Food Born Illness

Topics: Epidemiology, Typhoid fever, Outbreak Pages: 7 (2276 words) Published: January 15, 2014
Working Through a Food-Borne Illness
Alvine Discharge Diseases

Alvine Discharge Diseases
(1)
What key activities and important facts tie each of the individual cases together? Some key facts that tie both cases together are that typhoid was spread by some form of contaminated food by a person (milk, food, water, seafood). In the case of Typhoid Mary, it was spread by her handling the food improperly. She was a carrier, and thus when she did not use good sanitary food preparation skills (like washing of hands), she passed the typhoid along to others. In the second case in Schenectady, New York, water did not seem to play a part in the spread of typhoid. So in both of these cases, the key fats that tie them together is the way typhoid was spread-by people. (2)

Prepare a bar graph showing the dates and numbers of cases per day of the outbreak by date of onset for each typhoid case. Is this an epidemic curve? Why? Defend your answer. Yes, in my opinion this is an epidemic curve. An epidemic curve is a histogram that shows the course of an epidemic by plotting the number of cases by time of onset. The line rises quickly, and then falls fairy quickly. From the time of onset, the number rose quickly, and then it fell rather quickly, so I think this shows that it is an epidemic curve.

(3)
From the case and epidemiological data, can you estimate possible date of common exposure? Present evidence and facts other than just dates. The chart on page 353 clearly shows the date of common exposure. It was at the M.E. picnic on 5/30. I know this for sure because the incubation period for typhoid is 3 to 25 days after exposure. All 13 cases have the same date. This is more than coincidence. The first onset date was 6/5; therefore the exposure time would have been could have been 6 to 7 days before that (making it 5/30). (4)

Several unrelated cases appeared in the investigation. Explain the exposure to typhoid and implications of unrelated cases of typhoid and give several examples of possibilities. One possibility is that some was infected before the picnic on 5/30.I may be going out on a limb here, by my hypothesis is that someone or maybe some people was infected before the picnic and brought the typhoid with them, and that is how it spread. One person, in an unrelated case, was from 100 miles away, but visited Schenectady in the recent weeks. (Maybe he spread it) Some of them owned their own wells and some got water from the city. Different ones drank from Blair’s dairy, Borden’s diary, Kingning Dairy, canned, or owned their own cows. Exposure to typhoid: typhoid fever is one of the many salmonella infections and it becomes pathogenic because of the endotoxins that it produces. The source of infection is in the feces of asymptomatic carriers. Stool or urine of ill patients who have active cases of the disease is also a source. The organisms enter through the gastrointestinal tract and invade the blood stream and the lymph system. Incubation period is between 3 to 25 days. You will then slowly have symptom like; chills, malaise, headaches, anorexia, muscle aches, fever, and colored spots in crops on your abdomen and chest. Stool test are positive during the 3rd to 5th week after exposure, so some of the people had to have been exposed during the picnic and some before. (5)

Briefly outline additional steps that are needed in order to complete this particular investigation. Some additional records or information that could be gathered are: collecting clinical information like, medical records, lab reports, reviewing lab reports, applying the case definition, identifying the source of exposure, get travel history, implement control measures to prevent the disease and further spreading of it, then report it to the CDC. They can test the milk providers and dairies, seafood suppliers, and water. They could also follow these steps to obtain more information. They could detect possible outbreaks, defining and...

References: http://www.merckmanuals.com/professional/infectious_diseases/gram-negative_bacilli/salmonella_infections.html
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