1.3 Outbreak Investigation Refresher Course Outline

Version 2.3
ESR NCBID Epidemiological Skills Development Programme
Module 1.3
Outbreak Investigations
Refresher
Course Outline
Christine Roseveare
Specialist Science Solutions
manaaki tangata taiao hoki
protecting people and their environment through science

ESR NCBID Epidemiological Skills Development Programme
Overall Aims and Objectives and learning outcomes
Purpose of this course
To provide an introduction (or refresher) to outbreak investigation, through a
facilitated table-top case study
Overall objectives
By the end of the course students will have been introduced to a realistic outbreak
investigation and gained a greater awareness of the processes involved in the
epidemiological investigation of a common source outbreak.
Competencies
The course will support competencies in the following areas
• Confirmation and assessment of outbreaks
• Outbreak Investigation skills (operational aspects)
• Epidemiological Analysis
• Control measures
Participants will have had the opportunity to practice using symptom information and
incubation period to identifying possible infectious agents
Desired Learning Outcomes
On successful completion of this course participants will be aware of
• The main steps in an outbreak questionnaire
• The steps involved in carrying out a retrospective cohort study
• Recommended control measures
•
On successful completion of this course participants will be able to
• Assist with the development of an outbreak questionnaire based on a
standard template
• Developing line listing
• Recognise an epidemic curve for a common event outbreak
• Assist in investigating and controlling a common event outbreak/outbreak
requiring a retrospective cohort study
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ESR NCBID Epidemiological Skills Development Programme
Content overview
Session 01:
Confirmation and assessment
• Using symptom information and incubation period to identifying possible
disease agents
• Verifying the diagnosis
• Getting information about people who are ill
• Case finding
• Other important first steps
Session 02:
Field investigation operational aspects:
• Important Initial actions in the environmental investigation
• Line listings
Session 03:
Epidemiological Investigations (analytical epidemiology)
• How knowing the bacteria can help you identify a meal
• How to identify food source (sampling plus potentially epidemiological study)
• Pluses and minuses of various ways of collecting study data
• Main types of information that should be collected
• Designing an email introduction and adapting a questionnaire
• Plotting and interpreting an epidemic curve
Session 04:
Control and Response Measures
• What recommendations would you make to reduce the chance of another
outbreak
Session 05:
Review
• Extras – consider relevance, issues raised by this example etc
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ESR NCBID Epidemiological Skills Development Programme
Case study 1
Overview
During the course, students should be organised into four groups of 4-6 to work
through the study with the help of the facilitator.
Objectives of using case study format
• To give students the opportunity to apply theory to a realistic situation
• To develop experience in interactive group processes relevant to outbreak
investigation
Case study used in the course
• This study follows the investigation of a common event outbreak at a hotel
using a retrospective cohort design. It has been adapted from two other case
studies
a. Outbreak at a hotel convention. Study developed by the North Carolina
Center for Public Health as part of their epidemiology training
programme http://nccphp.sph.unc.edu/training/
b. Investigation of Food-borne outbreak. Study developed by Flora Ichiou
Huang and Manuel Bayona as part of the Young Epidemiology
Scholars Programme
http://www.collegeboard.com/yes/ft/iu/disease_outbreak_investigation.
html
1 This case study has been developed by Christine Roseveare, Debbie Smith, Kanchan Sharma, Ann
Sears, and Sally Giles
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ESR NCBID Epidemiological Skills Development Programme
Suggested timeline and structures
Session plan (~90 minutes)
Question Topic Resource Time
(min)
Introduction and overview 5
Q1 What disease do you suspect Chin, info sheets, 5
Q2 Why it helpful to consider incubation periods ESR Appendix 6 5
Q3 List of Initial steps Outbreak
5
Q4 Things to do at the hotel
investigation diagram 5
from ESR
Q5 Line listings 5
Q6 Using incubation to identify a meal 5
Q7 Value of investigation/decision point for
5
investigation
Q8 Best way of contacting/interviewing 5
Q9 Main components of outbreak
5
questionnaires
Activity Adapting a standard outbreak questionnaire PHU Master
10
Designing an email
questionnaire 5
Drawing an epidemic curve 5
Q10 Interpreting an epidemic curve 5
Q11 Interpreting an attack rate table 10
Q12 Control recommendations 5
Evaluation
Evaluation Sheets
Possible facilitation tools and structures to use
• Think pair share
• Timed talking
• Round table
• Storm and sort
• Consensus mat
• Concept mats
• Rally table
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ESR NCBID Epidemiological Skills Development Programme
Assessment and Evaluation
Assessment
There is not formal assessment for this course however all participants who attend
the full course will receive a certificate of attendance.
Evaluation
An evaluation for the pilot was completed using questions based on the North
Carolina Centre for Public Health Preparedness pilot testing template. Each course
will be separately evaluated.
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