A.A renaissance fair a custom of several years w Show more Clinical Information for The Outbreak Scenario: A.A renaissance fair a custom of several years was held at the local high school on Friday night the second week in May.
Dinner was served in the school lunchroom at 5 p.m. Many of the students and guests soon became ill. Numerous calls were received at the health department from area physicians reporting the incident. B.The city health department was notified at 8 a.m. on Saturday morning. There were 100 persons at the dinner. It was not known definitely how many became ill but there was evidence that more than half of the participants became ill. C.Dinner Description: The supper was held in the school lunchroom. A local catering service furnished the food. The arrangements committee had solicited women from the community to serve the dinner from 5 until 7:15 p.m. The food was placed on counters and consumed by the participants over a period of 2 hours and 15 minutes. As nurse epidemiologist you decided to develop and initiate a questionnaire to be administered to each of the participants. In an attempt to be helpful the arrangements committee volunteered to help with the phone calls to collect data. During the data collection process the following facts were discovered. The majority of cases had symptoms of acute onset (around 3 hours after food ingestion) of nausea vomiting diarrhea and abdominal pain. All recovered within 2430 hours. No fecal specimens were obtained for laboratory examination. Data regarding the particular items of food eaten by each of the individuals who were interviewed are summarized in the attached Morbidity table. I.Analysis Questions: On the basis of the clinical information furnished identify what diseases must be suspected/considered in the differential diagnosis. (This is not bacteria it is diseases.) Identify a minimum of 5. Based on your reading and the clinical investigation what was the probable incubation period of suspected pathogen and what is the likely pathogen? How the information concerning the incubation period assist in the differential diagnosis of the condition? Compute the attack rate (% ill) for the specific items of food consumed by those who became ill and those who remained well. (See table on following page). Figure the attack rate by using the following formula: a.Attack Rate = Number ill/total who ate (or did not eat) specified food. b.Exampl: After eating ham 60 people became ill. A total of 80 people ate ham. The attack rate would be 60/80=.75 or 75% Now figure the relative risk rate (fill in the table with your calculated relative risk rates). This rate allows the comparison of attack rates to determine which food held the most risk of illness. Figure the relative rates by using the following formula: a.Relative Risk Rate = Attack Rate of person who ate specific foods/ Attack Rate of person who did not eat specific foods Hints: 1.A relative risk of 1 means there is no difference in risk between the 2 groups. 2.An RR of <1 means the event is less likely to occur in the experimental group than in the control group. 3.An RR of >1 means the event is more likely to occur in the experimental group than in the control group. Based on the clinical information gathered (including attack rate and relative risk rate) determine what common vehicle (food) caused the outbreak? What are the possible sources of contamination of this food? Identify the responsibility of the nurse in preventing a reoccurrence (community education focus)? Food or Beverage Item Group A: Persons who ate specified food Group A: Persons who ate specified food Group A: Persons who ate specified food Group A: Persons who ate specified food Group B: Persons who did not eat specified food Group B: Persons who did not eat specified food Group B: Persons who did not eat specified food Group B: Persons who did not eat specified food Relative Risk Rate Food or Beverage Item Ill Well Total Attack Rate% Ill Well Total Attack Rate% Relative Risk Rate Baked ham 60 20 80 0 20 20 Roast beef 40 40 80 20 0 20 Baked salmon 40 20 60 20 20 40 Macaroni Salad 70 10 80 3 17 20 Tossed Salad 40 20 60 20 20 40 Relishes 10 20 30 20 50 70 Roll 40 20 60 20 20 40 Butter 40 20 60 20 20 40 Ice Cream 30 10 40 20 40 60 Banana Pie 40 40 80 20 0 20 Water 0 40 40 30 10 40 Milk 7 10 17 15 5 20 Coffee 60 20 80 0 20 20 Tea 5 15 20 0 0 0 Show less
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