HLTC07 Lecture 4.docx

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Trinity College Courses
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Barakat- Haddad

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HLTC07 Lecture 4- Oct 10 Introduction  Key roles - manage outbreaks that endanger the public’s health  Nature of outbreak can vary (infectious, zoonotic, exposure to toxic substances)  Cause can also vary (contamination, accidental or intentional)  Speed, coordination, and informed judgements are critical Outbreak Detection  An increasing number of persons who are showing a specific clinical pattern (unusual for certain situation and location) 1) Active surveillance - normal or contact reporting - required: sensitive and monitored surveillance system where the data are collected in a timely manner and regularly analyzed (recognizing HIV/AIDS, etc) (in order to detect an outbreak, it’s important to have a surveillance system that actually works) 2) Syndromic surveillance - E.g. ICD or 911 calls monitoring: non-specific clinical syndrome > it does not apply to individuals -> it’s aggregated to groups Infectious disease don’t need to wait for signals. many people already know there’s an outbreak of a disease Ex. Of syndromic surveillance ‘CFIA investigation into XL Foods (E. coli O157:H7) The Canadian Food Inspection Agency (CFIA) and XL Foods, Inc., are warning the public, distributors and food service establishments not to consume, sell, or serve various raw beef products that may be contaminated with E. coli O157:H7. The CFIA is working with the recalling firms and distributors to identify and verify all affected products. There is a strong possibility the CFIA’s food safety investigation will identify additional products meaning the recall could be expanded. Consumers who are unsure if they have affected products are advised to check with the store where they were purchased. If you are unsure whether a product is part of the recall, the safest course of action is to throw it away.’ Preparing for an investigation  WHO may be involved  Global Outbreak Alert and Response Network (GOARN) - a technical collaboration of existing institutions and networks that pool human and technical resources for rapid identification, confirmation, and response to outbreaks of international significance  Public health authorities at appropriate governmental levels, local and reference laboratories  Core team should be assembled - Established a hierarchy for decision and information sharing - Create objectives - Develop plans for re-evaluating the objectives - Delineate roles and responsibilities for the relevant agencies - Lead agency and principal investigator, to asses what needs are required for human resources and ask ‘do we have the resources to investigate?” - Assess need for additional human resources - Gaps in expertise Epidemiologist, lab technicians, communication specialists, statisticians, psychologists (if related to criminals) Laboratory preparation  Develop specimen collection and shipping protocols - e.g. specimen type, quantity, timing, type of containers, transport media, preservatives, labels, pre-shipping requirements, instructions for shipping  Develop specimen processing and testing protocols - tests each lab will conduct, how the results will be determined and interpreted, how results will be released  Obtain the materials and supplies and ship to outbreak location  After collection - ensure proper labelling and tracking Objectives On October 8, 2000 the Acting Director of Health services in GULU District, Uganda, received two reports concerning unusual illness and deaths. One day later, an outbreak investigation was launched and 2 days later the first intervention to contain the outbreak were instituted: An isolation unit was set up in the local health-care facility, protective material for health staff was dispatched, and the public was alerted of the risk of infection during funerals. On October 14, the National Ebola Task Force was constituted to coordinate and mobilize resources for the outbreak, which lasted for more than four months. A total of 425 confirmed cases of Ebola were recorded, with 224 deaths among them. Objective: what kind of outcome can come out of that regulation First objective: to limit to spread of the disease Between February 2003 and May 2004, ten outbreaks of gastrointestinal illness among schoolchildren at nine different schoo
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