** Key**
Chapter 20 Review Questions
- The
Centers for Disease Control and Prevention (CDC)
- Steps:
1) Prepare for field work, 2) establish existence of outbreak, 3) verify
cases, 4) establish case definition and search for additional cases, 5)
descriptive epi, 6) develop hypotheses, 7)
evaluate hypotheses, 8) refine hypotheses and conduct additional studies,
9) implement control and prevention measures, 10) communicate findings.
See Chapter 20 for
- (b) a
“time variable”
- (a)
the number of cases
- (a)
outlier
- Either
via a surveillance system or a case or health care worker notifying the
agency directly.
- Surveillance
systems are organizations set up to routinely collect and analyzed public
health outcomes.
- No,
they often miss cases and lack information on important contributors to
occurrence.
- No, it
can merely indicate an increase in reporting.
- An astute
pharmacist noted an increase in the number of requests for a drug used to
treat Pneumocystis pneumonia, and that these requests
were coming from atypical types of patients.
- The
decision to mount an investigation depends on: a) The ability to confirm a
greater than expected number of cases, b) the scale and severity of the
outbreak, c) whether a identifiable subgroup is disproportionally
effected, d) the potential for spread, e) political and public relations
considerations, f) availability of resources
- Goals
of investigations: a) assess the extent of the outbreak, b) reduced the
future number of cases, c) prevent future occurrence, d) identify new
disease syndromes, e) identify new causes, f) assess the efficacy of
current prevention strategies, g) address liability and legal concerns, h)
train epidemiologists, i) public relations and
public education.
- “Define
the problem” means to confirm the cases and show that an outbreak truly
exists.
- Occurrence
is described by person, place, and time factors.
- control
mechanisms.
- Hypotheses
are tested with epidemiologic, laboratory, and environmental
investigations.
- True.
- expected
- Examples
of information biases: changes in reporting procedures or case
definitions; fads and false alarms
- By increasing
the number at risk with no real increase in the incidence proportion or
rate.
- Improved
diagnostic procedures or increased awareness may cause an apparent
increase in occurrence, when no real increase in occurrence is operating.
- A case
definition is the standard criteria used to decide whether someone is a
case.
- (a)
case identification information (b) demographic information (c) clinical
information (d) risk factor information (e) reporter information (f)
denominator information
- (a)
assess quality and completeness of information (b) learn about the extent
of the outbreak (c) assess possible sources of exposure, mode of
transmission, incubation period, (d) learn about agent, host, and
environmental contributors (e) generate hypotheses about cause
- True
(see p. 357, Figure 20.1)
- Incubation
period = the time interval between invasion of the agent into the host’s
body and the appearance of first signs or symptoms.
- (a) Pathogenicity of the agent, (b) level of exposure, (c)
susceptibility of the host
- A
hypothesis is a tentative explanation that accounts for a set of facts
that can be tested by further investigation.
- disease
process
- Information
is reported to (a) the initial informants, (b) the local, state and
federal agencies, and (c) community affected by the outbreak
- how
and why.