The document describes the initial steps that would be undertaken to investigate a foodborne disease outbreak:
1. Detect the outbreak through public health surveillance methods like reports of illnesses.
2. Define cases using a case definition and find related illnesses by interviewing sick individuals.
3. Generate hypotheses about the outbreak source using epidemiological data, traceback investigations, and food/environmental testing.
Outbreak management ppt comprises the definition , history , investigations and the steps of management of outbreak. This was my seminar and UG class tpoic
Investigation of an epidemic by taking ebola as an example...Grandhe Sumanth
investigation of an epidemic by taking ebola as an example....................................................................................................................................................................................................................................................................
Outbreak management ppt comprises the definition , history , investigations and the steps of management of outbreak. This was my seminar and UG class tpoic
Investigation of an epidemic by taking ebola as an example...Grandhe Sumanth
investigation of an epidemic by taking ebola as an example....................................................................................................................................................................................................................................................................
Guidelines for Management of Outbreak in Healthcare Organizationdrnahla
Guidelines for Management of Outbreak in Healthcare Organization
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
To understand:
The principles of detecting and controlling an
outbreak.
What is needed for outbreak investigation
Steps in disease outbreak investigations.
Guidelines for Management of Outbreak in Healthcare Organizationdrnahla
Guidelines for Management of Outbreak in Healthcare Organization
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
To understand:
The principles of detecting and controlling an
outbreak.
What is needed for outbreak investigation
Steps in disease outbreak investigations.
Principles of diseses outbreak.in our societypptxw2tz2qrqxd
Principles of disease outbreak involve understanding the epidemiological factors that contribute to the spread of infectious diseases within a population. Key principles include:
1. Pathogen characteristics: Understanding the agent causing the disease, including its mode of transmission, incubation period, infectious dose, and virulence, is crucial for predicting its spread.
2. Host factors: Factors such as immunity, susceptibility, genetic predisposition, and behavior influence an individual's likelihood of contracting and spreading the disease.
3. Environmental factors: Environmental conditions, including climate, geography, sanitation, and population density, can facilitate or impede the transmission of diseases.
4. Transmission dynamics: Diseases can spread through various modes of transmission, including direct contact, droplet transmission, airborne transmission, vector-borne transmission, and fomite transmission.
5. Surveillance and monitoring: Timely and accurate surveillance systems are essential for detecting outbreaks, monitoring disease trends, and implementing control measures effectively.
6. Intervention strategies: Implementing interventions such as vaccination, quarantine, isolation, hygiene practices, vector control, and public health education can help prevent and control disease outbreaks.
7. Public health response: Coordinated efforts among healthcare providers, public health agencies, governments, and communities are necessary to respond promptly to disease outbreaks, mitigate their impact, and prevent further transmission.
Introduction to Epidemiology
History of Epidemiology.
Definition of Epidemiology and its components.
Epidemiological Basic concepts.
Aims of Epidemiology.
Ten Uses of Epidemiology.
Scope or The Areas of Application .
Types of Epidemiological Studies.
Chapter 11 DiscussionLearning ObjectivesBy the end.docxbartholomeocoombs
Chapter 11 Discussion
Learning Objectives
By the end of this chapter, the reader will be able to:
State three measures for preventing foodborne illnesses
Discuss 10 microbiological agents that are implicated in foodborne illness
Explain the significance of foodborne illness for the world’s population
List five categories of contaminants in the food supply
Describe one major regulation for protecting the safety of food from carcinogens
Foodborne Diseases/Infections
“illnesses acquired by consumption of contaminated food; they are frequently and inaccurately referred to as food poisoning”
An outbreak indicates “the occurrence of a similar illness among two or more people which an investigation linked to consumption of a common meal or food items, except for botulism (one case is an outbreak)”
Burden of Illness Pyramid
Risk Factors for Foodborne Illness – USA
63% Inadequate cooling and cold holding temperatures
29% Preparing food ahead of planned event
27% Inadequate hot holding temperatures
26% Poor personal hygiene/infected persons
25% Inadequate reheating
9% Inadequate cleaning of equipment
7% Use of leftovers
6% Cross-contamination
5% Inadequate cooking or heating process
… List goes on…
Risk Factors for Foodborne Illness
So what are some of the prevention measures we can take?
Clean, separate, cook, & chill
Hand hygiene
Irradiation of food (common for meats)
Risk Factors for Foodborne Illness
Investigating Foodborne Outbreaks
Detecting a possible outbreak
Defining and finding cases
Generating hypotheses about likely sources
Testing the hypotheses
Finding the point of contamination
Controlling an outbreak
Deciding an outbreak is over
Investigating Foodborne Outbreaks
Detecting a possible outbreak
Defining and finding cases
Generating hypotheses about likely sources
Testing the hypotheses
Finding the point of contamination
Controlling an outbreak
Deciding an outbreak is over
First step of process
Generally through public health surveillance (usually passive)
Nationally Notifiable Conditions
Establish a normal baseline incidence of a given disease
Detect an increase in the incidence, or a “cluster”
If the cluster has something in common, then it is considered an outbreak
Investigating Foodborne Outbreaks
Detecting a possible outbreak
Defining and finding cases
Generating hypotheses about likely sources
Testing the hypotheses
Finding the point of contamination
Controlling an outbreak
Deciding an outbreak is over
Usually the first cases identified are only a small part of the total outbreak
Develop a “case definition”, including:
Pathogen & symptoms
Time range & geographic area
Other criteria (common source or DNA/PFGE fingerprint)
May distinguish probable vs. confirmed
Using the case definition, active surveillance for additional cases
Surveying individuals
Looking through health records/laboratory reports
Reaching out to other health officials
Investigating Foodborne Outbreaks
Detecting a poss.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
1. Asuncion Kezeiah Claire
Aurelio, Lyca Mae
Berbano, Aira
Ganotisi, Marc Gielord
Giron, Maria Sophia Audrey
Gorgonio, Malaya Angela
Question 1 :Describe the initial steps you will undertake to investigate this food-borne
disease outbreaks.
Step 1: Detect a Possible Outbreak
Detecting an outbreak is the first step in investigating a multistate foodborne outbreak.
An outbreak with multiple sick people can be missed if they are spread out over a
wide area.
Outbreaks are detected by using public health surveillance methods, including
PulseNet, formal reports of illnesses, and informal reports of illnesses
How are outbreaks found?
One way health officials find outbreaks is through public health surveillance. By routinely
gathering reports of illnesses, they know how many illnesses to expect in a given time period
in a given area. If a larger number of people than expected appear to have the same illness in
a given time period and area, it’s called a cluster. When an investigation shows that ill people
in a cluster have something in common to explain why they all got the same illness, the group
of illnesses is called an outbreak.
Key words:
Public health surveillance: Routine gathering of reports of illnesses by health professionals
Cluster: A larger number of people than expected with the same illness in a given time
period and area
Outbreak: A group of illnesses in a cluster of people who have something in common that
caused the illness
PulseNet: A national laboratory network that connects local and multistate foodborne illness
cases to detect outbreaks
Informal reports of outbreaks
Informal reports occur when members of a community call the local health department to
report suspected food-related illnesses. For example, this might happen if several people got
sick after eating at a group dinner.
Formal reports of outbreaks
2. Doctors and microbiologists in each state must formally report infections that are on a list of
notifiable diseases when they diagnose them in patients. This list includes many foodborne
illnesses. As public health officials look at disease reports, they may notice that the number
of people with a particular illness is higher than expected. Formal reports also occur when a
health professional realizes that he or she is seeing more cases of an illness than would be
expected and calls the health department directly.
Step 2: Define and Find Cases
Finding sick people is important to help public health officials understand the size, timing,
severity, and possible sources of an outbreak.
A case definition is developed to define who will be included as part of an outbreak.
Investigators use the case definition to search for illnesses related to the outbreak.
Illnesses are plotted on an epidemic curve (epi curve) so that public health officials
can track when illnesses occur over time.
Finding sick people is important to help public health officials understand the size, timing,
severity, and possible sources of an outbreak. A case definition is developed to define who
will be included as part of an outbreak. Investigators use the case definition to search for
illnesses related to the outbreak. Illnesses are plotted on an epidemic curve (epi curve) so that
public health officials can track when illnesses occur over time.
Key words:
Case Definition: A list of criteria used to determine if an individual is included as a case in
an outbreak investigation
Case Count: The number of illnesses that meet the case definition
Epidemic Curve (Epi Curve): A graph that shows the number of illnesses over time
What is a case definition?
Case definitions are developed by health officials to spell out who will be included as part of
the outbreak. Case definitions may include details about:
Features of the illness
DNA fingerprint (if the pathogen is tracked by PulseNet)
The pathogen or toxin (if known)
Certain symptoms typical for that pathogen or toxin
Time range for when the illnesses occurred
Geographic range, such as residency in a state or region
There might be several case definitions for an outbreak investigation, each with a different
purpose. For example, one case definition might be for confirmed illnesses and another for
probable illnesses. The number of illnesses that meet the case definition is called the case
count.
3. Step 3: Generate Hypotheses about Likely Sources
Hypothesis generation is an ongoing process.
Possible explanations of an outbreak are continually changed or disproved as more
information is gathered.
Interviews, questionnaires, and home visits are helpful in narrowing down how and
where people in the outbreak got sick.
Hypothesis generation is an ongoing process. Possible explanations of an outbreak are
continually changed or disproved as more information is gathered. Interviews, questionnaires,
and home visits are helpful in narrowing down how and where people in the outbreak got
sick.
How are hypotheses generated?
Health officials use three types of data to generate hypotheses about the likely source of the
outbreak: epidemiologic, traceback, and food and environmental testing. Investigators begin
by trying to pinpoint how the pathogen spread. They review details such as:
The specific pathogen causing illness
Where sick people live
How old they are, their sex, and race/ethnicity
Did they have contact with a sick person
Why are interviews conducted?
When a contaminated food is suspected, investigators must consider many different
foods that may be causing the illness
Interviews help to establish a list of foods people ate before getting sick and collects
information on other exposures such as restaurants where the ill person ate and stores
where they bought food.
This list is used to help investigators determine what food or ingredients the sick people have
in common
Key words:
Hypothesis: A suggested explanation for the source of a foodborne outbreak
Hypothesis-Generating Interviews:Interviews with sick people that disclose what and
where they ate in the days or weeks before they got sick
Incubation Period: The time it takes to get sick after eating a contaminated food
Shotgun Questionnaire: A standardized questionnaire with a list of questions about foods,
meals, shopping habits, travel, restaurants, and events attended
4. Step 4: Test Hypotheses
A hypothesis is tested to determine if the outbreak source has been correctly identified.
Investigators use many methods to test their hypotheses.
Two main methods are analytic epidemiologic studies and food testing
Epidemiologic Studies
The most common type of study conducted during foodborne outbreaks are case-control
studies. Investigators collect information from sick people (cases) and non-sick people
(controls) to see if sick people were more likely to have eaten a certain food or to report a
particular exposure. Case-control studies try to include controls who have had the same
opportunities to be exposed to an unsafe food item as a case has. To achieve this goal,
controls are carefully chosen using matching or selection techniques.
Statistical Testing
If eating a particular food is reported more often by sick people than by well people, it may
be causing illness. Investigators can determine the strength of the association between food
and illness in an epidemiologic study by using statistical tests. Investigators also use
statistical tests to decide if more than one food might be involved in the outbreak.
Factors Considered When Interpreting Study Results
Frequencies of exposure to a specific food item
Strength of the statistical association
The food’s production, distribution, preparation, and service
Key words:
Hypothesis: A suggested explanation for the cause of a foodborne outbreak
Case: A sick person
Control: A non-sick person
Strength of association: How likely it is that illness has occurred due to the food rather than
chance
Stealth food: Foods that people are unlikely to remember eating. Examples: garnishes,
condiments, and ingredients that are part of a food item
Food Testing
Food testing can provide useful information and help to support a hypothesis. Finding
bacteria with the same DNA fingerprint in an unopened package of food and in the stool
samples of sick people can be convincing evidence of a source. However, relying only on
food testing can also lead to results that are confusing or unhelpful.
5. Step 5: Solve Point of Contamination and Source of the Food
Health officials use three types of data to link illnesses to contaminated foods and solve
outbreaks: epidemiologic, traceback, and food and environmental testing.
Health officials assess all of these types of data together to try to find the likely source
of the outbreak.
A contamination can happen anywhere along the chain of food production,
processing, transportation, handling, and preparation
What epidemiologic data is used to help find the likely source of the outbreak?
Patterns in the geographic distribution of illnesses, the time periods when people got
sick, and past outbreaks involving the same germ.
Foods or other exposures occurring more often in sick people than expected
Clusters of unrelated sick people who ate at the same restaurant, shopped at the same
grocery store, or attended the same event.
Key words:
Traceback: An investigation that starts with the sick people or restaurants and works its
way back through the chain of food production to search for a common point between the
people or places to find the contamination source
Step 6: Control an Outbreak
Once the food source of an outbreak is determined, control measures must be taken.
If contaminated food stays on store shelves, in restaurant kitchens, or in home
pantries, more people may get sick.
There are several different outbreak control measures that can be taken.
Public health officials choose measures based on the information available to them.
Measures can change as the investigation goes on.
What are outbreak control measures?
Cleaning and disinfecting food facilities
Temporarily closing a restaurant or processing plant
Recalling food items
Telling the public how to make the food safe (such as cooking to a certain
temperature) or to avoid it completely
Telling consumers to throw away the suspect food from their pantry or refrigerator
How are control measures chosen?
Public health officials may decide on control measures based on strong epidemiological
evidence of the disease’s origin, spread, and development. They do not need to wait for proof
of contamination from the laboratory. This practice can result in earlier action to protect the
public’s health. As officials learn more during the investigation, they may change, focus, or
expand control measures and advice to the public.
6. How are outbreaks communicated?
One of the most important actions public health officials can take to prevent illness is
warning consumers quickly about a contaminated food. Public health officials take action
to communicate to the publicwhen there is clear and convincing information linking illness to
a contaminated food. CDC is most likely to warn consumers when the investigation identifies
a specific food linked to illness, and there is a continuing risk to public health because the
food is still in stores or homes. In this scenario, there are specific, clear, and actionable
steps for consumers to take to protect themselves from contaminated food.
Step 7: Decide an Outbreak is Over
An outbreak is over when the number of new illnesses drops back to what investigators
normally expect.
With continued public health surveillance, if the number of illnesses rises again, the
investigation continues or restarts
When is an outbreak over?
An outbreak ends when the number of new reported illnesses drops back to the number
normally expected. The epidemic curve helps investigators see that illnesses are declining.
Even when illnesses from the outbreak appear to have stopped, public health officials
continue surveillance for a few weeks to be sure cases don’t start to increase again.
What if the number of new illnesses increases?
It could be that the source was not completely controlled
A second contamination involving another food or location is linked to the first
outbreak
The investigation continues or restarts
7. Question 2: Summarize the demographic and clinical information (descriptive
epidemiology) on these patients
Figure 1: Age of the Patients that have Gastrointestinal Illness
Figure 1: Gender of the Patients that have Gastrointestinal Illness
0
2
4
6
8
10
25-30 31-35 36-40 41-45 46-50 51-55
Male (9)
50%
Female (9)
50%
Number
of
Cases
Age
8. Figure 3: Onset of Symptoms of the Patients that have Gastrointestinal Illness
Figure 3: Symptoms of the Patients that have Gastrointestinal Illness
0
1
2
3
4
5
6
7
8
9
2-Aug 3-Aug 4-Aug 5-Aug
0
2
4
6
8
10
12
14
16
Number
of
Cases
Date of Onset
Number
of
Cases
Symptoms
9. Question 3: With this added information, what types of activities would you undertake
related to the chicken as the source of the illness?
Investigation of the food service facilities found numerous inadequacies, including cross
contamination problems, poor hand-washing practices and inconsistent temperature checks
of cooked food products. The implicated chicken had been cooked from the frozen state for a
short time and then placed in hot holding equipment at 140 degrees Fahrenheit prior to
serving.
Food handlers must have the responsibility to ensure that the food they serve is safe for
the consumers to eat and must have a safe and clean workplace. Thus, the food handlers
should know how to identify the different hazards that causes contamination to food.
To prevent any food contamination, first they have to wear the right personal protective
equipment like hair net, mask, gloves and apron
Next is they have to ensure proper hand washing before, after and in between preparation
tasks. They should also have to wash and sanitize all the equipment they use like utensils,
knives, chopping boards and work surfaces before and after use when preparing different
foods.
The handlers should also consistently monitor the temperature and the appearance of
foods to ensure that there is no possible bacterial growth present in the food.
In defrosting, when the food defrosts, the temperature rises and eventually will be easier
for bacteria to grow. Foods should be defrosted in the refrigerator or cool room, not at room
temperature. As it takes much longer to defrost in cool temperatures you will need to remove
foods from the freezer well in advance. If you are short of time, use a microwave oven or
place food in a strainer under cold running water.
Lastly, Cooking foods to a high enough temperature destroys most bacteria. Inadequate
cooking was could be the cause of food poisoning outbreaks. To ensure safe food you don’t
only check the color of the cooked food, but also need to use reliable methods of determining
that food has reached a sufficient temperature to kill bacteria. Measuring the internal
temperature of foods is the most commonly used method of ensuring that food has reached
sufficient temperatures.
10. Question 4: identify the food handling practices for the chicken which were most likely
to contribute to the illness. What control measures will you initiate?
poor hand washing practices
time period of food to be cooked
contaminated equipment
Control Measures:
1. Keep hands clean & hygienic (proper hand washing)
2. Cook the food thoroughly at safe temperature
3. Make sure all equipment needed from the preparation and cooking of food are
not contaminated.
4. Avoid cross contamination by separating raw, cooked and ready-to-eat foods.