cyclo_s.doc - A Multistate Outbreak of Cyclosporiasis A...

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A Multistate Outbreak of Cyclosporiasis A Classroom Case Study STUDENT’S VERSION Original investigators: Barbara L. Herwaldt, MD, MPH 1 , Marta-Louise Ackers, MD 1 , Michael J. Beach, PhD 1 , and the Cyclospora Working Group 1 Centers for Disease Control and Prevention Case study and instructor’s guide created by: Jeanette K. Stehr-Green, MD Reviewed by: Charles Haddad, Robert Tauxe, MD, MPH, Roderick C. Jones, MPH NOTE: This case study is based on real-life investigations undertaken in 1996 and 1997 in the United States and abroad that were published in the Morbidity and Mortality Weekly Report , the New England Journal of Medicine , and the Annals of Internal Medicine . The case study, however, is not a factual accounting of the details from these investigations. Some aspects of the investigations (and the circumstances leading up to them) have been altered to assist in meeting the desired teaching objectives. Some details have been fabricated to provide continuity to the storyline. Target audience: students with minimal knowledge of basic epidemiologic concepts who are interested in learning more about the practice of epidemiology including participants in the Knight Journalism Fellowship Program. Level of case study: basic Teaching materials required: none Time required: approximately 3 hours Language: English Training materials funded by: John S. and James L. Knight Foundation and the Centers for Disease Control and Prevention August 2004 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention Atlanta, Georgia 30333
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STUDENT’S VERSION A Multistate Outbreak of Cyclosporiasis Learning objectives: After completing this case study, the participant should be able to: 1) use the modes of transmission and incubation period for a disease to focus the search for the source of an outbreak 2) describe the two most common types of epidemiologic studies routinely used to investigate outbreaks 3) interpret the results of an epidemiologic study 4) consider potential sources of error in designing or carrying out an epidemiologic study 5) apply the criteria for causation to the results of an outbreak investigation 6) list considerations in implementing control measures before confirmation of the source of an outbreak 7) describe the occurrence, signs and symptoms, and control of cyclosporiasis Part I – Background On May 20, 1996, the following article appeared on the front page of the Toronto Sun: Exotic Parasite Sickens Canadian Businessmen By Xavier Onnasis TORONTO – Public health officials today confirmed that three Canadian businessmen, two from Toronto and one from Ottawa, were diagnosed with cyclosporiasis, a parasitic disease seen only in tropical countries and overseas travelers. The three men, who had recently traveled to the United States, became seriously ill with diarrhea over the weekend (May 16-18). One of the men was hospitalized at Princess Margaret Hospital when he collapsed due to severe dehydration.
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