six other
hospitals located in the general vicinity

to report cases of vomiting or diarrhea seen since March 5. A
TDH staff person was designated to
help the facilities identify and report cases. The health care
providers were also asked to collect stool
specimens from any new cases. Bacterial cultures from patients
seen in the emergency rooms were to
be performed at the hospital at which they were collected and
confirmed at the TDH Laboratory.
Specimens collected by the Student Health Center were to be
cultured at the TDH Laboratory.
Question 4: What information should be provided with each
stool specimen submitted to the
laboratory? How will the information be used?
Later that afternoon, preliminary culture results from 17 ill
students became available. The

specimens, collected primarily from the emergency room at
Hospital A on March 10, did not identify
Salmonella, Shigella, Campylobacter, Vibrio, Listeria, Yersinia,
Escherichia coli O157:H7, Bacillus
cereus, or Staphylococcus aureus. Some specimens were
positive for fecal leukocytes and fecal
occult blood.
Question 5: How might you interpret the bacterial culture
results? What questions do these
results raise?
By March 12, seventy-five persons with vomiting or diarrhea
had been reported to TDH. All were
students who lived on the university campus. No cases were
identified among university faculty or

staff or from the local community. Except for one case, the
dates of illness onset were March 9-12.
(Figure 1) The median age of patients was 19 years (range: 18-
22 years), 69% were freshman, and
62% were female.
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Figure 1. Onset of gastroenteritis among students, University
X, Texas, March 1998. (N=72) (Date of onset
was not known for three ill students.)
TDH staff met with the Student Health Center physician and
nurse, and several university

administrators including the Provost. City health department
staff participated in the meeting.
Question 6: What topics would you include in discussions with
university officials?
TDH and City Health Department staff gathered the following
information:
The university is located in a small Texas town with a
population of 27,354. For the spring
semester, the university had an enrollment of approximately
12,000 students; 2,386 students
live on campus at one of the 36 residential halls scattered across
the 200+ acres of the main
campus. About 75% of the students are Texas residents.
The university uses municipal water and sewage services.
There have been no breaks or

work on water or sewage lines in the past year. There has been
no recent road work or
digging around campus.
The campus dining service includes two cafeterias managed by
the same company and about
half a dozen fast food establishments; about 2,000 students
belong to the university meal plan
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which is limited to persons living on campus. Most on-campus
students dine at the main
cafeteria which serves hot entrees, as well as items from the
grill, deli bar, and a salad bar. A

second smaller cafeteria on campus offers menu selections with
a per item cost and is also
accessible to meal plan members. In contrast to the main
cafeteria, the smaller cafeteria tends
to be used by students who live off campus and university staff.
The smaller cafeteria also
offers hot entrees, grilled foods, and a salad bar, but has no deli
bar.
Spring break is to begin on March 13 at which time all dining
services will cease until March
23. Although many students will leave town during the break, it
is anticipated that about a
quarter of those living on campus will remain.
Hypothesis generating interviews were undertaken with seven of
the earliest cases reported by the
emergency rooms and the Student Health Center; all of the cases

had onset of illness on March 10.
Four were male and three were female; all but one was a
freshman. Two students were psychology
majors; one each was majoring in English and animal
husbandry. Three students were undecided
about their major.
The students were from five different residential halls and all
reported eating most of their meals
at the university’s main cafeteria. During the past week, all but
one student had eaten food from the
deli bar; two had eaten food from the salad bar, and three from
the grill. Seven-day food histories
revealed no particular food item that was common to all or most
of the students.
Except for the psychology majors, none of the other students
shared any classes; only one student

had a roommate with a similar illness. Five students belonged
to a sorority or a fraternity. Three
students had attended an all school mixer on March 6, the
Friday before the outbreak began; two
students went to an all night science fiction film festival at one
of the dorms on March 7. Students
reported attendance at no other special events; most had been
studying for midterm exams for most of
the weekend.
Question 7: Using information available to you at this point,
state your leading hypothesis(es) on
the pathogen, mode of transmission, source of the outbreak, and
period of interest.
Question 8: What actions would you take? Who would you
question? Where might you look for
the origin of the pathogen?

On the evening of March 12, about 36 hours after the initial call
to the health department, TDH staff
conducted a matched case-control study among students at the
university. Ill students (reported from
emergency rooms and the Student Health Center) who could be
reached at their dormitory rooms
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were enrolled as cases. Dormitory roommates who had not
become ill were asked to serve as
matched control subjects. Investigators inquired about meals
the students might have eaten during
March 5th-10th and where the foods were eaten. All

information was collected over the telephone.
Question 9: What are the advantages and disadvantages of
undertaking a case-control study
instead of a cohort study at this point in the investigation?
Twenty-nine cases and controls were interviewed over the
telephone. Investigators tabulated the
most notable results in Table 1.
Table 1. Risk factors for illness, matched case-control study,
main cafeteria, University X, Texas, March 1998.
Exposure
Ill Exposed/

Total ill* (%)
Well Exposed/
Total well* (%)
Matched
Odds Ratio**
95%
Confidence
Interval
p-value
Ate at deli bar –
lunch on March 9

11/28 (39) 1/29 (3) 11.0 1.6-473 <0.01
Ate at deli bar –
dinner on March 9
7/27 (26) 2/29 (7) 6.0 0.73-275 0.06
Ate at deli bar –
lunch on March 10
8/29 (28) 1/28 (4) 8.0 1.1-354 0.02
Ate at deli bar - dinner
on March 10
2/29 (7) 2/28 (7) 1.0 0.01-79 0.75
Ate at deli bar –
lunch or dinner on
March 9 or lunch on

March 10
15/27 (56) 3/28 (11) 7.0 1.61-63.5 <0.01
*Denominator does not always total to 29 because several
subjects could not remember where they ate the indicated
meal.
**The data provided for cases and controls cannot be used to
calculate the matched odds ratio which is based on an
analysis of discordant pairs.
Question 10: How do you interpret these data?
Online

Question 11: During which time/s and dates were students more
likely to become ill?
Question 12: Who might you consult in developing
actions/policies for the campus food service to
prevent a recurrence of this problem in the future? Why?
PART II
Based on this week’s readings and your knowledge of
epidemiological concepts address the following
questions:
Which offices need to respond? How would you coordinate a
response?
Did the case require an immediate public health response?
Determine what type of emergency is described in the case. Is
this an epidemic, endemic,

pandemic or an isolated incidence?
List categories and examples of questions that should be asked
of key informants who report a
suspected outbreak of foodborne disease
List four criteria for prioritizing the investigation of suspected
foodborne disease outbreaks (if
applicable)

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