BIOS 312 Lecture 14: Chapter 5 pt 2 (Note:pg 1-5 is a copy of previous notes, pg 6-10 are new notes)

On Friday, May 18th at 9:30 AM You receive a call from the school nurse at Northside elementary school. Northside elementary is a K‐5 school with a student body of 407 schoolchildren. Since Wednesday May 16th, they have had 40 students and 5 staff members absent due to flu‐like symptoms. Two staff members have been hospitalized with pneumonia. This is a very high number of cases for one week at the school. At 11:00 AM, You receive a call from Ruby Dolor, the Infection Preventionist (IP) at Smallsville Hospital. They have seen seven patients in the last three days who were complaining of fever, cough, chest pain and severe retrobulbar (behind the eye) headache. All patients were diagnosed with Community Acquired Pneumonia (CAP) and two were hospitalized. All patients were negative for Influenza virus, and sputum and blood cultures were also negative for bacteria. Five are treated as outpatients with azithromycin and the two hospitalized patients are being treated with cefotaxime and azithromycin. The two hospitalized patients are not improving and two of the outpatients were seen this morning for worsening of symptoms. Ms. Dolor wants to know if any other reports have been made. At 2:30 PM, Later that day, you receive another call from Greis Nursing Home, a skilled nursing facility with on‐site respiratory support facilities. You know this nursing home is located just a few blocks from Northside Elementary School. They have two residents who developed pneumonia on Wednesday, May 16th and three who developed pneumonia on Thursday May 17th. All cases are being managed in house. All are negative for influenza virus. Bacterial sputum and blood cultures are negative for the first 2 cases and pending for the remaining three cases. Legionella urine antigen tests are also negative. At 4:30 PM Your LHD has developed an initial suspect Case Definition and questionnaire to aid in Case Finding/Identification and Hypothesis Generation. You begin to contact suspect cases to perform initial interviews. A Public Information Officer (PIO) has been designated and preliminary information is being compiled to distribute to community stakeholders (hospitals, physicians and school district administrators). You prepare to continue interviews and staff phone lines over the weekend if necessary.

Question: IS THIS OF PUBLIC HEALTH CONCERN THAT REQUIRES FURTHER ATTENTION? WHY OR WHY NOT? AND AT THIS POINT IN TIME, WHAT WOULD BE THE APPROPRIATE RESPONSE FOR THE LOCAL HEALTH DEPARTMENT?

Case Study Advanced Pathophysiology: Chapter 19 Disorders of Motor Function (Grossman & Porth)

The parents bring their 3-month-old infant to the urgent care you work at complaining that he has had constipation for 5 days that was preceded by weakness for several weeks. Upon physical exam, you note hypotonia, hyperreflexia, and respiratory distress. You advise the parents you believe the child needs to be admitted to hospital and taken immediately to the local pediatric emergency room.

I believe this infant has infant botulism - am I correct????

I've been working a little with M. G. Bulmer's Principles ofStatistics (Dover, 1979) and cannot see how to properly computehalf of one question. This should be a basic probabilitycomputation, but I am not getting the same answer as the book'ssuggestion.

Here is the question (Chapter 2, Problem 2.4): If the threegenotypes (i.e., AA, Aa, aa) are all distinguishable, find theprobabilities that a) a pair of siblings and b) a pair of unrelatedindividuals will appear the same when p=q=.5.

The book offers .59 for a) and .38 for b). I can get bcorrectly, but I don't understand how to properly compute parta).

This does not seem like a complicated exercise!