传染病暴发调查.pptVIP

Epidemic Curves Common source: Intermittent exposure (e.g., contaminated blood product) 第八十七页，共126页 Epidemic Curve Figure 3. Date of illness onset for persons with E. coli O157:H7 infection and the outbreak PFGE pattern, MI, June 15 - July 15, 1997. (N=38) 第八十八页，共126页 Steps in Outbreak Investigation Verify the diagnosis Confirm the outbreak Case definition Descriptive epidemiology 第八十九页，共126页 Steps in Outbreak Investigation Verify the diagnosis Confirm the outbreak Case definition Descriptive Epidemiology Develop a hypothesis 第九十页，共126页 Developing a Hypothesis 第九十一页，共126页 Ask questions!!But of whom….And when... 第九十二页，共126页 Determining the Probable Period of Exposure Mean/Median incubation period Minimum/maximum incubation period 第九十三页，共126页 Estimating date of exposure Peak One incubation period Rubella = 18 days Probable time of exposure 第九十四页，共126页 Estimating date of exposure Maximum incubation 21 days Minimum incubation 14 days Probable time of exposure 第九十五页，共126页 E. Coli Epidemic Curve Figure 3. Average incubation period = 4 days ( range 3-8 days) 第九十六页，共126页 Focus of Questions 第九十七页，共126页 Focus of Questions demographic information clinical details of the illness with date of onset, duration, and severity of symptoms visits to health care providers or hospitals, and laboratory results ? a complete food history in the last 7 days ? water exposure in the last 7 days (e.g., drinking water, exposure to recreational waters) ? exposure to other ill persons in the last 7 days ? exposure to children in day care in the last 7 days ? exposure to a farm or farm animals in the last 7 days ? travel outside the immediate area in the last 7 days 第九十八页，共126页 Interview Results 第九十九页，共126页 Findings Thus Far Cases are spread over 10 counties No uniform attendance at any common event Onset of symptoms among known cases extends over approximately one month. The median age of patients is 31 years (range 2-76); 68% of cases are among fema