Gastroenteritis at a University in Texas Based on

Gastroenteritis at a University in Texas Based on an investigation completed by Nicholas A. Daniels, David A. Bergmire. Sweat, Kellogg J. Schwab, et al.

Question 1: What questions (or types of questions) would you ask the student?

Question 2: Do you think the student’s complaint should be investigated further? (VOTE) A) B) C) D) Definitely Probably not Definitely not

Question 3: Do you think these cases of gastrointestinal illness represent an outbreak at the university? Why or why not?

Question 4: How might you interpret the bacterial culture results?

Question 5: Based on the findings so far, what type of agent do you think might be causing this outbreak? (VOTE) A) B) C) D) Bacteria Virus Parasite Preformed toxin or chemical

Question 6: Based on the epidemic curve and likely causative agent, what is the likely mode of transmission and the period of interest for possible exposures related to this outbreak?

Question 7: At this point, what is your leading hypothesis on the mode of transmission in this outbreak? (VOTE) A) B) C) D) Foodborne Waterborne Person-to-person transmission Animal-to-person transmission

Question 8: What studies or other investigations would you undertake to explore this hypothesis?

Question 9: What instructions would you give to health-care providers for the collection of stool specimens from patients? Include instructions on how specimens should be collected, stored, and transported.

Question 10: Given that investigators suspect a virus as the causative agent, what contributing factors are likely to have played a role in this outbreak?

Question 11: What activities would you undertake during the environmental health assessment? What key areas should be explored during interviews with the cafeteria food workers?

Question 12: Do you agree with the decision to close the deli bar? (VOTE) A) B) C) D) Definitely Probably not Definitely not

Question 13: Interpret the results. Exposure American cheese Swiss cheese Ham Turkey Shredded lettuce Tomato Pickles Mayonnaise Mustard Ill exposed/ Well exposed/ 95% Total ill (%) Total well (%) Odds Confidence p-value Ratio Interval 13/28 (46) 4/20 (20) 3. 4 0. 80 -17. 5 0. 06 8/28 (29) 11/28 (39) 15/28 (54) 13/28 (46) 8/20 (40) 6/20 (30) 11/20 (55) 10/20 (50) 0. 61 1. 5 0. 95 0. 87 0. 15 -2. 4 0. 38 -6. 3 0. 26 -3. 5 0. 24 -3. 2 0. 30 0. 36 0. 57 0. 52 7/28 (25) 20/28 (71) 10/28 (36) 6/20 (30) 7/20 (35) 9/20 (45) 0. 78 0. 63 3. 1 0. 68 0. 18 -3. 5 0. 15 -2. 6 0. 78 -12. 4 0. 18 -2. 6 0. 50 0. 63 0. 06 0. 52

Question 14: What actions would you recommend/ require for the reopening of the deli bar?