Epidemiology module of practical skills for mbbs student
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Note: This report should be submitted by the investigating officer (State/District/PHC Nodal Officer) to the next higher authority within a week of completion of investigation. Tables and Graphs should be included wherever appropriate. EXERCISE Meerut district was reported to be affected by an “outbreak” of acute gastroenteritis (GE) in July-August, 2000. About 2270 cases and 413 deaths occurred during this period. Most of the cases had only diarrhoea and vomiting. Q.NO.1. How will you decide whether or not the district was in the grip of an outbreak? (Table-1 Describes the reported data on GE from the Meerut district during 1997-2000) Table 1
Cases and Deaths due to GE in district Meerut 1997-2000
Q.No.1. Now, will you consider it an outbreak of GE? If yes why? If not, why? ________________________________________________________ ________________________________________________________ * Analysis of the age distribution of 308 deaths revealed that about 9% of deaths occurred in children below five years of age and about 62% of deaths occurred in adults above 20 years of age. Q.No.2. Does it help you in suspecting cholera as the cause of this outbreak? ________________________________________________________ ________________________________________________________ Q.No.3. What was the most disturbing features in this outbreak? Was it preventable? * Rectal swabs from 59 cases were examined in the laboratories of NICD, Delhi. 15 Samples were positive for V.cholerae O1 biotype E1 Tor. The isolates were sensitive to tetracycline, nalidixic acid, ampicillin and chloramphenicol, but resistant to furazolidone and streptomycin. The other samples were found negative for any enteropathogens. Q.No.4. What are the possible reasons for 44 of 59 samples being found negative for entero-pathogens? ________________________________________________________ ________________________________________________________ Q.No.5. Assume yourself as the team leader for the investigation of this outbreak. (i) How will you plan the investigations? (ii) How will you control the outbreak? ________________________________________________________ ________________________________________________________
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